I’ve had quite a few parents ask if I could share the type of routine we use with B before each meal. I decided to go ahead and write up a blog post that does just that…only in more detail than how I usually explain it (Although if you ask my immediate family, they’ll probably say I went into as much detail with them as I’m about to do here :)) Keep in mind I’m no expert. I followed a program created by our food school therapist and tweaked it to fit our lifestyle and B’s personality. If you find this information helpful, I strongly recommend you contact a Speech and Language Therapist or Occupational Therapist certified in the Sequential Oral Sensory Feeding Approach. Please don’t hesitate to contact me on my blog or on Facebook if you have any specific questions about anything I posted.
Warm up activities to prep the sensory nervous system–>
• Jump on hoppity hop, climb stairs, jump in/around/out hula hoop, complete furniture obstacle course, jump on trampoline, crawl through tunnels (just some of many examples of things you could do to warm up the body prior to meal time).
Every day Meal Routine–>
• March, skip, dance, wiggle, slither, hop (whatever suits your fancy) to the bathroom. Sing a song on the way if she enjoys it. We like to sing “We are the Dinosaurs” by Laurie Berkner, but feel free to change it up. Wash/dry hands.
• B helps set the table. Sets plates out for everyone (including her extra learning plate), utensils, cups, whatever she’s capable of doing. This does NOT include food items.
• Wipe/wash table. This is great heavy work activity (we don’t do this because we have a tablecloth on the table).
Warm up mouth with following types of activities–>
• Blow bubbles, puppy bites (place washcloth at front and back of teeth and have B bite down hard on cloth while you try to pull cloth towards you). Have B imitate various shapes and faces you make using her mouth, lips, and tongue.
• Served Family Style. Depending on comfort level, B serves herself various items. Items are placed either on her plate or her learning plate (foods she’s not yet comfortable to eat). Each dish gets its own serving utensil (no cross contamination). If she is uncomfortable about serving herself, give her proper language, “What can mommy/daddy do to help you?” Put on her learning plate if she’s unable.
• Always have two preferred foods (foods she likes) at every meal. Each person at the table should take even a small amount of B’s preferred foods. Then, she doesn’t feel left-out because she’s eating something different from everyone else.
• Never have more than 5 TOTAL foods (preferred and non-preferred) for each meal. More than five foods can be too overwhelming.
• Eat without interruption for the first 15 min. of a meal (save some food to interact w/ at the end of the meal).
• Play with foods among all family members (preferred foods first). Pretend chips are sail boats, the ketchup is the lake, chicken nuggets are trampolines…whatever strikes your fancy.
• Start talking about non-preferred foods. The way they look and how they feel/smell. Play games. We’ve played “hot potato” with hash brown patties and “guess where we’re hiding the peanut inside our mouth” (tongue, cheek, front teeth, back teeth, etc…).
• Never force B to interact with a non-preferred food if she’s not ready. Instead, encourage dad and sister to play with you while B watches. She will engage if/when she’s comfortable.
• Remember the hierarchy ladder–>Look, touch, smell, snake taste (tip of tongue), hold in mouth, bite with front teeth and spit out, bite on back teeth and spit out, chew repeated times in mouth and spit, and spit/swallow. You may have to break it down into even smaller steps if needed.
Clean up Routine–>
• Encourage B to spit all items (preferred/non-preferred) items into a special bowl after each meal. If she’s not comfortable with putting in her mouth and spitting, let her blow or dump it off her own hand. If she’s really uncomfortable, let her blow/dump it off of your hand.
* Remember that sometimes you will need to make changes. For example, B cannot stand the smell of hotdogs at the table. So, we move her learning plate all the way in the middle of the table vs. near her. We also might put the hot dog in a plastic bag on days when the smell REALLY bothers her.
*It can be challenging, but she absolutely picks up on tone of voice. Be careful to use positive, encouraging language even when frustrated.
*Never force B to interact with a food she’s not ready to. This will cause an immediate fight/flight or shut-down response. If she’s stressing out, back down. It’s better to do too little than too much and cause regression.
*Use a progress chart to help encourage trying of new foods. Create a chart. Come up w/ a really strong incentive (key=STRONG incentive). B picked going to see a movie of her choice with her Godmother. Give a B a heart (sticker, stars whatever works) each time she works up the hierarchy ladder with a new food (look, touch, smell, snake taste…etc…). Don’t threaten with the chart. Only use it as a positive approach. If she refuses to smell a new food that day….then she just doesn’t get a heart. No need to point it out. Only recognize the hooray’s!
*Record each new food she tries in a journal. Write the food name in the journal and write numbers 1-10 under the name. After number 10, write the phrase “I know how to eat it!” Give B a star each time she eats that new food. According to B’s food therapist, it takes at least 10-20 tries before she will have any idea whether or not she actually likes a new food.