Saturday, January 24, 2009

Feeding Breakthrough!

Marshall has been in feeding therapy for I don't really know how long. He worked with his OT for at LEAST a year before she gave up and sent us to the Speech Language Pathologist. The OT helped him work on the sensory part of his feeding aversions and the SLP worked on the behavioral. What an amazing difference yesterday was. Not only did he eat Cream of Wheat for breakfast (which he always said he hates), he ate Spaghetti and Meatballs for lunch (Chef Boyardee)!!!! This is shocking! I can't tell you how long we've been frustrated with his terrible eating habits. We also took him off Pediasure and he now drinks whole milk, which he hated before and refused to drink.

So, how did the therapists do it? Like I said, it took well over a year with the OT working once a week with him. She said there are steps to eating.

Step 1 - The child is able to TOLERATE THE PHYSICAL PRESENCE/SIGHT of the food (i.e. will be in the same room as the food or at the same table as the food.)

Step 2- The child is able to INTERACT WITH THE FOOD (i.e. Uses a napkin or other food to touch the target food)

Step3- The child is able to TOLERATE THE SMELL OR ODOR of the food

Step4- The child is able to TOUCH THE FOOD TO HIS/HER SKIN (i.e. Tolerates the food touching a body part, including fingers, hands, face- the closer the physical proximity to the mouth, the more threatening)

Step5- The child is able to TASTE THE FOOD (i.e. Any action wich results in the child getting a taste of the food)

*These steps are progressive, such that the child will usually master step 1 before he/she masters step 2, etc. Each of the five major steps is composed of several sub-steps, which will vary from child to child. (I have another handout on that. I will scan it in)

So, that's what my OT did with Marshall. When the SLP got him, his feeding problems were behavioral. She also thought he had Reflux, which I agreed with because he would always tell me he threw up (multiple times a day). When we went to behavior feeding therapy, she started with a dry spoon and told him "open" and he was supposed to open big. He didn't mind the dry spoon that much but then she dipped it in some applesauce and said "open" and he did not want to open. She asked him, "Who is in charge of food? Is food in charge of us? No, food is food! Marshall is in charge of food." She tells him that every time. He's also not allowed to say "Yuck" or "I don't like that". He has to say "I'll try". She explained that everybody likes different things and it's OK if you don't like some food. You can just try it. Every time she dipped the spoon and put it in his mouth, he got to play with a toy for 20 seconds. She used Mr. Potato Heads the first time. Each time he took a bite, he got another piece of Potato Head. She IMMEDIATELY brings the toy out after she gets a bite in his mouth. That distracted him enough to forget he didn't think he liked applesauce. If he clamped his mouth shut and refused to try the food offered, she turned her back on him and ignored him for 2 minutes. As soon as she turned her back, he immediately said, "Ok, Ok. I'll try," but he still got ignored for the rest of 2 minutes. That worked wonders. I just did it yesterday.

There is so much more to tell but I've got to get going. I'll scan in all the papers my OT has given me and post them here. If I can find the SLP's paper on feeding therapy, I'll scan that too. My computer room is quite a mess right now because I just got a new-to-me desk.


Melissa said...

Thanks so much for posting this. It gives me encouragement that my little Josh will one day be able to eat normally. He has had OT for over a year as well for his feeding issues. But his is a motor/sensory problem. He will try things, but can't chew or manage it in his mouth yet. He is 20 months almost and still eats like a 8 month old. But it is nice to hear this exciting news for you. I do know the therapy will pay off, but it can get frustrating for us mom's who deal with it several times a day. Good job Marshall! If you have anything else on feeding, like hand-outs or anything, I would love to take a look. Thanks for sharing your success!

Jessica said...

Who Is your speech patholigist? Is it Krissy by chance? I am very proud of Marshall!

Anita Nap said...

Thanks ladies. I'm so happy for him too. His SLP is Courtney. We go to Sandy for therapy and his OT is Adrianne (not sure I spelled that right.) Courtney is only there on Thursdays but she really is the best one there. At least, that's what Adrianne told me.
I have more handouts that I want to share but our scanner isn't working since we switched our room around. I will try typing some of it out later.

familystemsupport said...

That is such good news for you and Marshall! Please share your tips as "P" has went from a wonderful eater to me having to buy baby food this weekend as he is choking on everything. Hope Marshall keeps up the good work!!