The Tactile System and your child’s eating-What do I do? Tops tips for the feeding environment.

You may have read previous posts about the sensory systems, and what over- and under-sensitivity look like with regards to eating.  And maybe you’re thinking, ‘yes, but so what?’.  This post begins a series on practical things we can do to support children with these difficulties.

So, first off, we’ll start with tips that are useful for most people.  If your child has difficulties that are not as severe, they might be enough to make a big difference.  Future posts will get more in detail into therapy techniques for more severely effected children.

The biggest thing you can do for your child’s eating is to make efforts to make the eating environment less stressful.  You might need to start by addressing things about your environment that don’t even involve food.

  • If your child has a negative reaction to sitting at the table:
  • Make sure you do other things around the dinner table and/or in their chair that they think are fun.  If they associate their chair and meal times with stress, then their negative responses will kick in way before the food gets there. Try having a time every day where they play in their chair, or you sing songs, or look at a book etc etc.  Let them choose the fun thing- our feeding chair is not a place where we want children to feel powerless.
  • Read about the ‘division of responsibility’ model (see previous post).  It is not your job to make your child eat, but to offer them opportunities.  I know this is easier said than done, but putting power back into balance in the mealtime dynamic can go a long way.
  • Offer foods that you know your child will eat, alongside other foods.  Starving children into eating will usually not work if your child has complex develeopmental and sensory issues.  If it does work, it will often come at a heavy cost with regards to your relationship, and your child’s relationship with food.  Offering a food you know a child will eat will bring down your stress,and their’s, and that’s a good thing.
  • Offer foods you actually like and eat yourself.  It is amazing how often we offer foods that we don’t like ourselves, beacuse we believe them to be good for us.  Your child is not an article in a magazine about nutrition, they will learn to eat the foods they see the family eating.  If you don’t eat kale, then don’t focus your time on it (NB I am not a dietitian- obviously making efforts to eat a healthy balanced diet are a  good thing, but it’s about being realistic).
  • Try and get everyone on the same page.  If you are taking a low-stress approach, but your Partner/Grandparent/childminder etc is putting the pressure on, this is less than ideal.  Our deeply-held views about food are often instinctive, and a child who is not eating will often trigger deeply held unspoken views (you shouldn’t waste food; children who don’t eat are being badly behaved etc).  Make efforts to help people see things from your child’s perspective.  However, if the discussions in themselves are causing more stress, maybe it is more appropriate for you to just control the interactions you can, and let the rest go.  People may well change when they see your way of doing things working.
  • Think about how you serve food.  Giving your child more control can really help the dynamic shift.  Think about serving food ‘family style’ (on shared plates on the middle of the table), and supporting people to serve themselves.  People can take as much or as little as they like, they can try small portaions of new things, and it makes it less easy to track what volumes have been eaten (a good thing, generally speaking!)
  • For children who do not like food touching (there are lots of good reasons for this, which we’ll talk about in another post), consider a divider plate.  If your child knows the foods don’t touch, they will be more able to relax and eat.
  • Check your own stress levels.  If mealtimes represent stress to you, then get the support you need to be able to bring your levels down.  Find a good feeding therapist, friend, counsellor, online support group etc who really gets it and is supportive.  Bringing your own stress down even a notch at mealtimes will support your child.
  • Educate yourself about your child’s developmental stage and their sensory processing.  It is really common for the stress levels at a family mealtime to drop massively once we know that a child is not showing these behaviours on purpose, or as a reaction to us personally.  Keep your eyes out on this blog for information, and for links to high-quality resources.

Posts from ‘Find the Key Speech Therapy’ are for information only.  They are not intended to, and cannot, take the place of advice from an appropriately trained Speech and Language Therapist who knows your child.  ‘Find the Key Speech Therapy’ does not take responsibility for the use of advice without appropriate professional guidance. 

 

Things We Love #1 Ellyn Satter’s Division of Responsibility

As a feeding therapist, I am always on the look-out for things to share with Parents and colleagues.  Ellyn Satter’s Division of Responsibility Model just about sums up everything I believe about children’s competence around food, trusting their instincts and reducing mealtime stress (for everyone).

Put simply (and like all true things, it is both simple on the surface and sometimes hard to achieve), it goes like this:

  • Children do want to eat, and they do have the capacity to regulate their intake (in fact they often do this better than us adults).
  • It is not a Parent’s job to make sure their child eats a particular volume, or even a particular food.

The Parent’s job is to decide:

  • What food to offer
  • When to offer it
  • Where to offer it

The child’s job is to decide:

  • Whether to eat
  • How much to eat

That’s it!  The rest is trusting your child.

I know this may not ring true for many Parents- if your child needs to be a certain weight for an operation, if they need more than the typical number of calories because of a health condition, if they have to be fed to a rigid schedule around their medications, or their vomiting, if they are very rigid and aversive in their approach to food.

Having a child who has complex medical and/or developmental issues can quickly distort this natural balance of responsibility around food.

I believe that one of the jobs of a Speech and Language Therapist is to try and work with you and the team around your child to restore this balance as much as we can.  This balance may look less than perfect a lot of the time, but refocussing on your child’s competence and natural wish to explore food (it is in there, really, it may be buried very deep though) should be part of any good feeding plan.

It can be really difficult to focus on a child’s developmental relationship to food in complex medical situations.  But feeding is more than just calories in.  Hopefully, your Speech and Language Therapist will advocate for your child in this regard within your medcial team, and work with you to nurture your child’s competence around food.

Ellyn Satter has written several very good books, and has a website and Facebook page- Google for more info.

Posts from Find the Key Speech Therapy are intended for information.  They are not intended, and cannot, take the place of advice from an appropriately qualified Speech and Language Therapist who knows your child.  Find the Key Speech Therapy does not take responsibility for the use of any advice without appropriate professional guidance.