4 minute read
Mealtime Mastery: Feeding Therapy and the Family Meal
BY: CARLIE KRUEGER, MS, CCC-SLP AND LOREN STASTNY, MA, CCC-SLP
Calling all families who struggle with mealtimes at home! Is it a fight to get your child to eat a variety of foods and textures? Are you worried your child might not be consuming enough for proper nutrition or growth? Want to get your child off liquid meals like milk or Pediasure? We are here to help! The Stewart Center at The Westview School recently began offering Feeding Therapy. Here are a few tips from our Sequential Oral Sensory (SOS) trained feeding therapists to try at home.
LET’S EAT TOGETHER
Creating a Family Meal routine is a wonderful place to start. Frequent family meals decrease disordered eating, alcohol and substance use, violent behavior, and feelings of depression or thoughts of suicide in adolescents, according to Harrison et al. 2015, a systematic review. They can also increase self-esteem and school success.
According to Dr. Kay Toomey’s SOS method, begin Family Meals by giving an advanced alert to your child and other family members, such as, “We will be eating in 5 minutes.” After the five minutes, support the child’s transition to a sink and say, “It’s time to wash hands now.” These cues can help the child get into a mealtime routine without increasing anxiety around food.
While washing hands, change the soap, water temperature, and washcloth or sponge every other day to encourage sensory preparation and exploration.
A PERFECT SEATING SETUP
Next, have your child sit at the table. Check to ensure the child’s feet are making full contact with the floor or a footrest so that the core is activated and postural stability is supported. Think about how uncomfortable it is to sit on a barstool without a foot rail. This is what it is like for children if their feet are dangling in their highchair or kitchen seat. We like to use the 90-90-90 position while eating. This means that the ankles, knees, and hips are all at 90 degrees when sitting for maximum comfort and physical support.
An appropriate seating position is crucial because secure stability at the table allows for better coordination and range of motion and can, therefore, lead to increased food consumption and participation at mealtimes. If seating is a challenge, place something under or behind your child for support. We love using wiggle seats or even the bumpy shelf liners for sensory input.
PLAYING WITH FOOD? YES!
Now the family-style serving begins! This is where each person passes each food and takes a small amount to put on their plate or the “Learning Plate.” The Family Meal should include one of the child’s preferred foods to entice the child to the table and to increase consumption. Everyone then eats, allowing the child to self-feed for at least the first 10 minutes of the meal. Adults should talk about the food using a range of adjectives and descriptors (red, sweet, salty, crunchy, spicy, etc.) and over-exaggerate chewing movements to “show and tell” the child how to manipulate the food in the mouth. Don’t worry about your manners right now! The goal is to have an enjoyable feeding experience with your child while providing repeated exposure to a variety of flavors and textures.
If the child needs encouragement to interact with the food, we love painting with purees and stick-shaped foods, stacking cubes like blocks and knocking them down, shooting mouth basketballs, having mouth races, and singing.
EVERYBODY CLEANUP
Finally, when done eating and drinking, begin a “Clean Up” routine, where your child blows or throws a piece of each food offered at that meal into the trash or a scraps bowl, then washes hands and/or table before mealtime is over. This may seem daunting, so feel free to start small by adding one step every 2-3 days and working at a pace that best serves your child and family.
To learn more about feeding therapy, contact the Stewart Center via email or phone!
Citation: Harrison, M E , Norris, M L , Obeid, N , Fu, M , Weinstangel, H , & Sampson, M (2015) Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian family physician Medecin de famille canadien, 61(2), e96–e106
