Food Chaining with Cheri Fraker and Laura Walbert (and Friends): Marsha Dunn Klein

Wednesday, April 2, 2008

Marsha Dunn Klein

What a wonderful weekend we had in Phoenix. First of all, the sun was shining and it was beautiful. What a treat. We attended Marsha Dunn Klein's course in Phoenix and it was wonderful. The second day is just full of ideas and we had such a good time. Of course we were our typical giggly selves, but we learned so much and it was so great to meet this amazing woman who has done so much! We get to go back to Arizona (Tucson) and do a course for her in May. Very exciting.

1 comments:

Alicia said...: Oooooh, Phoenix! It must have been so warm there! Ugh, I am so sick of this Illinois weather, rain, rain, cold, cold, wind, wind all day long. Blah! Can you tell I'm tired of being cooped up??? ;) Glad to hear you guys had a good time!; April 2, 2008 10:11 AM

Welcome Bloggers...Start Here

Hi
Welcome to our Food Chaining Blog, from Cheri and Laura and Friends...Check out this blog for therapy tips, articles, products, stories from some of our patient families, education materials, courses and information about feeding therapy programs for infants and children. Check out the Blog Archive for past posts that might be of interest. There are many links including one below to view videoropharyngeal swallow studies.

Cheri Fraker, CCC/SLP, Speech Pathologist and Feeding Specialist
Laura Walbert, CCC/SLP, Speech Pathologist and Feeding Specialist

Our Friends:
Sibyl Cox, RD, LD, CLC, Pediatric Dietitian
Shannon Cole Barker, OTR/L, Occupational Therapist
Stacey Vitale, CCC/SLP
Parents: Alicia, Jessica and Stephanie

Please note that all Preemietalk, ANEW and Pre/Food Chaining information is copyright protected.

September 12 and 13, 2008 Our New Feeding Course in Denver, Colorado

“What to Do and How, When and Why to Do It”
Registration: Continuing Education Programs of America www.cepauniversity.com
Presenters: Cheri Fraker, CCC/SLP, CLC and Laura Walbert, CCC/SLP, CLC
Date: September 12 and 13, 2008
Location: Denver, Colorado

As a therapist have you ever wondered…?
-What should I do with children and infants who aspirate? How much is too much?
-When should you try oral feedings, how much and when to advance the diet? How often should swallow studies be completed and what should I look for? Should I thicken liquids or not?
-What diet to recommend for the child with dysphagia?
-Does my oral motor therapy program work? How much, how often? What products should I order?
-What is sensory, what is behavior and what is motor? What should I do when kids refuse to eat?
-When to call the doctor? What are symptoms that need immediate attention in regard to vomiting, gagging, constipation, congestion and g-tube problems?
-When and how to move to cup or solid foods? What are the best products on the market?
-How to work with children with food allergies, g-tubes and trachs?

If you are feeling the challenges of working with infants and children with feeding disorders, this is the course for you! This course will address step by step how to do feeding therapy and help you problem solve and find answers to these questions and many more.

Coming This Fall...

Fall Course Schedule
-Denver, Colorado Sept 12 and 13 New Therapy Course (see below for details). Continuing Ed Programs of America www.cepauniversity.com.

-October 11, 2008 We are speaking on Food Chaining for one day at the Iowa OT association convention in Des Moine, Iowa.

-Toronto, Ontario-October 16 and 17 (This is a Thurs-Fri course) Food Chaining Course with pediatric dietitian Sibyl Cox. Continuing Ed Programs of America.

-November 6 and 7, 2008 What to Do When Kids Won't Eat (this course is for therapists, teachers and parents) Speakers: Cheri Fraker, CCC/SLP Laura Walbert, CCC/SLP, Sibyl Cox, RD, Alicia Hart, ANEW and Stacey Vitale, CCC/SLP Charleston, Illinois The Lumpkin Family Center for Health Education 1000 Health Center Drive, P.O. Box 372, Mattoon, IL. Presented by ANEW Way Images. Information coming soon.

-Atlanta, Georgia December 5 and 6, 2008
Dealing with No! The Best of Both Worlds: Get Permission and Food Chaining: Treatment of Children with Severe Feeding Aversion
Special Guest speaker Marsha Dunn Klein, MEd, OTR/L (details to come). Continuing Ed Programs of America.

About Cheri and Laura:
Fraker and Walbert’s therapy programs have been presented as effective therapy techniques at The World Congress of Gastroenterology, Hepatology and Nutrition, The North American Society for Gastroenterology, Hepatology and Nutrition, The American Speech Language and Hearing Convention, The UCLA/MCH Nutrition Leadership Conference and The American Academy for Cerebral Palsy and Developmental Medicine.

The Center for Selective Eating and Pediatric Feeding Disorders

Koke Mill Medical Center

3132 Old Jacksonville Road

Springfield, Illinois 62704

Pediatric Feeding Team Clinic

Cheri Fraker, CCC/SLP, CLC, Speech Therapist/Feeding Specialist

Laura Walbert, CCC/SLP, CLC, Speech Therapist/Feeding Specialist

Sibyl Cox, RD, LD, CLC, pediatric dietitian

Cheryl Swenny, psychologist

Gretchen Conway, MOT, OTR/L, occupational therapist

Michelle McCombs, Clinic Coordinator

Clinic: Mondays and Tuesdays 9-12

Phone: 217.862.0400 or 217.862.0403

Fax: 217.862.0440

Physician order required for evaluation

Disclaimer

This blog may contain suggestions for evaluation and treatment of infants and children with pediatric feeding disorders. Please note that general treatment suggestions
cannot take the place of a complete and thorough assessment (including modified barium swallow study or fiberoptic evaluation of the swallow) to determine safety of oral intake. Treatment of feeding disorders is recommended through a pediatric speech pathologist/oral feeding specialist and medical and/or pediatric feeding team. The primary
care physician should be contacted before changing any part of the current treatment program. Preemietalk is not liable for suggestions contained in this blog.

What is in the Food Chaining book?

I was recently interviewed on the radio about the Food Chaining book and I was asked what was in the book. So I thought it might be helpful to post that here. The book was written by our feeding team including a pediatric gastroenterologist, pediatric dietitian, occupational therapist and Laura and I. We wrote it because we were contacted by many families who did not have access to a pediatric feeding team. We thought it would be a helpful guide to families to work with their primary care physician and local therapists. We decided to write it in a manner that it could be used by parents and therapists/medical professionals. The first 5 chapters of the book help a parent or a therapist determine if there are underlying medical issues, nutrition problems, sensory problems, behavioral issues or swallowing/oral motor problems that contribute to the child's feeding disorder. The parent or therapist is provided with a multitude of intervention and treatment ideas. Multiple case studies are used to make the content very reader friendly.
The book then addresses how to use the techniques of food chaining. Food Chaining is basically about analyzing what a child eats successfully and re-creating offering food in a manner that matches the child's preferences. New foods are offered in a slightly different taste and texture in a progression to expand the child's ability to tolerate more variety in the diet. The book focuses heavily on teaching a child about food. There are additional chapters on special topics of prematurity, autistic spectrum disorder and Down Syndrome. Pre-Chaining programs are also explained. Pre-Chaining emphasizes precautionary care the first year of life to try to prevent feeding problems before they occur or lessen the severity of a feeding disorder. Hope this helps!

What is in the NICU to Childhood Book?

This book is geared toward therapist's and includes valuable strategies to outline exactly what to do with children who aspirate, have feeding aversion and refusals, behavioural feeding problems and digestive disorders, and how to effectively manage children with cerebral palsy, tracheostomy tubes, autism, cancer, cleft lip and palate, Gastroesophageal Reflux Disease (GER), and failure to thrive.

The text covers the entire spectrum of how to meet the needs of infants with varied appetites, formulas, and provides step-by-step methods to improve bottle, breast, cup, spoon, and self-feeding skills. Treatment is covered from NICU to childhood-adolescent years. It also includes a bonus medical based feeding intake and referral guide, nipple comparison charts, evaluation forms as well as photographs of positioning techniques, use of equipment, and much more.

Our Favorite Pediatric GI...Food Chaining Co-Author Mark Fishbein, MD

Dr Fishbein is a co-author of the Food Chaining book. He has mentored Laura and I and we had the gift of working with him for nine years in feeding clinic before he returned to Chicago in May 2006. He also diagnosed my son with Cyclic Vomiting Syndrome and saved my family. There are many great GI's out there, but he is our favorite!! We are still working with him via telemed and research projects.

Mark Fishbein MD
Associate Professor of Pediatrics
Northwestern University's Feinberg School of Medicine
Division of Gastroenterology, Hepatology, and Nutrition
Attending Physician, Children's Memorial Hospital
1.800.KIDS DOC (1.800.543.7362)

# Ounces Liquids Per Day- Guidelines for Infants

We recommend...The Pediatric Dysphagia Newsletter

The Pediatric Dysphagia and Feeding Newsletter
Krisi Brackett MS SLP/CCC has focused her career in Speech Pathology in the specialty area of Pediatric Feeding and Dysphagia Services, and currently practices feeding intervention in private practice. Krisi founded and publishes The Pediatric Feeding and Dysphagia Newsletter, an international quarterly publication on pediatric feeding issues. Krisi lectures nationally, about her work sharing practical tips for handling this special population of speech patients.

What is "Oral Aversion?"

Oral aversion is described as a consistently observed negative response (grimace, avoidance behaviors) with sensory input to the peri-oral and/or intra-oral region. Oral aversion may be a related to a variety of medical conditions, such as gastroesophageal reflux, aspiration, prematurity, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), etc., as well as from negative oral experiences such as nasogastic (NG) or orogastric (OG) feedings or from long term intubation.

Aversion may be evident at birth and may impact breast/bottle feeding, spoon-feeding and the transition to table foods. However, oral aversion is distinct from feeding aversion and behaviors can go beyond the feeding experience. A child with an oral aversion may be aversive to oral care, avoid contact to the mouth with hands and toys and therefore may not experience normal developmental mouthing activities. The child may also present with motor deficits and may be physically unable to bring hands/objects to mouth. Caregiving practices and parenting style may also contribute to oral aversion. The parent may discourage mouthing of toys/objects and insist on feeding the child beyond the appropriate developmental stages to control the feedings due to concerns regarding safety of oral nutrition or to avoid messy mealtime experiences.

An oral aversion may also be part of a more global presentation of a sensory processing disorder. Oral aversion can manifest itself in a variety of presentations including hypo-reactive and hyper-reactive responses sensory input. Treatment should focus on a whole body approach providing pleasurable age appropriate child directed oral motor experiences. The therapist should work progressively toward the mouth as tolerated. Analysis of the food items accepted by the child may reveal that only particular types or textures of food are tolerated. Treatment focuses on expanding flavor prior to texture and providing variety in the diet as tolerated. The child may present with a very restricted food repertoire and nutrition can also be significantly impacted.

Websites for Food Education

Websites For Learning About Food and Cooking Fun:

www.familyfun.com

www.mealappeal.com

www.spatulatta.com

www.nutritionexploration.org

www.kidshealth.org

www.kidnetic.org/kids

www.kidscook.com

www.dole5aday.org

http://www.scholastic.com/schoolage/activities/k-2/kitchensci.htm

http://personal.cfw.com/rollinso/SciFood.html

http://chemistry.about.com/od/homeexperiments/

http://www.chatham.edu/pti/Kitchen-Chem/Bcleveland-01.htm

http://www.foodscience.psu.edu/outreach/fun-food-science.html

http://www.clubmom.com/display/245307

http://homeschooling.gomilpitas.com/explore/chemistry.htm

http://homeschooling.gomilpitas.com/explore/chemistryfood.htm

Cosmeo (subscription)
www.cosmeo.com

Kidssoup (subscription but cheap)
www.kidssoup.com

Enchanted Learning (subscription but cheap)
www.enchantedlearning.com

www.kidsgardening.com
(eating rainbow specifically this page...)
http://www.kidsgardening.com/2005.kids.garden.news/june/pg2.html

more eating rainbow

http://www.nutrition.ecsd.net/eat%20a%20rainbow.htm

Educating about agriculture
http://www.ageducate.org/activities/
with resources for teachers (but can be modified by parents and therapists)
http://www.ageducate.org/resources/

Food for Thought from University of Illinois Extension
http://www.urbanext.uiuc.edu/foodforthought/

more from U of I extension on nutrition and health
http://www.urbanext.uiuc.edu/nutrition/index.html

Neat Solutions for Healthy Children
(books and items to buy with food, agricultural themes)
http://www.neatsolutions.com/Healthy%20Food%20Choices/Farm.htm
Home page for Neat Solutions (coooking ideas, curriculum, resources)
http://www.neatsolutions.com/index.htm

Illinois Agriculture in the Classroom
(everything can be modified to use at home or in therapy!)
http://www.agintheclassroom.org/060605/aitchome.html

BAM! Body and Mind (from CDC)
http://www.bam.gov/sub_foodnutrition/index.html

FSA Kids
http://content.fsa.usda.gov/fsakids/default.htm

Small Step Kids
http://www.smallstep.gov/kids/html/index.html

American Egg Board
http://www.aeb.org/KidsAndFamily/

Learn To Be Healthy.org
http://www.learntobehealthy.org/kids/

MouthPower.org
http://www.mouthpower.org/mouthpower.cfm

Cooking with Children (British website!)
http://www.bbc.co.uk/food/recipes/mostof_cookingwithchildren1.shtml

Brainpop (some free videos but others are subscription!)
http://www.brainpop.com/health/seeall/

Eat Smart Play Hard
http://www.brainpop.com/health/seeall/

About Produce
www.Aboutproduce.com (not working lately??)

Indian Services
many aspects to website including a nutrition section--talks about foods available on reservations under funding programs, tips for nutritional and health presentations for those of the Native American Culture, dietitians working with Native American families, recipes, etc...
http://www.ihs.gov/index.asp
http://www.ihs.gov/MedicalPrograms/Nutrition/
http://www.ihs.gov/misc/links_gateway/sub_categories.cfm?sub_cat_id=0806

Food Chaining with Cheri Fraker and Laura Walbert (and Friends)

Wednesday, April 2, 2008

Marsha Dunn Klein

1 comments:

Listen to Music if Desired

Welcome Bloggers...Start Here

September 12 and 13, 2008 Our New Feeding Course in Denver, Colorado

About Us

Oral Motor Therapy

Coming This Fall...

The Center for Selective Eating and Pediatric Feeding Disorders

Disclaimer

My Blog List

Parents Guide Magazine Article on Food Chaining

Hello Visitors

Tracker

Blog Archive

Memorial Medical Center: A Great Place to Work

We also work at (in our spare time) The Center for Selective Eating and Pediatric Feeding Disorders

Preemietalk Cheri and Laura's private business #1

ANEW Cheri, Laura, Sibyl, Alicia and Stacey Business #2

Coming Soon

Pre-Chaining

Cheri-My Son Luke's battle with Cyclic Vomiting Syndrome

Our Book...subtitle is wrong in the picture, but this is the only one I could copy into the blog

What is in the Food Chaining book?

Book Review for Food Chaining -St Louis Post Dispatch

Food Chaining Book

NICU to Childhood Book

Evaluation and Treatment of Pediatric Feeding Disorders from NICU to Childhood

What is in the NICU to Childhood Book?

99 Balloons Eliot's Story...Beautiful, please watch...

Sensory Experiences Are How a Child Learns About Food

And One Sibling is in Sensory Overload

Our Favorite Pediatric GI...Food Chaining Co-Author Mark Fishbein, MD

A Wonderful Therapist in Mattoon, Illinois

Stacey and Ewan

Cincinnati Children's Hospital Special Needs Resource Directory

Rate A Plate...Learn about Nutrition of Your Food Choices

Nuby Cup

Sassy Extra Gentle Soft Bowl Spoon

One Step Ahead Chair

Dr. Brown Bottles

Therapeutic Tastes: Bionix Bottle

Children's Medical Ventures Website

Tummy Tunnels

# Ounces Liquids Per Day- Guidelines for Infants

Mmmmmm

Fruit vs Birthday Cake

Jase

Ewan's Food Chaining Journey

Ewan's divided plate

Recent breakthroughs

Learning about Food and Nature

Food Chaining: Learning about Food

Learning about Seasons

Food Chaining: Having Fun with Food

Have Fun with Food

Learn about Seasons

Pumpkins!

Animals Eat Too

Uh..Learn about food in OTHER ways

Food Can Overwhelm a Child Visually

Apples!

Pizza with Squid Ink Sauce

Giggles

Pre-Chaining Programs

Alex's PreChaining Program

Getting Better

Food Chaining Programs: Ewan's Food Rainbow

The Way a Sensory Child Eats a Soft Pretzel

Some of Our Favorite Feeding Products

We recommend...The Pediatric Dysphagia Newsletter

Food Chaining: Enjoying Birthday Cake

What is "Oral Aversion?"

Sometimes we are just dog tired!

Websites for Food Education

The Autism Life

Koke Mill Therapy Team

Each child has his own walk through life