Building Trust

Gains in therapy, any therapy, are built on a foundation of trust. The best way I have found to build trust is to go SLOW. The majority of children I see in the clinic have little to no control over what they can do. They are limited by external (adults) or by internal (limited mobility) forces. When parents come to me, I give my speech explaining why feeding therapy is a slow process: "Your child has to trust me. I need to touch their face, go in their mouths, pull and tug. I'm going to introduce foods to them. This maybe no big deal or it may be the most negative thing in their life at the moment."

I'll give the example of the dentist: "Most people do not like going to the dentist. Why? because he is in your mouth, pulling, tugging. You have no control over when you can close your mouth, when you can swallow. It is scary. Then there is the noises - the drill, the suction."

Initially therapy can be the same thing. Especially feeding therapy. A vibrating toy to the face and mouth can be like a drill. A NUK brush like a suction machine. It is all new and very different. When I can build trust, and the child knows I am not going to do anything harmful, we have progress. And we make progress faster, happier and easier then if I had gone straight to the mouth.

What have they tried.

Now I find out what the parents have tried. This helps since I want to know what has worked and what hasn't work. Even if it worked for a little while. It is a piece of the puzzle. It also helps to know where the child is coming from as well as the parents. Desperate parents will try anything when they are told that their child has to eat. If they don't their child/baby, will be malnourished. This can lead to so many things such as decreased brain growth and overall developmental delays.
So what have they tried. I have heard it all:
1. We don't feed him/her until they ask. - they never do.
2. We only let him/her run around and we follow him/her around and feed them.
3. We put him/her in a high chair and just opened his/her mouth and made them eat.
4. We distract him/her with toys or T.V.
5. We just let him/her have milk.

the majority of parents will tell me these things with guilt in their voice. More than once I have hear a parent say how they are just a bad parent because they have tried one or some of these methods. I always tell parents: there are bad parents in the world...they are the ones that don't care...you care, you try these things for your child. For THEIR best." And that is why they are here with me.

I'm not stressed anymore.

That is the turning point in feeding therapy as a therapist. When a parent comes to the sessions less stressed. When they are less stressed they become my partner in figuring out ways to help their child. When they become that partner, it makes my life easier because it make the child and the family lives easier. There is no battle. There is listening, observing, and problem-solving. Priorities are made and parents feel that their child is a family member. Now parents are able to listen to the issues at hand, be it physical issues or sensory issues. They are more willing to try and fail and try again. Therapy in general is not a cure but a way to guide someone to their greatest potential. Stress and blame do not help in the journey.

What is important?

What is important to the family? That is what I start with when I first see a family. Most of the time their child hasn’t been eating or gainng weight for quite some time. It is a constant battlefor every bit and every ounce. Why don't they eat? You HAVE to eat...why doesn’t my child? There are multiple reasons why a child doesn't eat. But what is important to the parents? Is it the weight gain or the types of food they eat? Is it that their child sit and eat with them at a meal. Most of the kids I see the parents have been told that their child is not gaining weight. The majority of parents feel that it is a direct reflection on their parenting. I find that it is much easier to help the parents by decreasing their stress about their child's eating habits and concentrate on what the parents are doing right and what is normal for their child and other children. Toddlers, special needs or not, are a HANDFUL!!! But fun...

Who Am I?

I am an occupational therapist who specializes in feeding. What does that mean? I treat children, mainly 18-24 month-olds, who: 1. don't eat 2. don't eat enough 3. only eat pureed or soft food, or 4. only eat certain food. Most of the children I see do not have a diagnosis. They are kids with no really history of delays other than difficulty eating. Some do have other delays or a diagnosis.

Why feeding? I have no idea. Occupational therapy is using a person's occupation to assist in the rehabiliation. With children it is more habilitation. As an occupational therapist (OT), I look at the whole child and what a child should be doing at their age - playing, sleeping, and eating. Part of playing and eating is socializing and being part of a family. I find that when eating is not going well, the whole family unit falls apart. Eating is what sustains us. It is how we fuel our body. Without food in out system and sleep - we cannot function. When feeding goes wrong it takes away from living.

My philosophy is being positive. Not happy but enjoying all the small steps towards the goal. Life is a journey of many paths. I'm honored to be part of the journey that my families take.