I wrote this as an answer to a question on the blog and decided to expand it and post it because I think these are some very important points to remember.
My therapy is a method, not a protocol, but my more than that, my therapy is an experience, every session we experience something together about life and about food. For example, this is how I think about sessions...On Monday I made quesadillas with Jack. Not, Jack ate x numbers of this or touched this food x times. We had an experience together. We had fun. When you go out with friends, does someone count your bites? We had a session about food but we also learned something. Where quesadillas come from, how you say "quesadilla," and for fun, can you say it three times really really fast? He wasn't afraid and I said it the fastest. He now knows what the brown spots on a tortilla shell are. He made one for his dad in my electric skillet. We used cookie cutters and pizza slicers to cut it so he could see what his teeth would have to do too. We rolled up little strips of quesadilla and the three of us had a little meal. We picked out some things to go with it that we liked to eat. We picked out our divided plates and our drinks. We cleaned up together. I told him it might be fun to show Mom how to make one for his dad sometime like we did in therapy. NOT go home and make quesadillas four times this week because that is the kiss of death for learning to enjoy a food and no one eats like that. His family emailed me that they made them at home this week and he ate about 1/4 of it, rated it a 4/5 on his food chaining rating scale when the meal was over. My goals: educate, explore, explain, experience and enjoy all wrapped up in one experience that became something real world. A session that carried over to life and hopefully will become one more food Jack likes. Cheese and crackers became quesadillas which may become thin crust cheese pizza too, or not. This is about the yes AND the no. If there is a huge resounding, "I can't tolerate that"...whole body NO, then move on. You have a wide range of options or re-visit that food later. You went too far, did too much or picked something really negative not based on that child's sensory individualized eating profile. Start off with the learning to eat side of this. "Hey Jack, there is cheese and bread and we can do all kinds of crazy things with it! Did you know that?" Cookbooks, pictures, cooking shows, making your own cooking show or commercial, blowing up cheese in the microwave to see what happens to it.
One more thing...ALL kids can learn about food, the same way they learn about the activities of daily life. If you are verbal or non-verbal, you can and you do learn. I am currently deeply crazy in love with one of my patients who cannot speak. He also cannot see well. He KNOWS it is me no matter where I see him (radiology, doctor's office, mall, treatment). I say his name and clap my hands, that is our greeting. He vocalizes and I find out what kind of day he is having. He answers me with a yes by rocking his body back and forth. We hold hands. He tells me no by dropping his head. We giggle and talk. We listen to music. We eat. I hug him goodbye and he locks his wheelchair over and over because he doesn't want to leave. We communicate so much. He has strong opinions if you look and listen. He makes me smile just writing this. Words are just one aspect of our communication, our interaction and the very human experience we have together. There is a little boy in that wheelchair. Though some would just push food in his mouth and force him without acknowledging his person-hood. Simply because he cannot talk. Almost like he is an object instead of a child. Our job is to teach kids, all kids, that you can enjoy and experience food that feels good to you and that you can refuse food that does not. There are the ways we can make food nutritious and make you healthy for life. Teach kids that some things you will learn to eat in time too. Most of us acquire taste for fruits and especially for vegetables later in life, teach them that. But overall, kids need to know that they should be and deserve to be treated with respect at the table all the time.
ALL kids, ALL diagnoses, ALL the time.
So, spend time on the social side with kids. Treatment is as much about the relationship as it is about the food. We laugh, we talk, we pretend, we cook, we look, we explore, we try in a way that fits our sensory need, we critique and rate and we live life with food in it, as Alicia says so eloquently. For more from Alicia, visit the Autism Life.com.
One more thing...I think it is hard when we act like food is a ritual. It is not. Don't forget that we eat differently all the time and we approach food differently based on what is happening around us. Think of how you are at holidays, very focused on food, in a cafeteria, very focused on getting out of there..eating at a picnic, a baseball game, in a car, on your couch. We adjust our approach to food, our positioning, our pace, our bite size and our focus (think zoned out staring at a movie screen) vs trying some new and novel food we have never eaten before with hyperattention to what you are doing. Some kids CANNOT handle the food and the environment, so they don't eat or eat a few bites of a very familiar food. It is too much to process it all. They don't have enough control of the situation to eat, so they simply drink or wait until school is over and eat on the bus or in the car. We must make kids skilled eaters who have sensory systems that can shut out the background noise, smells, movement and varying sources of stimulus. Our kids set up their rigid walls because they have to. They are not confident eaters so they gravitate to the simple, mash it type food, crush and crunch and push it down with liquid. Oral motor wise, the open mouth posture of eating, makes you eat simple food. There are reasons kids do what they do, eat what they eat, drink what they drink. Study and observe, learn and ask them what works. Build positive after positive and you will truly meet your goals and give a child the gift of enjoying a life with food.
My therapy is a method, not a protocol, but my more than that, my therapy is an experience, every session we experience something together about life and about food. For example, this is how I think about sessions...On Monday I made quesadillas with Jack. Not, Jack ate x numbers of this or touched this food x times. We had an experience together. We had fun. When you go out with friends, does someone count your bites? We had a session about food but we also learned something. Where quesadillas come from, how you say "quesadilla," and for fun, can you say it three times really really fast? He wasn't afraid and I said it the fastest. He now knows what the brown spots on a tortilla shell are. He made one for his dad in my electric skillet. We used cookie cutters and pizza slicers to cut it so he could see what his teeth would have to do too. We rolled up little strips of quesadilla and the three of us had a little meal. We picked out some things to go with it that we liked to eat. We picked out our divided plates and our drinks. We cleaned up together. I told him it might be fun to show Mom how to make one for his dad sometime like we did in therapy. NOT go home and make quesadillas four times this week because that is the kiss of death for learning to enjoy a food and no one eats like that. His family emailed me that they made them at home this week and he ate about 1/4 of it, rated it a 4/5 on his food chaining rating scale when the meal was over. My goals: educate, explore, explain, experience and enjoy all wrapped up in one experience that became something real world. A session that carried over to life and hopefully will become one more food Jack likes. Cheese and crackers became quesadillas which may become thin crust cheese pizza too, or not. This is about the yes AND the no. If there is a huge resounding, "I can't tolerate that"...whole body NO, then move on. You have a wide range of options or re-visit that food later. You went too far, did too much or picked something really negative not based on that child's sensory individualized eating profile. Start off with the learning to eat side of this. "Hey Jack, there is cheese and bread and we can do all kinds of crazy things with it! Did you know that?" Cookbooks, pictures, cooking shows, making your own cooking show or commercial, blowing up cheese in the microwave to see what happens to it.
One more thing...ALL kids can learn about food, the same way they learn about the activities of daily life. If you are verbal or non-verbal, you can and you do learn. I am currently deeply crazy in love with one of my patients who cannot speak. He also cannot see well. He KNOWS it is me no matter where I see him (radiology, doctor's office, mall, treatment). I say his name and clap my hands, that is our greeting. He vocalizes and I find out what kind of day he is having. He answers me with a yes by rocking his body back and forth. We hold hands. He tells me no by dropping his head. We giggle and talk. We listen to music. We eat. I hug him goodbye and he locks his wheelchair over and over because he doesn't want to leave. We communicate so much. He has strong opinions if you look and listen. He makes me smile just writing this. Words are just one aspect of our communication, our interaction and the very human experience we have together. There is a little boy in that wheelchair. Though some would just push food in his mouth and force him without acknowledging his person-hood. Simply because he cannot talk. Almost like he is an object instead of a child. Our job is to teach kids, all kids, that you can enjoy and experience food that feels good to you and that you can refuse food that does not. There are the ways we can make food nutritious and make you healthy for life. Teach kids that some things you will learn to eat in time too. Most of us acquire taste for fruits and especially for vegetables later in life, teach them that. But overall, kids need to know that they should be and deserve to be treated with respect at the table all the time.
ALL kids, ALL diagnoses, ALL the time.
So, spend time on the social side with kids. Treatment is as much about the relationship as it is about the food. We laugh, we talk, we pretend, we cook, we look, we explore, we try in a way that fits our sensory need, we critique and rate and we live life with food in it, as Alicia says so eloquently. For more from Alicia, visit the Autism Life.com.
One more thing...I think it is hard when we act like food is a ritual. It is not. Don't forget that we eat differently all the time and we approach food differently based on what is happening around us. Think of how you are at holidays, very focused on food, in a cafeteria, very focused on getting out of there..eating at a picnic, a baseball game, in a car, on your couch. We adjust our approach to food, our positioning, our pace, our bite size and our focus (think zoned out staring at a movie screen) vs trying some new and novel food we have never eaten before with hyperattention to what you are doing. Some kids CANNOT handle the food and the environment, so they don't eat or eat a few bites of a very familiar food. It is too much to process it all. They don't have enough control of the situation to eat, so they simply drink or wait until school is over and eat on the bus or in the car. We must make kids skilled eaters who have sensory systems that can shut out the background noise, smells, movement and varying sources of stimulus. Our kids set up their rigid walls because they have to. They are not confident eaters so they gravitate to the simple, mash it type food, crush and crunch and push it down with liquid. Oral motor wise, the open mouth posture of eating, makes you eat simple food. There are reasons kids do what they do, eat what they eat, drink what they drink. Study and observe, learn and ask them what works. Build positive after positive and you will truly meet your goals and give a child the gift of enjoying a life with food.