Friday, April 7, 2017

Food For Thought - Teaching the Art of Eating To An SPD Child

Eating is a challenge for a child with SPD.
They aren't just being picky.
Teach them to eat and enjoy it!
Did you know that there are actually many tiny steps involved with learning the skill of eating? Contrary to what many of us think, eating isn’t an instinctive thing. Babies learn to suck, swallow, then eventually, chew and move bits of food around in their mouths. And when a child has developmental issues that impede on their ability to learn these skills, eating can be a challenge.
For my son, he never seemed to move past the mushy food stage. He stuffed food in his mouth to ‘feel’ it, he had difficulty chewing foods with any chewy, crunchy or lumpy textures requiring more grinding like chewing (as when eating meat) and he wasn’t able to tell when his mouth was empty.
In order to teach a child eat, and enjoy it, he needs to be worked through all of the baby steps from tolerating, interacting with, smelling, touching, tasting then, finally, eating the food. My son’s amazing OTs worked with him on several areas including gag sensitivity, oral motor strength and other proprioceptive issues (we’ll focus on each of these areas in more detail in future postings).
The first thing caregivers should do is learn each of those tiny baby steps mentioned earlier. Not only does this help reduce anxiety at mealtimes for the child, it also helps caregivers be more in-tuned with where their child is in terms of ‘eating readiness’ and be able to respond accordingly. Here’s a brief breakdown of the steps of eating:
Tolerating Food:
·       Being in the same room as the food is being prepared/cooked;
·       Being at the opposite side of the table as the food, then slowly tolerating the food a little closer to until she’ll have it right in front of her and look at it.
Interacting With the Food:
·       Helping to prepare/cook the food;
·       Using utencils/container to stir or pour food/drink;
·       Using utencils to serve food.
Smelling Food:
·       Tolerating the aroma of the food in the same room;
·       Tolerating the aroma at the table;
·       Tolerating the aroma of the food in front of him;
·       Leaning down/picking up the food to smell it.
Touching the Food:
·       Using fingertips;
·       Using whole hand;
·       Tolerating food on chest/shoulder
·       Tolerating food on the top of the head;
·       Tolerating food on chin/cheek;
·       Tolerating food on/underneath nose;
·       Tolerating food on lips;
·       Tolerating food on teeth;
·       Tolerating food on the tip of the tongue/full tongue.
·       Child licks lips, uses tongue to lick food;
·       Bites off piece and spits it out;
·       Bites pieces, holding in the mouth for a few seconds then spit it out working up to being able to chew;
·       Chews then partially swallows;
·       Chews then swallows independently.

OTs work with children through these steps using fun activities and games. For example, my son’s OT took a food he loved (apple sauce) and started with getting him to touch it and coping with the tactile side of eating, a strategy that helped him learn to tolerate textures. At the beginning, he wanted nothing to do with food on his hand, face or other body parts. But his OT would put some on her own arm or face, calling it a ‘tattoo’. After a few sessions, he was willing to try too.
By the end of his first round of OT, Xander began to tolerate different minced fruits in his apple sauce, as well as mildly flavored cream cheese. It sounds like such a minor thing, but these tiny steps helped my son to be more tolerant with having new things on his plate as well as encouraging him to expand his food palate.
For children who have poor oral-motor skills, highly sensitive sensory defensiveness, poor proprioception or other issues, eating can not only be a huge challenge but extremely frustrating. Until we knew the severity of my son’s issues, there were many tears and meltdowns at the dinner table.  Now that we understand all the steps involved with eating, as well as his specific eating issues and needs, we are working together to making the food experience more enjoyable for him.

Eating truly is a skill that many children struggle with. But with the help of a knowledgeable OT and/or nutritionist, caregivers can learn how to incorporate the above steps into meal times and get their child crunching, munching, chewing and loving food. The key is tackling those baby steps, having lots of patience and giving tons of praise for each and every attempt.

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