Breakthrough moments

We all love breakthrough moments whether it be in therapy or just in the experiences of life! Lets take the first acceptance of more than one bite of an apple for example. What was 'ok' about the apple or the experience this time around? First of all most of the children seen for feeding therapy do have some inefficient compensatory strategies that are used to manipulate foods and in many cases those patterns appear to develop secondary to abnormal sensory experiences.

Of course some children do have limitations due to issues surrounding strength, tone or range of motion but in this post I am specifically referring to the child who has learned to 'chew' with lips closed, rolling food across the mouth, tongue mashing, 'suckling' food as a result of a combination of factors...not just oral motor. I feel this is sometimes overlooked as a child is put into a category of "sensory" or "oral motor" or strictly "behavioral"....when in fact there is likely many factors contributing.

A child who refuses an apple chunk may readily accept a very thin slice of apple. When looking at strictly sensory you may think "Well, it is visually more appealing, he likes the flat shape" or something to that affect. When looking at strictly oral motor one may say "This is easier to handle from an oral motor standpoint as the flatter, thinner shape is easier to chew".....when applying both sensory and oral motor I can see that the following is also true "The appearance is not only appealing, thus decreasing his anxiety, but he also knows that he can bite AND consistently chew this food creating a more normalized sensory response" The thickness of chunks may be overwhelming from both oral motor and sensory viewpoints resulting in "This is too hard to chew, too yucky feeling in my mouth, too painful to swallow whole...i'll either spit it out or refuse it all together!"

Point being...explore all possibilities and different angles before landing on your own conclusion prematurely! Know your child, observe his whole being, his reactions to sensory stimuli, the types of foods accepted vs the types of foods avoided. This does not always result in a clear pattern and despite identifying your child's favorite spices, flavors, textures, shapes, environments, etc underlying conditions play a role as well. Inconsistent feeding behaviors varying from accepting wide ranges of food one day and next to nothing the next or on another day could indicate gastrointestinal discomfort. This brings me back to the importance of NEVER assuming a child's feeding complication is strictly sensory, behavioral or oral motor. Those who know me know that I am opposed to some of the intensive feeding programs that are out there or behavior approaches that reinforce having to swallow food that is spit out or waiting the entire hour for a 'breakthrough' in which the child is broken down to try a bite. This is not the kind of breakthrough moment I like to experience with my own child or with any child in treatment! I realize each child is different and there is probably a basis for choosing that type of treatment, I hope to encourage parents to have patience as their child learns to eat in a happy and healthy way!











A breakthrough moment for one child may simply be pretending with the food



For another, it is dipping a food into a new sauce!