Typical feeding session

I have been able to attend several feeding sessions during my first semester of OT school. I kept a very detailed journal of these sessions, although obviously I can’t share it in that form since it would violate HIPAA. I’ve therefore modified all the details about the session in this post, so that the information about the specific children is left out and only the treatment approach remains. Names changed too.

Sometimes feeding sessions are needed in OT or SLP due to a child having a host of oral issues including hyper or hyposensitivity and possibly sensory defensiveness. The OT I was observing, Connie, told me that she has had some children cover their eyes in panic when watching her eat something they find repugnant, such as pancakes due to their mushy quality. The sessions I watched were co-treats with a great SLP. Connie had me set up with washcloths, soapy water, and several large towels. I was inwardly thinking huh? Then the SLP came in with a ton of food from the cafeteria – turkey, green beans, cheerios, Doritos, pudding, goldfish crackers, etc. We were operating off this feeding workshop called SOS which discusses the 32!!!! Steps of feeding and how complicated it really is, and ways to help children with feeding difficulties. This is made even harder for the many kids who have tactile defensiveness, since they don’t want to even touch food.

Apparently, the same procedure is used pretty much every time in order to accustom the child to the routine. The food varies slightly based on the child’s particular needs, but follows specific rules set by the SOS program, such as making sure each subsequent food shared a trait with the previous food. Of course that’s a simplified explanation. Anyway, here is how a typical feeding session would go, using this SOS program.

We started by all sitting at a table with the soapy basin. We each received a washcloth and had to dip the washcloth in the soapy water, squeeze it out, and wash our hands with it. Then put our washcloth behind our chair. The wet washclothes were present in case a child feels the need to wipe their face or hands, when dealing with foods that bother them.Then get a dry one to wipe off, and do the same. I was primarily there as a social modeler, ie doing whatever everyone else did, to show the child its normal, natural, give some mild peer pressure, etc. Connie then brought out some chocolate pudding and put a spoonful of it on all of our plates (sometimes the child is encouraged to pass out the food so that the child can feel in control). We then discussed its texture, its color, dipped it in our fingers, painted with it, licked it, experimented with it on our face, etc. We then moved on to another brown food, cheerios. We dropped these to hear the sound they made, discussed how they were crunchy, made patterns in the pudding, discussed color and shape. We then moved on to French fries, which are also brown. We discussed their long shape, pretending they were earrings, eyebrows, walking them around, discussing how soft they were, how we could tear them apart, how we could take a bite and move it around on our tongue, hide it in our mouth, spit it out…then we got out ketchup for the fries.

After the French fries I believe we moved on to another round object – green beans. At some point we moved onto goldfish crackers, which were popular. (I think I forgot a food or two in this since you wouldn’t go from green beans to goldfish crackers.) We discussed crunchiness, color, and so on. Then it was time for Doritos which are also orange, and triangles. Again, crunchiness was discussed. Now it was time to bring out another triangle – TURKEY MEAT. The OT pushed this into triangles and gave it to us and we ended up having to eat the Dorito and turkey meat together! The OT, Connie, gagged when she ate the Dorito-turkey but hid it well. I wanted to laugh.

Throughout this entire experience, we all had to smile, act enthusiastic, chew with our mouths wide open, make exaggerated swallows, chomps, show the food in our mouth, show our tongue and talk animatedly about how we use our STRONG TEETH, how the food goes into our mouth and into our TUMMIES, etc, etc.

At clean-up time, OT Connie and the child have to “blow” their food into the trash can. I was REALLY glad I did not have to do this part. They essentially have to bite into every food on their plate, and then spit it out into the trashcan. Many children balk at this since it involves having things in their mouth they don’t like. However, since the point is for enjoyment and not aversion, they aren’t pushed overly hard with this. Overall it has been fascinating to watch feeding sessions. I really enjoyed the learning experience!

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This is a picture of my favorite picnic sandwich while in CA – french bread, mortadella, brie, and chips. Yum. So eating a Turkey-Dorito in feeding group didn’t make me gag because it’s YUMMY!

Jun 21, 2007 | Category: Occupational Therapy | Comments: none

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