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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 

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Get moving and have fun over the festive season

Make sure you get your body moving to stay warm and get in the Christmas spirit.

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Connection and community matters

Summer is here, and we have hope that we are now leaving behind the struggles of Spring 2020 and C-19. The world has been reminded about the importance of social relationships – we have all realised how much we value family, friends and having strong support and connections. Stay with us or join us and be a part of our Sensory at Home communities as we enter a new phase after being ‘sensory stuck at home’.

Sensory at Home

Sensory at Home Teens

Sensory at Home Grown-Ups

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Top Tips for Sleep

In a Children’s Occupational Therapy practice, many parents tell OTs that they feel they could cope better if they just got more sleep. When I heard about Matthew Walker’s “Why We Sleep” book from a colleague on a course, I bought it and read it cover to cover. I then shared it with everyone in my life struggling with sleep because this book links sleep with mental health, physical health and sleep through the lifespan.

Here are “Why We Sleep” top tips for sleep hygiene from the appendix- is you want more information about why for any of these tips, go back to the book and dig deeper:

1)    Stick to a sleep schedule: go to bed and wake up at the same time each day as people have a hard time adjusting to changes.  Sleeping in on weekends can’t repay our sleep debt.

TOP TIP: set and alarm for bedtime

2)    Don’t exercise too late in the day: try to exercise 30 minutes on most days but no later than 2 or 3 hours before your bedtime

3)    Avoid caffeine: Coffee, cola, certain tea and chocolate contain stimulant caffeine and can take 8 hours to fully wear off.  Older teens may benefit from being cautioned that nicotine and alcohol also worsen sleep.

4)    Avoid large meals before bed: these can cause indigestion and having too many fluids might mean you need to get up to use the toilet

5)    If possible avoid medications that disrupt or affect sleep: over the counter and herbal remedies for cough, cold or allergies can disrupt sleep.  If you are worried, talk to a pharmacist or health care professional to see if any drugs you take might contribute to insomnia

6)    Don’t take naps past 3pm: Naps can help you catch up on lost sleep but if you nap too late in the day, it can be harder to fall asleep at night

7)    Relax before bed: don’t overschedule your day so you have no time to unwind.  Reading or listening to music could be part of your bedtime ritual

8)    Take a hot bath before bed:  Your body temperature will drop after getting out of the bath and this may help you feel sleepy and relaxed so you are more ready to sleep

9)    Have a dark, cool, gadget free bedroom:  Noises, bright light, an uncomfortable bed or warm temperatures can distract you from sleep.

10) Have the right sunlight exposure: Try to get outside in natural sunlight for 30 minutes a day.

11) Don’t lie in bed awake if you are still awake after 20 minutes or starting to feel anxious or worried get up and do some relaxing activity until you feel sleepy.  The anxiety of not being able to sleep can make it harder to fall asleep

 

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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