Posted on Leave a comment

Practical strategies for parents and teachers when supporting a child who is struggling to eat

Once we understand the many reasons a child in our care may struggle to eat, and we understand that selective eating may be a red flag for an underlying neurodevelopmental or sensory integration difference. Then as caregivers, we ask what can I do next? Which practical strategies can I use at home or in school to support a child who is struggling with eating?

The first and most important step is to have a child evaluated by a trained and registered medical professional, it is important to rule out medical conditions. A specialist speech and language therapist will be able to check that a child can swallow safely.

An occupational therapist can assist with feeding and eating difficulties because both feeding and eating are occupations, and so this is their area of expertise. The therapist might look at how eating can be broken down into smaller easier steps that a child can manage, or suggest that you change something in the environment such as finding more suitable seating, reducing noise, smells or distractions. An occupational therapist with post-graduate training in Ayers’ Sensory Integration will be able to both assess and treat any underlying sensory integration and processing difficulty which can be interfering with eating. In this post-Kath Smith (OT) talks about how a child’s gross motor movements, seating and posture can interfere with eating, and how these can be addressed by an occupational therapist.

But what next? what can we do at home and in school to support therapy? How can we transfer the things we have learned from the therapist to our own environments and to the (at least) 6 opportunities a day we get to interact with our kids to support them to become confident, adventurous eaters.

Here are some of the strategies we have tried, every child is an individual and so some ideas will work and some won’t. I also say, its best to take baby steps in the right direction, big changes that happen quickly are not helpful for anxious children. Just make one small change, as they say, Rome was not built in a day!

  1. Keep an open mind, Listen to what the occupational therapist is saying, you are the expert in your child, but she is the expert in supporting our kids to overcome the difficulties they face. It is very likely that your therapist has seen and treated other children with similar issues before. This works best when we collaborate.
  2. Ditch the rewards, punishments and star charts.
  3. Think about seating
  4. Reduce sensory overload from the environment
  5. Reduce stress and pressure
  6. Pick your battles
  7. Use a visual support
  8. Try to understand how your child views food
  9. Make it fun
  10. Serve a buffet
  11. Model Model Model…

For more ideas have a look at these blogs and websites

From the Empowered Educator – 15 Strategies to encourage SPD toddlers to eat!

From Ellyn Satter Institute – The Division of Responsibility in Feeding 

Posted on Leave a comment

Best Practice Guidelines? Analysing Novak and Honan (2019)

Novak and Honan (2019) published a paper in the Australian Occupational Therapy Journal which has caused controversy, which was discussed in an earlier Sensory Project blog post: https://sensoryproject.org/novak-and-honan/.

Particularly upsetting was a traffic light system which indicated that sensory integration therapy is a red light (or do not do) intervention but that ABA (short for applied behaviour analysis) could be viewed as a green light (or can definitely use) intervention.

This is especially concerning as ABA has been linked to PTSD. Testimonials from those who have had ABS therapy have told us about the negative affect they have found this therapy has had on their lives.

Recently, the US Government has issued a report worth sharing that adds further information about ABA and it’s usefulness, which is in contrast to Novak’s article. The report, about comprehensive autism care, found that at best ABA does not change symptoms and at worst, ABA worsens them: https://www.altteaching.org/us-government-reports-that-aba-doesnt-work/

We are keen to hear your thoughts about the Novak’s article and the traffic light system. Follow the link below and join the discussion:

https://forms.gle/5rjeRKTVYzhwBHiGA

Posted on Leave a comment

Research Update: Examining overlap and homogeneity in ASD, ADHD, and OCD: a data-driven, diagnosis-agnostic approach

“Our results motivate a paradigm shift to challenge how ASD, ADHD, and OCD are currently defined, diagnosed, and treated. In particular, this paper adds to the evidence that these diagnoses may not exist as uniquely-defined diagnostic constructs, and highlights the need to discover other groupings that may be more closely aligned with biology and/or response to treatment.”

So, this study by Kushki et al 2019 is by no means simple. However, the results support our clinical experience of the overlap and common features seen in practice. We see similar overlap is the assessment data we gather, particularly when we SIPT our clients with these diagnoses. The study uses state of the art technology and research methodologies, statistical calculations, and techniques I had never heard of. I had to look them up. However, the research appears to support what we see in clinical practice. I look forward to reading more by these researchers in Canada.

“…we used a data-driven, diagnosis-agnostic approach to examine overlap across three neurodevelopmental disorders (ASD, ADHD, and OCD)…we observed that differences in the domains primarily affected in these disorders may exist along a continuum that includes typical development.”

“The majority of the data-driven clusters contained participants from multiple diagnostic categories, highlighting shared phenotypes and neurobiologies among the diagnostic groups.”

“Social difficulties and inattention are commonly reported as shared features of ASD, ADHD, and OCD….our results support the emerging recognition that the existing behaviorally-defined diagnostic labels may not capture etiologically, biologically, and phenomenologically homogeneous groups.

“…our results are consistent with the notion that that the ASD-like features, and to some extent inattention traits, exist across a continuum that includes typical development”

Read more here: https://www.nature.com/articles/s41398-019-0631-2

Posted on

More exciting research: ASI, Autism and the neuroscience revisited.

Read the full article here: https://www.mdpi.com/2076-3425/9/3/68/htm

Posted on

ASI and Supporting Parents of Children With Autism: The Role of Occupational Therapy

“…When creating an intervention plan, occupational therapy practitioners evaluate children with autism using observation and parent and teacher reports and also interview parents about their child’s relationships and eating, self-care, and daily living skills…”

Ayres Sensory Integration intervention is one of the most frequently requested and highly utilized interventions in autism. This intervention has specific requirements for therapist qualifications and the process of therapy. This systematic review of studies providing Ayres Sensory Integration therapy to children with autism indicates that it is an evidence‐based practice according to the criteria of the Council for Exceptional Children.” Schoen et al 2018 read more here

National Autistic Society in the UK explains Why is occupational therapy important for autistic children?

Occupational therapy using an Ayres’ Sensory Integrative approach – research supports the use of Ayres’ Sensory Integration, not just for Autism but also for other neurodevelopmental difficulties. See ASI 2020 Vision Goal 1 – Scholarship recent research and FB Group Evidence ASI

You can also read more about The Role of Occupational Therapy in Supporting Parents of Children With Autism on  AOTA’s website