Stage one – Assessment.
I will come to your home to take detailed history, observe a feeding situation and/or watch recordings. I will be assessing the safety of feeding, how your child’s mouth works and what textures and consistencies they prefer. I may also bring some items to trial. We shall discuss next steps and recommendations. If I have concerns regarding your child’s mouth, throat or safety of the swallow, I will refer on to the appropriate professionals (with your permission).
Stage two – Feeding clinic visits
Therapy takes place at the Lyall Bay clinic. Your child’s needs will reflect the techniques used. These will be discussed prior to therapy commencing. SOS (Sequential oral sensory) techniques may be used. This involves working through sensory steps before we consume food (being in the same room, having the item near, touching, smelling, placing it on your upper body, face, mouth and at times taking a bite of different sizes). We have the same routine each session to give structure and familiarity. For older children we will become food scientists, exploring and discovering items.
The focus of the sessions is to explore different textures not to consume. Research shows a child needs to explore food before they will be successful at eating. If items are consumed during the sessions it is a bonus. I recommend a block of at least 4 sessions.
Food is provided. Please alert the therapist if there are any allergies/dietary requirements. If so the therapist may give you a list of foods to bring.
Therapy sessions may be with one or two children. This will be discussed before the block begins. Children are great models for each other however a match of skills is not always possible or best practice at that point in time.
Stage three – Follow up phone call/ email.
We will agree on a time frame for follow up to check in and note progress. Further steps can be discussed at this time.
An adult needs to be present for each session for carry over into the home setting. (You can alternate with different adults – please discuss with me before the block starts).
Expect to get messy. We are exploring a variety of textures (crumbly, solids, wet, dry, puree etc). You may wish to bring a spare top, (for both you and your child). Mess is good.
Your child will follow your lead. If you are doing an action (copying me), your child is more likely to imitate. You may need to pretend you are completely comfortable even if you are not. We will have discussed techniques in the initial assessment so you will know what to expect.
For maximum benefit practice needs to occur. We can discuss how often and how this will work in your family life. Some people can manage 3 times a week, others at weekends.
I don’t give the food it’s name. Children learn what they will and won’t eat. They make the rules. Even if the food item is served in a way they have never had before they will hear the label/name, recall they don’t do that item and won’t even try it!
This technique also allows the introduction of food items that look similar. e.g. we do a session with sticks of different foods and celebrate we can do sticks, rather than one food item.
Therefore in the sessions (and carry the idea over into practice at home) I will describe an item. e.g. A piece of raw carrot = A long straight hard orange stick. A slice of cucumber = a round green and white, wet on the inside circle.
Positive language is used by the adults. There are no “yucks” “oh no” “eeh messy” “you don’t eat that at home.” Everything is positive and said in “a matter of fact” voice.
The phrase “You can…….” is used throughout the sessions rather that “Can you…….” (Don’t worry about slipping up – this is a new learning experience for you all).
Rewards and praise.
I will be stating facts and remain consistently calm throughout the session. Whatever your child manages in regards to the food will be rewarded in the same way. I will state “you can…….(naming what they did),” and them move on to the next stage. (Inside I will be doing cartwheels and be overjoyed at their success, and I will share this with you at the end).
It is very tempting to become excited and full of praise when your child does something new. This is after all a very challenging situation for them.
When we praise we draw attention to what the child is doing (they may not have full awareness of doing something new/challenging). By alerting them to their behaviour they may become overwhelmed or realise their actions were a big deal and this was something they don’t normally do. They may not do it again.
After the session, praise them for what they did, e.g “It was great you touched that red wet circle” “You can touch red circles” (circle of tomato sauce). Each stage of the session brings it’s own challenges and acknowledging these steps towards eating is important. Keep in mind the short term goal is to explore new foods, (not consume – this is an added bonus).