tag:blogger.com,1999:blog-70017564325790658822023-10-16T01:09:38.527-07:00Food Chaining with Cheri Fraker and Laura WalbertPicky EatingFood Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.comBlogger204125tag:blogger.com,1999:blog-7001756432579065882.post-11348877777621769482017-01-29T02:32:00.000-08:002017-01-29T03:05:16.288-08:00NEW 2017 Online Food Chaining Course: Northern Speech Services <a href="http://www.northernspeech.com/db5e/"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1wxWMV0uABp0KxLhqS9PZk_N3edg7D6gvFOtzs9bBK3siBRWbc4AEnr6KCS8a-jG8mRHGM0oZUyg7YshG87s356CaPlTMYSKMUYCoOVWieCn7agHAn4wt1rzrH5Cl4H213obOoauBt0g/s1600/fruit_smoothies.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1wxWMV0uABp0KxLhqS9PZk_N3edg7D6gvFOtzs9bBK3siBRWbc4AEnr6KCS8a-jG8mRHGM0oZUyg7YshG87s356CaPlTMYSKMUYCoOVWieCn7agHAn4wt1rzrH5Cl4H213obOoauBt0g/s320/fruit_smoothies.jpg" width="320" height="243" /></a></div></a> Hi All! We are happy to share our first online Food Chaining course. The Food Chaining online course for treatment of picky and problem eating is now available at Northern Speech Services. It is a 59.00 class through Northern Speech Services.com.
<a href="http://www.northernspeech.com/db5e/"></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com2tag:blogger.com,1999:blog-7001756432579065882.post-37872520786239922632016-09-01T05:33:00.001-07:002017-01-29T03:09:20.141-08:00Want to sponsor a conference? Consider our NEW 911 Food Chaining Course with Cheri Fraker, Laura Walbert and Sibyl Cox<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzMUgKS9avqeoqWYQU7nQKIyq27I1KR3v8bUnhHvaBwr7aSW_bOEssm-_NnWwB8758jLckfnvErp84VtOugaWe5iLvvNq5FC1ZAbiad0N_fiCQ4JVwmpXFCul-z3fWeL51qo_7_8DrNrY/s1600/question-mark2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzMUgKS9avqeoqWYQU7nQKIyq27I1KR3v8bUnhHvaBwr7aSW_bOEssm-_NnWwB8758jLckfnvErp84VtOugaWe5iLvvNq5FC1ZAbiad0N_fiCQ4JVwmpXFCul-z3fWeL51qo_7_8DrNrY/s320/question-mark2.jpg" width="320" height="175" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV6WxLCyTnffHNQi6jOzmGaDaDGqARKNqtey6PMtBuXRjQutk6UHaFOKP7-WMDJXVz1E8Dwdq4CyHzlHeQ1gIg5DPup43MqfDvqLzag0VruLLLl9HEQFL8mgktODFUUYBcLq0rNhDwpAo/s1600/911.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV6WxLCyTnffHNQi6jOzmGaDaDGqARKNqtey6PMtBuXRjQutk6UHaFOKP7-WMDJXVz1E8Dwdq4CyHzlHeQ1gIg5DPup43MqfDvqLzag0VruLLLl9HEQFL8mgktODFUUYBcLq0rNhDwpAo/s320/911.jpeg" width="320" height="213" /></a></div>
We speak by invitation. If you would like to schedule a conference in your location, contact us at preemietalk@comcast.net. We provide a variety of courses on PreChaining and Food Chaining. This is our newest course. Review schedule below.
From Triage to Treatment: Therapy 911
What to DO for Your Most Challenging Feeding Therapy Patients
Cheri Fraker, MS, CCC/SLP, Laura Walbert, MS, CCC/SLP, and Sibyl Cox, RD, LD, CLC
Contact Hours: 13
Audience: OT, PT, ST, behavior specialists, and parents.
Schedule:
Day One
8:00 -8:30 am Registration
8:30-9:30 The 911 issues
9:30-10:15 Analysis of the diet: Nutrition and Food Chaining
10:15-10:30 Break
10:30-11:15 Supplementing the diet: A guide to correct use of formulas and supplements
11:15-12:00 911 Team care: Is it failure to thrive? Therapy for the malnourished child
12:00-1:15 Lunch Break
1:15-2:15 Dysphagia therapy for the oral and tube fed child
2:15-3:15 Feeding therapy for transitioning to oral feeding
3:15-3:30 Break
3:15-4:15 The key decisions in treatment: Getting started on the right track
4:15-5:15 Help! The Most Challenging Cases, Where to Start and The Phases of Treatment
(Saturday)
Day Two
8:30-9:30 Cases: The digestive tract disorders
9:30-10:15 Videos (What Good Therapy LOOKS Like)
10:15-10:30 Break
10:30-11:15 911: Cases: Dysphagia
11:15-noon 911: Cases: Extreme Aversion
Noon-1:00 Lunch Break
1:00-2:15 911: Autistic Spectrum Disorder
2:15-3:00 MORE Case studies-Eyes that SEE (analysis of videos from host facility)
3:00-3:15 Break
3:15-4:00 Troubleshooting: Panel Q and A
About the Speakers:
Cheri Fraker, CCC/SLP and Laura Walbert, CCC/SLP are certified, licensed pediatric speech pathologists who specialize in feeding and swallowing disorders in infants and children. They have published and presented on feeding disorders internationally. Cheri and Laura work at Koke Mill Medical Center’s The Center for Selective Eating and Pediatric Feeding Disorders, a multidisciplinary feeding team clinic in Springfield, Illinois. They are co-owners of Preemietalk and ANEW way Images.
Sibyl Cox, RD is a registered and licensed pediatric dietitian and certified lactation consultant and she specializes in pediatric nutrition. She has provided nutritional assessments and counseling to infants and children and their families in inpatient care and outpatient clinics at the Southern Illinois University School of Medicine Department of Pediatrics. Ms. Cox graduated from the University of Missouri-Columbia with a Masters of Science in nutrition and completed the coordinated program in dietetics. Sibyl is a member of the Academy of Nutrition and Dietetics, the Illinois Academy of Nutrition and Dietetics, the American Society of Enteral and Parenteral Nutrition, and NASPGHAN's Council for Pediatric Nutrition Professionals.
Disclosures:
Cheri and Laura have co-authored “Evaluation and Treatment of Pediatric Feeding Disorders from NICU to Childhood.” Cheri, Laura, and Sibyl Cox are co-authors of “Food Chaining: The Six Step Solution to Solve Feeding Problems, Stop Picky Eating and expand Your Child’s Diet” for which they received royalties. None of these products will be advertised nor sold at this venue. They have published and presented on feeding disorders internationally and are receiving an Honorarium for this presentation.
Seminar Description:
Cheri Fraker, CCC/SLP and Laura Walbert, CCC/SLP will be joined by pediatric dietitian Sibyl Cox, RD from the SIU School of Medicine. This new, advanced feeding therapy course is designed to teach participants how to triage a feeding disorder, identify the 911 risks to the child, determine who to call to make appropriate referrals and then form a plan to work together as a team during diagnostic therapy. The Therapy 911 course will help therapists avoid problems before they start, solve problems when they do occur and help therapists learn how to get a derailed therapy program back on course. Oral and tube feeding regimens will be discussed. Dynamic learning will be emphasized via an interactive model of teaching with participant participation. The most complex case studies will be used throughout the course. Videos will be used to maximize learning. Treatment strategies will be discussed and analyzed in detail. This course will provide the treating therapist with practical, common sense information to implement immediately and will provide the education you need to develop your diagnostic skills and improve your treatment outcomes. Course handout will provide easy to use guides, references and forms and it is designed for daily use.
Seminar Objectives:
By the conclusion of this course, the participant will be able to:
List anatomical and physiological factors that create roadblocks to successful oral eating.
Identify the professionals needed to overcome the obstacles to oral eating.
Discuss the criteria for tube placement, need for special formulas and supplements, and specific tube feeding regimens
Identify the appropriate hierarchy of medical, nutritional and therapeutic interventionFood Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-42331189200768487852016-02-28T07:31:00.000-08:002016-02-28T07:31:01.130-08:00How Do I Chew? Let Me Count the Ways....HELP your child develop the skills to be able to expand the dietHow Do I Chew, Let Me Count The Ways....Therapists, TEACH your kids how to eat. First, make sure the swallow is safe by doing a thorough swallow study using Varibar barium. In treatment, you must eat with the child in your sessions. Tell the child what your tongue, your teeth, your lips are doing. Show them what happens when you do it wrong. Put a towel on yourself, take a drink and let it dribble out. Laugh. Tell them what happened and why in fun ways that they can understand. You have to tell kids what your mouth is doing...are your cheeks making walls, are the walls squeezing your tongue, is your tongue sweeping like a broom, pushing or rolling or making the big slide? No kid wants to stare inside your mouth, but have fun with mirrors too. One of my patients had food collecting under his tongue. He, on his own, decided that the tongue was like a bridge and had to push the food out that got under the bridge. Then all I would have to say is, "uh-oh, oh boy, oh boy, there are chips trying to go under the bridge." He would laugh and push them out.
As for teeth, show the kids different foods and what the teeth must do. Ask "are your teeth just crunching up and down or are they crushing food up and down and side to side?" I have some McDonald's chicken nuggets with faces. I dress them up in Halloween hats, etc. But they are great for me to show kids what the teeth do. I have them pretend one nugget is like a tooth. I put a cracker on the table and tap up and down. Well, just up and down is not enough. Your teeth saw food back and forth and crush and rip and tear. So, I show them the grinding motion of the teeth and the side to side. I teach them what foods you need to work your teeth "hard" with. I show them that all food becomes mashed up by the hard work our teeth do, so you really don't have to be afraid of soft or mashed food because that is what your teeth do to food...they make mashed food. Then we decide what we can do to make those soft foods better and safer to taste. I always use my puppets that eat (mine is Starvin' Marvin) and that nasty mouth from Super Duper together and show kids what happens inside the mouth too. For example, show them what your mouth does for crunchy food (Triscuits). Talk about the sounds of chewing. Tell them "Wow, the other teeth think that food is too loud! CRUNCH!" vs. tastes of frosting "that is too quiet!" Giggle about cold food on the teeth or warm up with sips of warm cocoa. Make a social story about your mouth and teeth. Learn about the sensations and how our patterns change based on what we are eating.
My absolute favorite thing in the world is the DuoSpoon, designed by my friend Marsha Dunn Klein. You can order these on Marsha's website. I have used this with so many kids and dipped so many things on it and I see progress. It is an amazing product. I absolutely love it and the TriChew teether. Thank you Marsha for bringing us all your gifts and talents and products. What about eating? Start small with bites, tiny pieces of food (mouse size bites and work up to T-Rex bites) and help the child learn to work his way up to larger bites when his skills have improved. Make sure the child likes what you are offering too! Kids can make amazing progress in therapy with the right approach! Hope these things help you in your treatment plans.<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidP8qndUEFu9WWfGNJ50SaeukeCoXk3ZzePgcQRO60OjXZMFcyWDixTTEKcDvzjsI2p7NQDRHPuWOiZltiLoE8U5Cs1bioRIMgORtvoxmrqWT2fGgvA4Ip_XhnQ62hNoQFwfXVXyTEOJ4/s1600/Aversion+older+baby.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidP8qndUEFu9WWfGNJ50SaeukeCoXk3ZzePgcQRO60OjXZMFcyWDixTTEKcDvzjsI2p7NQDRHPuWOiZltiLoE8U5Cs1bioRIMgORtvoxmrqWT2fGgvA4Ip_XhnQ62hNoQFwfXVXyTEOJ4/s320/Aversion+older+baby.jpeg" /></a></div>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-82016356299662283702016-02-28T07:27:00.000-08:002016-02-28T07:27:00.081-08:00How to Help The Child with Severe Picky (Selective) Eating Hi Chaining Friends
I have seen so many families over the years tearfully tell their stories of dealing with a child who does not enjoy eating, who would choose to starve instead of eat and how their lives feel derailed by the battle ground at the table. These parents carry a heavy burden and they are often harshly judged, even by members of their own family. Many people equate "picky" with brat and bad parenting. These parents go to doctors and pursue help and they are often told, "he will outgrow it" and that only increases their fear and anxiety because they know he won't. They know something is wrong, what they do not know is what to DO about it. I am going to try to help you find those answers. I have 28 years of experience in pediatrics (boy, that makes me feel old just saying it) and I developed Food Chaining as a family friendly, common sense approach to helping selective eaters eat with joy. My job is to help nourish body and soul and help parents put this huge challenge behind them. I tell families when they come to clinic that if they only take away and implement a few key suggestions, in time and with consistency, many of these issues will resolve. So here is my version of a Top Ten List as someone who has made a career of looking at pediatric feeding disorders from 40,000 feet. Big picture, I hope this helps both therapists and parents set children on the road toward eating with enjoyment.
1) The Two Week Cool Down-put your energy in stopping the cycle of stress, put it into creating a peaceful table. This is to prepare your family for implementing Food Chaining into your life as a way of life, not another 'program.' You waste your energy trying to direct, prompt or force your child to eat. Anxiety destroys appetite. Your meals are probably unbelievably stressful, step back and put on your waitress apron and simply provide your child with food at three meal times and two (in some cases three snack times) and make no comment whatsoever about what your child chooses to eat or not eat. Observe what your child likes and see how eating changes without the push factor. The foods you offer should be those your child enjoys eating and a few of the foods your child eats sometimes. Do you go to a restaurant and order what you hate? Each plate should contain a 'green light' food that is pleasing to the child. You would not want to eat at a restaurant where a waitress stood over your table and said,"take a bite" or "chew chew chew." The child needs to stop fearing the table, you need to eat your meal and talk about your day with your family. Don't let anxiety make you the food police. Don't overparent...let the child actually experience a meal on his own. You can't do it for him. Set up a schedule of meals, offer foods that we suggest, if your child doesn't eat, don't panic, you have three meals and three snack times to offer. Let your child learn to choose wisely. Don't carry a bag of food around everywhere you go. You have taken away every learning opportunity. Consequences teach us to make better choices. Your child learns that the only safe food is the food in the food bag. It just reinforces selective eating over and over. You can't panic when your child doesn't eat. Your child needs to be stretched a bit to reach for something new. If you put the food bag in front of him, he will only eat that. Crying and tantrums are going to be there, don't over react. Crying will stop, selective eating won't if you cave to crying. That is why we have a counselor on our team to help you deal with no. We give you our phone numbers and email contacts....use them. Shape your child's behavior, don't crumble when your child is upset. We learn from these challenging times. Let your child learn, don't overparent. You are not heartless, you need to be strong. We are here for you. Use our advice.
2) Listen to what a good, reputable specialist tells you. Find someone with many, many success stories. Ask to talk to other parents who have been in the program. Listen to what we tell you when you come and spend money to have professional help. This is especially important when there are physical roadblocks to eating that need to be treated. We set up programs for families that often involve preparing a child's body for being able to eat. This may involve seeing an otolaryngologist, clearing the nasal passages so your child can actually develop the right skills for eating, improving breathing patterns, wearing a binder to develop good, deep breathing patterns, evaluating swallowing skills, having a swallow study, treating high grade reflux that irritates from behind the nose to the belly, treating constipation and assessing for allergies. The parents and kids who succeed listen to our expert advise and follow everything we ask of them. Those families are in and out of treatment in a matter of months, those who take only part, stop medications, don't offer chewy utensils to build a child's skills, continue to push or walk away thinking a therapist will do this for them....either fail or come back months/years later with the same problem only compounded. I say this with love and respect for families, but how has leaning on your own understanding served you so far? You are seeking help but can't put the problem down and trust in the professionals who see this every day. You have to put it down, so others can help you carry it. I learned this the hard way with my son Luke's issues with cyclic vomiting and our years of searching for answers-so no judgment here. I was so protective, so over mothering of him because I was left with no other options, but when the right doctor came along, I had to let go to trust and I had to change my hover mode or my kid would not be strong in this world. I had good, truth speaking professionals, who became friends tell me to follow a treatment plan exactly so they could continue their diagnostics trusting that I wasn't messing it up all the time and Luke got the care he needed. So, if you don't listen to me/the team in feeding clinic, you don't attend sessions, you don't follow advice, you push the vegetable on the child you cannot eat that yet...you can't expect improvement. You are part of the team too, you are who we are depending on to make sure the plan gets off on the right foot. Be consistent, follow the therapist's plan and communicate with the team when you are tempted to jump off course. Listen. Learn. Follow Advice exactly. Lather, rinse, repeat, this is not a quick fix. Treatment takes time. Be patient. Trust in those who have more knowledge on the subject than you do, that is why you are going to see them in the first place.
3) Stop thinking about vegetables. If you poll a room of 100 people (like I do when I teach a course) and ask "How many of you ate all your vegetables as a child?" Usually one hand goes up and I doubt the truth of that person. Hee hee. It is NORMAL not to eat many vegetables when you are small. Children have stronger bitter taste receptors than we do. Vegetable can be an acquired taste and texture of food. So your child tastes and feels something you do not when he tries a vegetable. Pushing him to eat it for hours at a table just about guarantees that he will never eat it again. Laura had this happen to her with a lima bean. Pushing is overparenting. Our job is to offer little ones vegetables in small portions. Our job is to put colorful vegetables in line of sight. Our job is to teach them about gardening and health and model eating vegetables. Many of my kids will eat spinach leaves between two Ritz crackers. We make tree sandwiches, we laugh, the crackers makes the spinach/mixed green leaf almost impossible to taste. I model and before I know it, the kids are doing the same. The more we green our lives, the better, but don't be the Green Giant. Don't hover...let eating happen in time. You are investing in your child's future by letting them see, touch, wash, play with, prepare vegetables but the ultimate decision whether or not to eat the vegetable is up to the child. Most kids with help and food education will eat a fruit of some kind or we can make it into a drink/smoothie, dip it in chocolate, etc. Fruit may come first. Don't sweat the veggies.
4) In the beginning, ONLY offer new foods that don't create fear. This is why when Food Chaining that we offer foods that are very, very similar to the foods the child eats currently. Change is gentle. Change is done in this stage to let 'new' =nice. If you offer brussel sprouts as your new food, new=fear. Anxiety is compounded. You are building trust in this stage of treatment. You are breaking old patterns. This is usually done while we implement the other aspects of our care plan.... building advanced chewing/biting skills with chewy utensils, assessing for allergies, treating reflux, treating adenoiditis, post nasal drip and getting the diet in place with the right amount of milk, juice and establishing a feeding schedule. The first foods of Food Chaining certainly are not the last. People who scoff that we offer junk food, do not get it. The child's body must be prepared for eating the more complex foods before offering the more complex foods. This is the training wheels stage of eating. If you can't breathe through your nose, taste and texture perception is way, way off. Super taster adults who are paid to taste food were blind folded and had a clip on the nose. These experts called a bite of egg a marshmallow and a spoon of cinnamon, curry. They did not know what they were eating. They were not comfortable eating. They swallowed air. They lacked the pressures to swallow complex foods. It was hard to eat. Hold your nose and try to eat and drink. Do it right now! It doesn't work. We need to time to treat these issues. The nose is key to success at the table. The first foods are what we set up to help eating get back to normal WHILE we are treating the body. If you don't follow up with the doctor and treatment plan or if your doctor doesn't follow what we suggest (he should as he sent you to us for help in the first place) then the treatment plan has a hole in it and it won't work. The whole enchilada baby. That is the only way. If your child is snoring, has dark circles under his eyes, is a restless sleeper and eats like PacMan (open mouth chewing), he isn't safe to eat baked chicken, roast, steak or other complex foods. You are pushing him beyond his capability. Swallowing disorders? Must be treated. So he IS afraid, respect that no often means 'can't."
5) GI docs are really your friends. (Get the RIGHT doc). Constipation management must be daily. MiraLAX in clear liquids daily, not hit and miss, not in milk. If you can't poop, you reflux more, you feel bad and the GI tract must be healthy. Eczema, red rash, bumpy skin, belly pain complaints, constipation, poor weight gain all have to be treated. If weight is too low, appetite is shut off. If their are vitamin deficiencies food can taste bad. Pediatric GI consults matter and you must follow the treatment plan and let the doctor do his job. Scoping is part of that. If the doctor suspects your child has eosinophilic esophagitis (EoE) your child's health is at risk. We need to find the foods your child's body can tolerate safely. The doctor isn't scoping just to scope, he is scoping for a reason. Let him do his job. You don't have to like your GI, but let him rule out reflux esophagitis, EoE and GI tract disorders. These problems are easy to treat with the right help and your child can feel better than ever before. If the nose and the gut don't work eating won't either. We are not sending you to doctors to just make money, we see patterns from 40,000 feet that tell us you tried to do everything right but your child's body has needs for special diets and to help the tract work right. Kids don't know they feel that bad, they have always felt bad. Eating is not good when you have a GI disorder. Don't overparent and over rule the GI doc....listen and let him do his job and give us the information we need to select the right kind of diet for your child.
6) This is not your fault. Mommy guilt, Daddy guilt is a powerful thing. Now you know, give yourself a break. You found help for your child, just follow the plan. It is a long haul. Be good to yourself. Treatment can help. We have great families that can also help you. Be patient, if your child has a swallowing disorder, your child may need a feeding tube. A feeding tube is a bridge to our goal to help your child eat in part by mouth each day. The tube keeps your child safe and hydrated while we work on building the skills to a level that helps your child eventually not need that support. Some kids always need that support, but they can enjoy tasting and eating too...with the right kind of care and medical management.
7) Be honest, tell us what is working and what is not working, tell us about your good days and bad days, let us go to Plan B is Plan A isn't working. This is your program. We have to hear the truth...good or bad....to help you. We can take it. You are also part of the team. You are the star of our feeding team. If you don't tell me what is wrong, I will assume nothing is. Hope this helps. I have many, many examples of food chains on this site, on Pinterest Food Chaining board, etc....it is about much more than food. Food is the last step. The true obstacles to eating are the nose, the GI tract, a lack of skill, the emotions and fear at the table.
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLPYhCMbruC8WL9_yyCEbwL3r-3mY_n7X0FfTY1WIJFXiOa_m-Dekhscy-WHkXSMRH1GrtsXRSWVuFoh7fOqIl7vdnG3wHXFngGrcxb_NJq-cVGAVOI3Lcgedb9NCFBcB6opkpySeGYZA/s1600/Mike+and+Jace+book.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLPYhCMbruC8WL9_yyCEbwL3r-3mY_n7X0FfTY1WIJFXiOa_m-Dekhscy-WHkXSMRH1GrtsXRSWVuFoh7fOqIl7vdnG3wHXFngGrcxb_NJq-cVGAVOI3Lcgedb9NCFBcB6opkpySeGYZA/s320/Mike+and+Jace+book.jpeg" /></a></div>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-82805230358065918522015-06-18T11:51:00.000-07:002015-06-18T11:51:47.652-07:00Cosmeo.com Visual Learning Resource from the Discovery Channel<a href="http://www.cosmeo.com/bysubject.cfm?science"></a>
We are huge fans of the Cosmeo.com website. This site from the Discovery Channel has over 30,000 educational videos and tutorials in every subject in school from K-12. You can customize to your state. Great for the visual learner and there are also videos about brushing teeth, food, healthy eating....wonderful resource. About nine dollars per month, but there is a free trial period. I would love to see schools using Cosmeo. We loved it. Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-89372091768239282962015-06-18T11:48:00.001-07:002015-06-18T11:52:11.624-07:00Feeding Matters-Visit their site, great resource for families and therapists<a href="https://www.feedingmatters.org/"></a>
Check out the Feeding Matters website. Another great resource. Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-127410913358204022015-06-18T11:45:00.001-07:002015-06-18T11:52:16.756-07:00Kidsme Food Feeder<a href="https://www.youtube.com/watch?v=9H9wbGN6p3M"></a>
Kidsme Food Feeder is a great product! Check out the Kidsme website or order on Amazon. Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-10681020289920758982014-08-09T05:53:00.000-07:002014-08-09T05:53:12.260-07:00Parents of Picky Eaters...How to Help and Not "Over Parent"Hi Chaining Friends
I have seen so many families over the years tearfully tell their stories of dealing with a child who does not enjoy eating, who would choose to starve instead of eat and how their lives feel derailed by the battle ground at the table. These parents carry a heavy burden and they are often harshly judged, even by members of their own family. Many people equate "picky" with brat and bad parenting. These parents go to doctors and pursue help and they are often told, "he will outgrow it" and that only increases their fear and anxiety because they know he won't. They know something is wrong, what they do not know is what to DO about it. I am going to try to help you find those answers. I have 28 years of experience in pediatrics (boy, that makes me feel old just saying it) and I developed Food Chaining as a family friendly, common sense approach to helping selective eaters eat with joy. My job is to help nourish body and soul and help parents put this huge challenge behind them. I tell families when they come to clinic that if they only take away and implement a few key suggestions, in time and with consistency, many of these issues will resolve. So here is my version of a Top Ten List as someone who has made a career of looking at pediatric feeding disorders from 40,000 feet. Big picture, I hope this helps both therapists and parents set children on the road toward eating with enjoyment.
1) The Two Week Cool Down-put your energy in stopping the cycle of stress, put it into creating a peaceful table. This is to prepare your family for implementing Food Chaining into your life as a way of life, not another 'program.' You waste your energy trying to direct, prompt or force your child to eat. Anxiety destroys appetite. Your meals are probably unbelievably stressful, step back and put on your waitress apron and simply provide your child with food at three meal times and two (in some cases three snack times) and make no comment whatsoever about what your child chooses to eat or not eat. Observe what your child likes and see how eating changes without the push factor. The foods you offer should be those your child enjoys eating and a few of the foods your child eats sometimes. Do you go to a restaurant and order what you hate? Each plate should contain a 'green light' food that is pleasing to the child. You would not want to eat at a restaurant where a waitress stood over your table and said,"take a bite" or "chew chew chew." The child needs to stop fearing the table, you need to eat your meal and talk about your day with your family. Don't let anxiety make you the food police.
2) Don't overparent...let the child actually experience a meal on his own. You can't do it for him. Set up a schedule of meals, offer foods that we suggest, if your child doesn't eat, don't panic, you have three meals and three snack times to offer. Let your child learn to choose wisely.
3) Don't carry a bag of food around everywhere you go. You have taken away every learning opportunity. Consequences teach us to make better choices. Your child learns that the only safe food is the food in the food bag. It just reinforces selective eating over and over. You can't panic when your child doesn't eat. Your child needs to be stretched a bit to reach for something new. If you put the food bag in front of him, he will only eat that.
4) Crying and tantrums are going to be there, don't over react. Crying will stop, selective eating won't if you cave to crying. That is why we have a counselor on our team to help you deal with no. We give you our phone numbers and email contacts....use them. Shape your child's behavior, don't crumble when your child is upset. We learn from these challenging times. Let your child learn, don't overparent. You are not heartless, you need to be strong. We are here for you. Use our advice.
5) Listen to what a good, reputable specialist tells you. Find someone with many, many success stories.
6) Ask to talk to other parents who have been in the program. Listen to what we tell you when you come and spend money to have professional help. This is especially important when there are physical roadblocks to eating that need to be treated.
7) We set up programs for families that often involve preparing a child's body for being able to eat. This may involve seeing an otolaryngologist, clearing the nasal passages so your child can actually develop the right skills for eating, improving breathing patterns, wearing a binder to develop good, deep breathing patterns, evaluating swallowing skills, having a swallow study, treating high grade reflux that irritates from behind the nose to the belly, treating constipation and assessing for allergies. The parents and kids who succeed listen to our expert advise and follow everything we ask of them. Those families are in and out of treatment in a matter of months, those who take only part, stop medications, don't offer chewy utensils to build a child's skills, continue to push or walk away thinking a therapist will do this for them....either fail or come back months/years later with the same problem only compounded. I say this with love and respect for families, but how has leaning on your own understanding served you so far? You are seeking help but can't put the problem down and trust in the professionals who see this every day. You have to put it down, so others can help you carry it. <i>I learned this the hard way with my son Luke's issues with cyclic vomiting and our years of searching for answers-so no judgment here. I was so protective, so over mothering of him because I was left with no other options, but when the right doctor came along, I had to let go to trust and I had to change my hover mode or my kid would not be strong in this world. I had good, truth speaking professionals, who became friends tell me to follow a treatment plan exactly so they could continue their diagnostics trusting that I wasn't messing it up all the time and Luke got the care he needed. </i> So, if you don't listen to me/the team in feeding clinic, you don't attend sessions, you don't follow advice, you push the vegetable on the child you cannot eat that yet...you can't expect improvement. You are part of the team too, you are who we are depending on to make sure the plan gets off on the right foot. Be consistent, follow the therapist's plan and communicate with the team when you are tempted to jump off course. Listen. Learn. Follow Advice exactly. Lather, rinse, repeat, this is not a quick fix. Treatment takes time. Be patient. Trust in those who have more knowledge on the subject than you do, that is why you are going to see them in the first place.
8) Stop thinking about vegetables. If you poll a room of 100 people (like I do when I teach a course) and ask "How many of you ate all your vegetables as a child?" Usually one hand goes up and I doubt the truth of that person. Hee hee. It is NORMAL not to eat many vegetables when you are small. Children have stronger bitter taste receptors than we do. Vegetable can be an acquired taste and texture of food. So your child tastes and feels something you do not when he tries a vegetable. Pushing him to eat it for hours at a table just about guarantees that he will never eat it again. Laura had this happen to her with a lima bean. Pushing is overparenting. Our job is to offer little ones vegetables in small portions. Our job is to put colorful vegetables in line of sight. Our job is to teach them about gardening and health and model eating vegetables. Many of my kids will eat spinach leaves between two Ritz crackers. We make tree sandwiches, we laugh, the crackers makes the spinach/mixed green leaf almost impossible to taste. I model and before I know it, the kids are doing the same. The more we green our lives, the better, but don't be the Green Giant. Don't hover...let eating happen in time. You are investing in your child's future by letting them see, touch, wash, play with, prepare vegetables but the ultimate decision whether or not to eat the vegetable is up to the child. Most kids with help and food education will eat a fruit of some kind or we can make it into a drink/smoothie, dip it in chocolate, etc. Fruit may come first. Don't sweat the veggies.
9) In the beginning, ONLY offer new foods that don't create fear. This is why when Food Chaining that we offer foods that are very, very similar to the foods the child eats currently. Change is gentle. Change is done in this stage to let 'new' =nice. If you offer brussel sprouts as your new food, new=fear. Anxiety is compounded. You are building trust in this stage of treatment. You are breaking old patterns. This is usually done while we implement the other aspects of our care plan.... building advanced chewing/biting skills with chewy utensils, assessing for allergies, treating reflux, treating adenoiditis, post nasal drip and getting the diet in place with the right amount of milk, juice and establishing a feeding schedule. The first foods of Food Chaining certainly are not the last. People who scoff that we offer junk food, do not get it. The child's body must be prepared for eating the more complex foods before offering the more complex foods. This is the training wheels stage of eating. If you can't breathe through your nose, taste and texture perception is way, way off. Super taster adults who are paid to taste food were blind folded and had a clip on the nose. These experts called a bite of egg a marshmallow and a spoon of cinnamon, curry. They did not know what they were eating. They were not comfortable eating. They swallowed air. They lacked the pressures to swallow complex foods. It was hard to eat. Hold your nose and try to eat and drink. Do it right now! It doesn't work. We need to time to treat these issues. The nose is key to success at the table. The first foods are what we set up to help eating get back to normal WHILE we are treating the body. If you don't follow up with the doctor and treatment plan or if your doctor doesn't follow what we suggest (he should as he sent you to us for help in the first place) then the treatment plan has a hole in it and it won't work. The whole enchilada baby. That is the only way. If your child is snoring, has dark circles under his eyes, is a restless sleeper and eats like PacMan (open mouth chewing), he isn't safe to eat baked chicken, roast, steak or other complex foods. You are pushing him beyond his capability. Swallowing disorders? Must be treated. So he IS afraid, respect that no often means 'can't."
10) GI docs are really your friends. (Get the RIGHT doc). Constipation management must be daily. MiraLAX in clear liquids daily, not hit and miss, not in milk. If you can't poop, you reflux more, you feel bad and the GI tract must be healthy. Eczema, red rash, bumpy skin, belly pain complaints, constipation, poor weight gain all have to be treated. If weight is too low, appetite is shut off. If their are vitamin deficiencies food can taste bad. Pediatric GI consults matter and you must follow the treatment plan and let the doctor do his job. Scoping is part of that. If the doctor suspects your child has eosinophilic esophagitis (EoE) your child's health is at risk. We need to find the foods your child's body can tolerate safely. The doctor isn't scoping just to scope, he is scoping for a reason. Let him do his job. You don't have to like your GI, but let him rule out reflux esophagitis, EoE and GI tract disorders. These problems are easy to treat with the right help and your child can feel better than ever before. If the nose and the gut don't work eating won't either. We are not sending you to doctors to just make money, we see patterns from 40,000 feet that tell us you tried to do everything right but your child's body has needs for special diets and to help the tract work right. Kids don't know they feel that bad, they have always felt bad. Eating is not good when you have a GI disorder. Don't overparent and over rule the GI doc....listen and let him do his job and give us the information we need to select the right kind of diet for your child.
11) This is not your fault. Mommy guilt, Daddy guilt is a powerful thing. Now you know, give yourself a break. You found help for your child, just follow the plan. It is a long haul. Be good to yourself. Treatment can help. We have great families that can also help you. Be patient, if your child has a swallowing disorder, your child may need a feeding tube. A feeding tube is a bridge to our goal to help your child eat in part by mouth each day. The tube keeps your child safe and hydrated while we work on building the skills to a level that helps your child eventually not need that support. Some kids always need that support, but they can enjoy tasting and eating too...with the right kind of care and medical management.
12) Be honest, tell us what is working and what is not working, tell us about your good days and bad days, let us go to Plan B is Plan A isn't working. This is your program. We have to hear the truth...good or bad....to help you. We can take it. You are also part of the team. You are the star of our feeding team. If you don't tell me what is wrong, I will assume nothing is. Hope this helps. I have many, many examples of food chains on this site, on Pinterest Food Chaining board, etc....it is about much more than food. Food is the last step. The true obstacles to eating are the nose, the GI tract, a lack of skill, the emotions and fear at the table. Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-88269950392020889012013-08-21T06:04:00.001-07:002013-08-21T06:04:17.790-07:00Pure-A Foods Great Product! Check it out at ASHA 2013<a href="http://www.pure-afoods.com/">http://www.pure-afoods.com/</a> Chef inspired pureed meals. This is a GREAT idea. I can think of many clients this would benefit from my peds kids who cannot transition off baby food to my oncology patients. Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-86807378241657380202013-03-29T04:36:00.001-07:002013-03-29T04:36:09.042-07:00Welcome to Food Chaining! For more on Food Chaining, also visit our Facebook Food Chaining page or check out our Food Chaining book on Amazon.com. For additional information about our approach, you may also enjoy The AutismLife.com or books Brains, Trains and Video Games and Foods, Moods and Isms: Living the Eosinophilic Life by Alicia Hart. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIdj8A5ODkXl5kvAaYv0mSrDrYP1i48BmAG8N8imUdpBHBpvCSiFe9KPTPa8c-Lql999YSuIxDdqjm4urn3TBgYu1vYbXSHUPr3T12uoSmS4c7RbRnl3cccvmUd4gYEXVELdIILWxl9x4/s1600/Joyful+Ewan.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIdj8A5ODkXl5kvAaYv0mSrDrYP1i48BmAG8N8imUdpBHBpvCSiFe9KPTPa8c-Lql999YSuIxDdqjm4urn3TBgYu1vYbXSHUPr3T12uoSmS4c7RbRnl3cccvmUd4gYEXVELdIILWxl9x4/s320/Joyful+Ewan.jpg" /></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-22583718574295677612013-03-29T04:29:00.001-07:002013-03-29T04:37:45.978-07:00Love Me Feed Me...Great book!! Check this out on Amazon.com<a href="http://www.amazon.com/Love-Me-Feed-Adoptive-Struggles/dp/0615691315/ref=sr_1_1?ie=UTF8&qid=1364556038&sr=8-1&keywords=Love+Me%2C+Feed+Me">http://www.amazon.com/Love-Me-Feed-Adoptive-Struggles/dp/0615691315/ref=sr_1_1?ie=UTF8&qid=1364556038&sr=8-1&keywords=Love+Me%2C+Feed+Me</a>
Love Me, Feed Me is a relationship-building, practical guide to help fostering and adoptive families enjoy family meals and raise children who eat a variety of foods and grow to have the body that is right for them. Grounded in science, but made real with the often heart-breaking and inspiring words of parents who have been there, Dr. Katja Rowell helps readers understand and address feeding challenges, from simple picky eating to entrenched food obsession, oral motor and developmental delays, “feeding clinic failures,” and more. Though written primarily for the adoptive and fostering audience, Rowell, aka, the “Feeding Doctor,” shares that her clients are more alike than different. “This book is a distillation of the advice and support I provide all my families as they transform a troubled feeding relationship into a healthy one, and bring peace and joy back to the family table.”Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-21412022801671665542013-03-07T05:54:00.001-08:002013-03-29T04:31:36.153-07:00Copyright and Disclaimer Notice These blog posts/writings are the exclusive property of Cheri Fraker, CCC/SLP and are copyright protected.
This blog may contain suggestions for evaluation and treatment, feeding techniques for 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.
Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-32875024405213765932013-03-06T23:49:00.003-08:002013-03-07T01:19:37.266-08:00Pre-Chaining Therapy: Common Sense Approach to Infants with Oral Sensory Motor Dysfunction (Feeding Disorders)<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmuqBxOnM9ugoAdF_ooRzi0fXUc4TjKypAob6E5hkjhDNa_U7xquoTIBS7yRwH9rL_0Qc2j8dNV-qmLYB-Lo1wKpAqeX4LFyvQD5QKN4bjb2hQ1l6YcG7-spck_DGfA19yNMH17gnC6wU/s1600/Baby+taking+a+bottle.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmuqBxOnM9ugoAdF_ooRzi0fXUc4TjKypAob6E5hkjhDNa_U7xquoTIBS7yRwH9rL_0Qc2j8dNV-qmLYB-Lo1wKpAqeX4LFyvQD5QKN4bjb2hQ1l6YcG7-spck_DGfA19yNMH17gnC6wU/s320/Baby+taking+a+bottle.jpg" /></a> Pre-Chaining therapy in my opinion, is the most important treatment of all the work I do as a feeding specialist. Pre-Chaining is our therapy program to prevent feeding aversion ("Pre-Chaining"because we want to fix problems before Chaining is needed) for infants who are premature, have health issues and/or are at risk for missing the typical developmental transitions of eating (spoon at 6 months, table foods by 12 months, bottle to cup drinking, etc.) There are also more typically developing, term infants who need this type of therapy. Unfortunately, many of the red flags of feeding disorders are dismissed or missed completely. Parents KNOW something is wrong, but they are often told, "he'll outgrow it" or weight is ok, but they know that feeding is very, very 'off' somehow.
I was asked a question about babies and Pre-Chaining therapy. What do I look for and how do I assess/treat? So thought I would share. I look at infants with great care. I try to see everything that contributes when feedings don't work at all or when they start unraveling. I LISTEN to parents concern, if they are concerned, I am even more concerned. They know their baby.
I pray that God gives me eyes that SEE these infants. Each baby is different and I must customize treatment to each baby, but there ARE patterns. I will try to explain what I look for...so, here goes...
Therapists...do you know how to diagnose and treat "<i>oral sensory motor dysfunction</i>" in infants? Yes, oral SENSORY MOTOR dysfunction, NOT oral motor sensory. Do you know what this is? I use this term for infants as I develop a comprehensive treatment plan. I am trying to help the infant who struggles severely to feed in a safe, coordinated, calm manner. What problems do I see that would fall under oral sensory motor dysfunction? (What infants have "OSMD"-if you will). Infants who struggle to tolerate a bottle nipple and can only breastfeed. The baby may simply not seem to know how to bottle and/or spoon feed and may only have one source of nutrition via breastfeeding. All attempts to feed in a different manner from breast are unsuccessful and stressful. Infants who have state regulation issues...('colic' symptoms, poor transitions in state) Infants who then struggle to move on to cup or spoon... who tolerate only one or two flavors of baby food. Infants who can feed only in a sleep state. Infants who gag severely with bottle nipple presentation or cannot tolerate a pacifier, distressed, hyperalert infants who also have sleep issues AND add to that mix, in some babies, there is also the gradual pulling away from feeding due to allergy (eczema, bumpy skin, increasing aversion, GI changes-constipation, gassiness and vomiting). NOT to mention, choke, cough, watery eyes, oral spillage, gulpy swallows and the whole dysphagia presentation....
I believe when the baby struggles so much to eat, whether they have one or two of the above symptoms or all of them, it results in a cascade of events, in which the baby is taken out of the realm of achieving successful feeding. It is like dominoes that will not fall...there is no timed, ordered sequence to feeding, there is no reliable motor plan, the infant cannot find a place to fall into an organized state and feedings don't work. Feedings are chaos. This creates anxiety and in some cases, justifiable panic for the parents, further disrupting the feeder child relationship-interaction. The parent or the therapist (please don't do this!!) may choose a high flow nipple to try to 'get the feeding down' and this opens up an entire Pandora's box of ADDITIONAL problems (fatigue, aerophagia, pharyngeal-nasal backflow, laryngeal penetration and even aspiration).
When these feeding problems happen in infancy, you do not have a BEHAVIORAL feeding disorder. The infant cannot CHOOSE not to eat. It is beyond their cognitive capability. These issues mean there is a physical oral sensory motor biobehavioral problem that changes feeding behaviors. Behaviors grow out of these issues.
If that wasn't enough of a problem there are also some babies who have an anatomical problem as well (vocal cord dysfunction, paralyzed cord, laryngeal cleft, undiagnosed dysphagia) or physical challenges (tone, torticollis, developmental, cardiac or genetic disorders). So you have this long laundry list of challenges to overcome at feeding times...8-12 times per day in early infancy. The infant never experiences normal feeding. What happens is, "it hurts, it is scary or I can't breathe....therefore I eat like this"...as the baby does not experience what is typical feeding, therefore the baby does not learn feed in a typical manner.
I would love to hear input from others in speech and occupational therapy, parents and other professionals But this is how I see this, how I treat it and how I watch these kids carefully because in my opinion, many of them become the older children with severely selective eating and feeding aversion.
Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-90572856837524227022012-12-06T16:59:00.001-08:002013-06-01T19:54:53.222-07:00Funbites.comhttp://www.funbites.com/<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSVn-8kQW7cp4IbQDqMVjjQAqIZHdE8jqMlgifbeoD7ovJjT9BhJCiVmXry_gWR6UmLT8H-pwSgH25QrTa3L4vDYkF4ZH4LZu8QZXPSRxnxP9ZjLc0HvIPkM2aK4L6ahlRr6VX7nYEP4A/s1600/Funbites+picture.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSVn-8kQW7cp4IbQDqMVjjQAqIZHdE8jqMlgifbeoD7ovJjT9BhJCiVmXry_gWR6UmLT8H-pwSgH25QrTa3L4vDYkF4ZH4LZu8QZXPSRxnxP9ZjLc0HvIPkM2aK4L6ahlRr6VX7nYEP4A/s320/Funbites+picture.jpg" /></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com6tag:blogger.com,1999:blog-7001756432579065882.post-1553694290161145042012-09-19T04:25:00.000-07:002012-09-19T04:25:10.787-07:00Simply Thick recall for ALL infantsSimply Thick has been recalled for all infants. Go to my Facebook Food Chaining page for many suggestions and feeding products to discuss with your physician and feeding specialist. Infants on thickened feedings will need to be re-evaluated and new treatment plans developed. Discussions with your pediatric GI, pediatrician, otolaryngologist, dietitian and speech pathologist will be needed to form a safe new plan to protect your baby's lungs and maintain safe nutrition. <a href="http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm256250.htm"></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com2tag:blogger.com,1999:blog-7001756432579065882.post-67913204299465932252012-08-03T05:50:00.001-07:002013-03-08T04:09:24.143-08:00Interested in One of Our Feeding Courses for your facility? If you ask us, we will come....LOTS of continuing education courses out there and we try to give you our very best each time. We don't teach the same course the same way twice and search for new information, pictures, case studies, research studies and look for new ways to give you handouts, links, blogs that can provide quick references for your busy days.
Studies reveal that we only process and keep about 20% of the information presented at a course taught in a traditional manner. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOTDCkZhkwwncFgtKJAN7H5yn0RAUPnYblnJXujWeDVhnUkL0SRX6HoVzEDNehRbuvFxJ0MDWbWubJVVbCOaRwC-tWdsAB5qdRF5K6_8fA4v8ggURO0mWRILEqvgvq6RZKjAbye5jJlbQ/s1600/IMG_0360.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOTDCkZhkwwncFgtKJAN7H5yn0RAUPnYblnJXujWeDVhnUkL0SRX6HoVzEDNehRbuvFxJ0MDWbWubJVVbCOaRwC-tWdsAB5qdRF5K6_8fA4v8ggURO0mWRILEqvgvq6RZKjAbye5jJlbQ/s320/IMG_0360.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhh5CQsLL0UUJ8dwnfhFwD7bZOsSVfFiOiS1UIIjlTZPYKu1ioqW3K6mblFFjHqVwu1JMvmlZLm4NKHIzGsLdmayIXGI6fM9qDQbqOPp8mmQZYRnDNzKCBEBpBpbiV49rgmK9RPMCeUdOM/s1600/IMG_0363.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhh5CQsLL0UUJ8dwnfhFwD7bZOsSVfFiOiS1UIIjlTZPYKu1ioqW3K6mblFFjHqVwu1JMvmlZLm4NKHIzGsLdmayIXGI6fM9qDQbqOPp8mmQZYRnDNzKCBEBpBpbiV49rgmK9RPMCeUdOM/s320/IMG_0363.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZ7QZDgtC_r1f2EG9-zIlnPvUj36v6zCqmHbyNwaoh1nVtVocMw8YiD1j4_Dv5HlD4gfhGDWrQrdYvOQqheFjIS3yAglAidbgjZYTosZj9tqz-1gpyFukyjGxL_pLeHaax7BtPlMgEQzg/s1600/IMG_0354.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZ7QZDgtC_r1f2EG9-zIlnPvUj36v6zCqmHbyNwaoh1nVtVocMw8YiD1j4_Dv5HlD4gfhGDWrQrdYvOQqheFjIS3yAglAidbgjZYTosZj9tqz-1gpyFukyjGxL_pLeHaax7BtPlMgEQzg/s320/IMG_0354.JPG" /></a> I have written an educational guide (a minibook) to go along with the course instead of just a handout of slides. This includes information on PreChaining, Food Chaining, aspiration, health consequences, a cranial nerve oral motor evaluation, research studies, nutrition guides for babies and kids, formula/supplement guide, reading list, sample report, etc. The powerpoint is primarily pictures and video, improving the learning process significantly. We offer a variety of courses and can customize a course to a facilities request if needed. We offer an advanced, updated <i>"Feeding Therapy from NICU to Childhood"</i> course with big emphasis on dysphagia. We are trying to give you our very best. So now we have the <i>peds GI baby course</i>, <i>ENT/Dysphagia/PreChaining </i>course, <i>RD course</i>, <i>NICU</i> course, <i>Chaining I, Chaining II, Dealing with NO Best of Both Worlds Chaining and Get Permission, Advanced Chaining, Advanced NICU to Childhood, What To DO How When and Why to Do It course and T is for Treatment</i>. We speak at state conventions or teach 1-2 day lectures. Love suggestions too, so feel free to message me about what you would like to see as I develop our fall courses.
Thank you to all who have attended any of our <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiU6_qe10OKb35nel_DR04wnBgWtarmT8xf302mPn892HOJXQ1t__777qci0LmJpr-CLIQS5dOzuFOZAg7RUBQEuuOeAJbEF0SgbRAeDk7h86P6j4ZpDI4dfqtir8sHCE5ilfj61TCUk98/s1600/IMG_0154.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiU6_qe10OKb35nel_DR04wnBgWtarmT8xf302mPn892HOJXQ1t__777qci0LmJpr-CLIQS5dOzuFOZAg7RUBQEuuOeAJbEF0SgbRAeDk7h86P6j4ZpDI4dfqtir8sHCE5ilfj61TCUk98/s320/IMG_0154.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXscNLnYgAS2WcL7WhIldNriEwzjTjSoi6fQ-5K47jchGVuYmnsiRZx5bmF3ckUbMMTYA67ykWqam0BHACG2_g0ejFyLomC-ra6Q8TN8e0Gy2si4dRFQMoxGRh90VuHJ0UR3-M7XfuCc0/s1600/IMG_0155.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXscNLnYgAS2WcL7WhIldNriEwzjTjSoi6fQ-5K47jchGVuYmnsiRZx5bmF3ckUbMMTYA67ykWqam0BHACG2_g0ejFyLomC-ra6Q8TN8e0Gy2si4dRFQMoxGRh90VuHJ0UR3-M7XfuCc0/s320/IMG_0155.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeU7_q2w-UTx8oj3Fo0uWjaYx3V7WXMpvRubxLvHQ_2PZjr40E-boUFUjZTJoYXRUASZNy3BDxtPwFZ6FQFun_h_Xq2TbwmJE8y7v7qc7rg0IaT0n7vewbwsY_kpO-2LOo8v1R6hTUiuQ/s1600/IMG_0156.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeU7_q2w-UTx8oj3Fo0uWjaYx3V7WXMpvRubxLvHQ_2PZjr40E-boUFUjZTJoYXRUASZNy3BDxtPwFZ6FQFun_h_Xq2TbwmJE8y7v7qc7rg0IaT0n7vewbwsY_kpO-2LOo8v1R6hTUiuQ/s320/IMG_0156.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivJbbbJhXsHmsuf8gCV_XBntsEcKifB8Za-ufxn6xiTE451_F-VtO4-l9rNw_o_jebI3soLyDkEUHB4Q0Xchz2AcJ4qS5EIdks8cSECz5_zhu-W2qBTxk1L9XiyaJ5ZbwwVpORl9rDi7o/s1600/IMG_0159.JPG" imageanchor="1" ><img border="0" 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src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbnIjAVsCRTIyWrrgNH5VEI4bl8pLjaGuBQkPInjxHGwQz3cuD5fyHYljNia3MohvALusP4DSJulzEtp9zCUl_gVElhFrAMPDgj57VkACicEpT2hLM1UfhGPVnjw93xAOhJj8LQWpy58E/s320/IMG_0231.jpg" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvlb2I6BCce3zpc5ycB95l0LrxqPhSc2VtdbwXb2jzkxfiizP3y7ALE5MqrQLn4jXqYemPi6xi5qmJKpT-gTyLljCiEUfVwuIUR5K0z1aaJDQV4yIttSGQioBpneq_wg3vWzkcIa9gbZI/s1600/IMG_0254.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvlb2I6BCce3zpc5ycB95l0LrxqPhSc2VtdbwXb2jzkxfiizP3y7ALE5MqrQLn4jXqYemPi6xi5qmJKpT-gTyLljCiEUfVwuIUR5K0z1aaJDQV4yIttSGQioBpneq_wg3vWzkcIa9gbZI/s320/IMG_0254.jpg" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhi2bBtSu3HZvONhF3fmGxMja8mTuoZ-UEGs2sR8u7fcS4sbK-AWpbQIMwGoRp-v_IDZarkr9iYRcpp7_vMqzRnHnplrOIpCOzfnUOHqzRpcH5XfpZqdXO11xIx84DCemZUqVkZc-msM30/s1600/IMG_0353.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhi2bBtSu3HZvONhF3fmGxMja8mTuoZ-UEGs2sR8u7fcS4sbK-AWpbQIMwGoRp-v_IDZarkr9iYRcpp7_vMqzRnHnplrOIpCOzfnUOHqzRpcH5XfpZqdXO11xIx84DCemZUqVkZc-msM30/s320/IMG_0353.JPG" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiABvZUs2uvuudsCKLCMIPyfWJkdwVPDS1ju2OdiObuCtOgx9d-AS7ACQq3gMFV6aiJrTEL3uzD3C_tQ450VwWlUM7xD0oSlic4bbv_ElyDkvcWuX2Q2WOIwtPdvuPOv7-PiTO3MwTBli4/s1600/IMG_0355.JPG" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiABvZUs2uvuudsCKLCMIPyfWJkdwVPDS1ju2OdiObuCtOgx9d-AS7ACQq3gMFV6aiJrTEL3uzD3C_tQ450VwWlUM7xD0oSlic4bbv_ElyDkvcWuX2Q2WOIwtPdvuPOv7-PiTO3MwTBli4/s320/IMG_0355.JPG" /></a>courses too! We LOVE teaching and making new friends!
Here are comments from course reviews for our Chaining courses last year:
Extremely valuable information….wonderful presenters, loved having the physician info…“ (OT)
“The presentation style was effective and easy to follow!“(SLP) “I have been to a lot of courses and this one is the very best, practical and full of helpful tips!“ (SLP)
“Including the MD was a real bonus – thank you!“ (SLP-OT)
“I look forward to taking more of your courses & will recommend to co-workers.“ (SLP)
“The course was well designed, balancing medical, motor, sensory needs & the food chaining method. Thanks so much! “ (OT)
“Loved the videos on what to do and what not to do! That was very beneficial.“ (RD)
“Wow, this course really helped me and will be invaluable when I return to work on Monday.“ (SLP)
“I am really glad I came to this…should have brought the whole team!“ (OT)
“I have been counting down to this conference for months and it did not disappoint!“ (SLP)
“Well organized and put together, thank you for a wonderful experience.“ (PT) “A wonderful presentation…..“ (SLP)
“This course was worth every penny I spent for it.“ (RD)Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com14tag:blogger.com,1999:blog-7001756432579065882.post-1286915577018304642012-08-03T05:30:00.000-07:002012-08-03T05:32:50.292-07:00Go to Our Food Chaining Facebook page for more food ideas/photos<a href="https://www.facebook.com/pages/Food-Chaining/127078483991561"></a> I have been really busy these days and updating the Chaining Facebook page is really quick. So don't miss out on tips and suggestions (great discussions too)on the Food Chaining Facebook page. https://www.facebook.com/pages/Food-Chaining/127078483991561 or just google search Food Chaining Facebook or my name and it comes up!Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-30272237806672129172012-06-21T09:25:00.001-07:002012-06-21T09:27:51.635-07:00Do Food Chaining the RIGHT way...Just read on a message board that Food Chaining means taking the child who only eats Mac and Cheese and making him eat other types of Mac and Cheese. Sigh....Now, why in the world would I want to expand to MORE Mac and Cheese? People don't get it and I hope posts like these help. It is not linear, it is not imposed on a child, it is about building success and joy at the table and taking away fear and nausea.
So as for the Mac and Cheese Child, I would leave that food alone but take the cheesy flavor and expand it to other foods and textures or take the pasta and add the same cheesy flavor and expand it. Could I help him LEARN to explore new foods with his senses and eventually eat cheese pizza or quesadilla?
OR I might take the Kraft Macaroni and Cheese powder and make as they normally prepare it but add one different pasta noodle to it (Sponge Bob, etc) and try to find the "prize" (different noodle) on one of the family members plates. Food should be fun! See the difference between completely changing the food item and sliding it in front of the child. A change like this = a meltdown and a big NO for all your efforts.
OR I might explore cheese + salsa with salsa as his first ever vegetable. I would also instead TEACH the child about new foods and flavor families in dry cereals, breads/grains, crackers, chips and maybe work that salty preference toward nuts as a protein source.
It is different child to child. It is about respect and understanding normal kid eating. Most of us don't eat a wide range of veggies until late teens or adults. Can we change the texture to a tolerated texture and build the flavor families. Can we modify and make fruits and vegetables in a format that the child can learn to love. Spinach leaves rock when dipped in garlic salt or ketchup or chocolate sauce-depends on the child. Dry dips and wet dips can help many children. Vegetable chips, sweet potato fries work for some but not for others. It isn't a protocol it is a process. Don't make chains that bind, write chains that free children. Love you all. Happy Chaining! Get the message out there!Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com2tag:blogger.com,1999:blog-7001756432579065882.post-75289443268917289342012-06-02T09:40:00.000-07:002012-06-02T09:40:05.644-07:00Visit us on Facebook or Twitterhttps://www.facebook.com/pages/Food-Chaining/127078483991561 Check out our Facebook Fan Page or Food Chaining on Twitter.Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com1tag:blogger.com,1999:blog-7001756432579065882.post-33904055239394254882012-05-11T12:36:00.001-07:002013-03-07T16:37:01.882-08:00What's Up Doc? Important Medical Journal Articles for the feeding therapist<b>What’s Up Doc?
An Overview of Medical Journal Articles</b>
<i>Physician-based research studies are included for the therapist to share with medical staff and these references can also be used to justify treatment plans when dealing with insurance companies. Our physicians have requested journal articles addressing feeding therapy and these are some excerpts of the best articles we have found.</i> 1) “Feeding disorders are common in early childhood, with the reported incidence of minor feeding problems ranging between 25% and 35 % in normal children and with more severe feeding problems observe<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMThfbhEncNpaKmpDximExyyGV_wljKxfskGAJj-kXCaucL3PeMskgR-c4bXgDlX03R072-UeYZYdCUs48HIkoq0VlEmzJl_yNhqAu-Je5G8tbSJY1TR67FogOEJnHVg-nfeNgHM2ECLE/s1600/Doctor.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMThfbhEncNpaKmpDximExyyGV_wljKxfskGAJj-kXCaucL3PeMskgR-c4bXgDlX03R072-UeYZYdCUs48HIkoq0VlEmzJl_yNhqAu-Je5G8tbSJY1TR67FogOEJnHVg-nfeNgHM2ECLE/s320/Doctor.jpg" /></a>d in 40% to 70% in infants born prematurely or children with chronic medical conditions. Symptoms of feeding and swallowing disorders in children have many manifestations and clinical presentations including food refusal, failure to thrive, oral aversion, recurrent pneumonia, chronic lung disease or recurrent emesis. Anatomic or functional disorders that make feeding difficult or uncomfortable for the child may result in a learned aversion to eating, even after the underlying disorder is corrected. Delays in the initiation of feeding may affect the normal acquisition of feeding skills. The complexity of the feeding process and multiple interacting factors that affect the acquisition of feeding skills make the diagnosis and treatment of feeding disorders particularly challenging and complicated."<i>Rudolph C, Link D: Feeding Disorders in Infants and Children. Pediatric Clinics of North America. Volume 49, number 1, February 2002.</i>
2)"Observation of a feeding session by experienced occupational therapists, speech pathologists, psychologists, and nurses often provides tremendous insight into the underlying feeding problem. Positive interactions between the child and parent, such as shared eye contact, reciprocal vocalizations, praise and touch, or negative interactions, such as forced feeding, lack of conversation, eye contact or touch, threatening, bribing, and inconsistency are noted. Observations of the child's responses to offered foods, including disruptive behaviors, such as turning the head away from food or throwing of food, provide valuable information. These observations highlight primary or secondary behavior problems that allow for future structuring of appropriate behavior treatment interventions."<i>Rudolph C, Link D: Feeding Disorders in Infants and Children. Pediatric Clinics of North America. Volume 49, number 1, February 2002.</i>
3) "A study of children with special health care needs in Washington State found that <b>nutrition or feeding-team intervention for disabled children who had slow growth or failure to thrive improved dietary intake and adequacy in all of the children who had inappropriate or inadequate intake, decreased illness and hospitalization, improved feeding skills, improved feeding behavior, decreased constipation, and enhanced developmental feeding progress. Estimated medical cost savings achieved by providing nutritional or feeding team services ranged from $180 to $5000 per year, per child. </b> Optimally, the team should include the disciplines of speech pathology, occupational therapy, psychology, nutrition, gastroenterology, and otolaryngology for the core evaluation. Support from other specialists in radiology, social services, child life, neurology, and pulmonary medicine often is used. An interdisciplinary evaluation facilitates integration of expertise from different disciplines to provide insight into the various factors that interact in contributing to the child's swallowing disorder and overall health."<i>Lucas B, Nardella M, Feucht S: Cost considerations: The benefits of nutrition services for a case series of children with special health care needs in Washington State.Dev Iss 17:1-4, 1999.</i>
4) "A child may refuse to eat even after an underlying anatomic abnormality has been corrected due to a learned aversion to feeding. Behavior therapy often can overcome this type of "conditioned" food refusal. Various therapeutic approaches may improve the efficiency and safety of feeding. <b>These include changing the texture of foods, pacing of the feeding, changing the bottle or utensils: and changing the alignment of the head, neck, and body with feeding. One small study showed that the systematic presentation of food in a consistent manner improved feeding skills in some children even with neurologic impairments. "</b> <i>Babbitt RL, et al: Behavioral assessment and treatment of pediatric feeding disorders. J Dev Behav Pediatr 15:278-291, 1994</i>
5)"In children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status. These data also indicate that decreased morbidity (reflected by a lower acute care hospitalization rate) may be related, at least in part, to successful management of feeding problems. Our results emphasize the importance of a structured approach to these problems, and we propose a diagnostic and treatment algorithm for children with developmental disabilities and suspected feeding disorders. Children with developmental disabilities are at increased risk for developing feeding-related difficulties, including gastroesophageal reflux, oral motor dysfunction, pharyngoesophageal dyskinesia, and aversive feeding behavior. If not adequately treated, feeding disorders may result in additional complications including esophagitis, reactive airway disease, aspiration pneumonia, and bedsores. Previous reports indicate that enteral feeding regimens for nutrition support in developmentally disabled children improve overall nutritional status."<i>Schwarz S, Corredor J, Fisher-Medina J, Cohen J, Rabinowitz S: Diagnosis and Treatment of Feeding Disorders in Children with Developmental Disabilities. Pediatrics Vol 108, Number 3, Sept 2001.</i>
6)"At each stage of development, the infant nervous system is primed to acquire new motor skills. <b>A lack of feeding experience during these "critical periods" of development results in great difficulty mastering the skills later in life; infants may not be able to eat orally for the first months of life may learn how to spoon- and cup-feed without ever learning an effective nutritive suck and swallow. </b> Development of the oral phase requires normal anatomy, intact sensory feedback, and normal muscle strength and coordination. Children with neuromuscular disorders often present initially with poor feeding skills in infancy."<i>Rudolph C, Link D: Feeding Disorders in Infants and Children. Pediatric Clinics of North America. Volume 49, number 1, February 2002.</i>
7)"Specific feeding aversions have been observed in children after cancer chemotherapy and in children with metabolic disorders that result in discomfort after ingestions of specific foods. More generalized feeding aversions develop if an infant aspirates or chokes during feeding or experiences pain in temporal proximity to feeding. Infants who have experienced prolonged airway intubation or tube feeding often have learned that any efforts to approach their mouth or face will result in discomfort from airway suctioning, tape removal, or tube manipulation. Therefore they resist efforts to approach their mouths. When they are able to eat, this "oral aversion" must be gently extinguished."<i>Rudolph C: Feeding Disorders in Infants and Children. Journal of Pediatrics 1994;125:S116-24</i>
<b>Medical journal excerpts are included for the therapist to share with physicians. Our physicians have asked us for physician-based research on feeding therapy, infant swallowing and modified barium swallow studies. We feel these articles will be useful to other therapists working in high-risk nurseries and pediatric units, so we included them at the beginning of chapters for a quick and easy reference. </b>
8) "<b>Coordination of the oral and pharyngeal phases of swallowing is essential for prevention of aspiration. During swallowing, respiration ceases and the pharynx is cleared before respiration resumes. If either of these protective mechanisms fails, aspiration of milk can occur despite anatomic protection. </b>If there is a lack of relaxation of the upper esophageal sphincter (cricopharyngeal achalasia) the pharynx will not be cleared and aspiration may result. Similarly, if inspiration occurs during the swallow, aspiration may result. Coordination of swallowing and breathing is particularly challenging in the infant in whom the respiratory rate is relatively high. During vigorous sucking and swallowing, as occurs early in a feeding session, there is often a significant reduction in minute ventilation with mild hypoxia, even in normal infants; patients with compromised cardiac or respiratory function often have serious difficulties with hypoxia during the feeding. In the preterm infant, the coordination of sucking, swallowing and breathing is not fully mature. Preterm infants tend to hold their breath for several seconds, during which time a number of sucks and swallows occur. This pattern of multiple swallows without respiration decreases with increasing postconceptual age."--<i>Hanlon MB, et al: Deglutition apnea as indicator of maturation of suckle feeding in bottle-fed preterm infants. Dev Med Child Neurol 39:534-542, 1997</i>
9)"<b>Any patient with aspiration in addition to a significant feeding disorder with clinical findings suggestive of cranial nerve IX or X involvement should undergo MR imaging to diagnose brain stem, skull base, or spinal problems that can interfere with swallowing, such as a Chiari malformation. </b> MR imaging of the chest is useful in patients suspected of having a vascular ring/sling cause for stridor or dysphagia. Chest CT scanning may be particularly useful to assess the severity or progression of chronic pulmonary disease, which affects decisions regarding feeding safety. GI endoscopy may be useful in selected cases to rule out strictures, webs, or inflammatory lesions definitively in the esophagus and stomach, but it is generally not a substitute for radiologic evaluation."<i>--Rudolph C, Link D: Feeding Disorders in Infants and Children. Pediatric Clinics of North America. Volume 49, number 1, February 2002</i>
<b>Volume 120 Number 4 October 2001 Copyright 2001 American College of Chest Physicians</b>
10) Summary: Objective of article was to describe 13 neurologically normal infants with chronic respiratory symptoms who had swallowing dysfunction with silent chronic aspiration without gastroesophageal reflux as the cause of their respiratory symptoms. Isolated swallowing dysfunction and aspiration without GER in neurologically normal infants have not been widely reported. Study was completed as a retrospective chart review. 112 otherwise healthy patients referred for respiratory symptoms underwent pH studies and videofluroscopic swallow studies. Symptoms included recurrent wheezing and intermittent stridor. Ten of 13 infants had spitting and/or choking episodes with feeding. All had normal pH monitoring and abnormal VFSS. Aspiration noted on thins, but 6 patients also aspirated on thick consistencies. No structural anomalies. Nine infants treated with thickened foods, four oral feedings were stopped, three had nasojejunal feeding and one gastrostomy feeding. VFSS repeated every 3 months. In all infants, swallowing dysfunction resolved in 3 to 9 months.Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-1041199955038613812012-05-08T01:07:00.002-07:002012-05-08T01:07:22.503-07:00<div class="separator" style="clear: both; text-align: center;">
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Dr. Fishbein and his daughter went on a mission trip to the Ukraine. The Chaining book was translated for his trip. He presented Laura, Sibyl and I with a copy as a surprise last weekend at the Chaining II course. Check it out!Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-18900144227905245022012-05-08T00:22:00.001-07:002013-03-07T16:32:50.776-08:00I Speak Sensory, Do You? Link on info about Sensory Processing Disorder<a href="http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html"></a>
As I am an adult with sensory processing disorder, I am very interested in helping kids who struggle with sensory issues at the table, at school, on the playground and in the community. SPD is a very real issue and often mistaken for ADD or ADHD, though there are children who have both. The books <i>Out of Sync Child </i>and <i>Out of Sync Child Has Fun </i>by Carol Stock Kranowitz are also great resources for physicians, therapists and families. http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtFVZsXPDizZCpyqeZNeOPzt6Z8j52r7I5Cv8Sv8JVsdpo6FzA79BOC-CfE7KrFLUqMjKDr2VJOo2sMPHpT0wZicxXj5sQpX6zyHSW_1zaiyU_nw9Xu4I88UkKZf17f-Y5IUWYqtoXP58/s1600/IMG00024-20090116-1241.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtFVZsXPDizZCpyqeZNeOPzt6Z8j52r7I5Cv8Sv8JVsdpo6FzA79BOC-CfE7KrFLUqMjKDr2VJOo2sMPHpT0wZicxXj5sQpX6zyHSW_1zaiyU_nw9Xu4I88UkKZf17f-Y5IUWYqtoXP58/s320/IMG00024-20090116-1241.jpg" /></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-81133869439288799702012-05-08T00:16:00.002-07:002013-03-07T16:27:20.040-08:00Flavor Masking and Dips with Alicia Hart<a href="http://www.youtube.com/watch?v=kAZBoK5PcBI"></a>
Dips are a great way to help kids learn to eat new foods. Flavor masking is a technique in Food Chaining therapy. Here is our lovely friend and Chaining Mama, Alicia Hart talking about how to use dips to expand a child's diet.
http://www.youtube.com/watch?v=kAZBoK5PcBI<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM8ohe1J8Mc0Ye41r8Ke-XlculOD3jL7f1Mx7yburJfyem87aVdDZBjs3vumpzE3roZi4jcTYgWEZiEJhrwjoG8vt824LdwtiVBblIOc9PtI4P66Gxsy8iB1rezdqKj3NKklVmZfi8TE4/s1600/chocolate-fondue_k0911667(2).jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM8ohe1J8Mc0Ye41r8Ke-XlculOD3jL7f1Mx7yburJfyem87aVdDZBjs3vumpzE3roZi4jcTYgWEZiEJhrwjoG8vt824LdwtiVBblIOc9PtI4P66Gxsy8iB1rezdqKj3NKklVmZfi8TE4/s320/chocolate-fondue_k0911667(2).jpg" /></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-74110908669251675622012-05-08T00:11:00.002-07:002013-03-07T16:32:01.794-08:00Bento Boxes: Laptop Lunches<a href="http://www.bentonbetterlunches.com/2012/03/springy-sassy-box-bentos.html"></a> Love this website and it is a great visual for kids. Think about how much a menu with pictures in a restaurant helps us select and prepare to eat food. This is a great way to keep food separate and present it to children. Great for teens and adults too!
http://www.bentonbetterlunches.com/2012/03/springy-sassy-box-bentos.html<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO5QXczbBsSFDcs9JLDYliELXifvlAlZDxL0U0_kN7cd-UjGYAxX9IZF-kPeLWo7vGPLackNQLOXKjTxJ3v6rLAP0m9HbPutuqUmhoUdz7NRjuJ5o32CZ66XlG-wsvAB_MELsJQ0uxKyI/s1600/Bento_038_20052008.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO5QXczbBsSFDcs9JLDYliELXifvlAlZDxL0U0_kN7cd-UjGYAxX9IZF-kPeLWo7vGPLackNQLOXKjTxJ3v6rLAP0m9HbPutuqUmhoUdz7NRjuJ5o32CZ66XlG-wsvAB_MELsJQ0uxKyI/s320/Bento_038_20052008.jpg" /></a>Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0tag:blogger.com,1999:blog-7001756432579065882.post-59998306213366277572012-05-08T00:05:00.001-07:002012-05-08T00:35:27.459-07:00Radiology Assistant...my Favorite Dysphagia Website<a href="http://www.radiologyassistant.nl/en/440bca82f1b77"></a>
Great link here to watch and analyze swallow studies step by step! Check it out! http://www.radiologyassistant.nl/en/440bca82f1b77Food Chaininghttp://www.blogger.com/profile/08611426780200539931noreply@blogger.com0