We were blessed with a pretty awesome team of therapists at our local branch of Disability Services and I often said that it never felt like a chore to take Nicholas there because the adults always seemed to be having just as much fun as the kids! I was impressed with our ‘Speechie’ Alison from our very first appointment and her knowledge, vision and passion was very visible when working with our children. While I can no longer utilise her services in person, I am thankful that she continues to share her wisdom with us here on the blog.
In my last post on Mummalove, I introduced the idea that the job title ‘speech pathologist’ is a long way from describing what a Speechie actually does. I gave myself a new and improved title: a ‘teaching-parents-how-to-support-communication-and-feeding-ologist’. Now that you’ve all had some time to practice the communication part, I want to talk about how to support your child’s feeding development and reduce stress at mealtimes.
Eating solid foods is a very complex task. We have to coordinate our bodies to get the food in our mouth, judge whether we need to chew it, and if so, use our tongue to move it to our teeth. Once it is all chewed, we gather it into a ball, close off our airway to avoid choking, and swallow. The process involves all of our senses, organs and muscles, so although it is often taken for granted, eating is actually very difficult to do!
It is not surprising then that up to 80% of children with Down Syndrome are estimated to have difficulties related to food or feeding. These difficulties often stem from low muscle tone, a complex medical history, weak sucking reflexes, or a persistent tongue protrusion reflex. These result in children having problems moving the food around in their mouth, issues coping with the sensory properties of foods, and/or learning that eating is unpleasant. While it comes as a bit of a shock to parents initially, the way we support children through these concerns is to help them learn about their food through play.
To help you understand how ‘playing’ with food can help, take a moment to imagine you are in China and this century egg, a local delicacy, is served to you at a restaurant.
Would you pick it up and eat it straight away? I think not. Would you be more likely to eat it if your mum sat next to you saying “hurry up and eat!”. Again, no. When this egg was given to me a few years ago, I sat and looked at it for a while in the centre of the table before putting a piece on my plate. I then looked more closely at the colours, and poked it with my chopsticks to explore the texture. Then I broke a bit off and smelt it. No, I didn’t eat it, but I was calm and comfortable. The next time I came across a century egg I was a bit more familiar and saw mum eating hers, so felt confident enough to have a small taste. However, had mum made me eat it the first time I would have definitely become stressed and never gone near a century egg again! Every time a new food is given to a child, they have that same century egg experience. Yet, for some reason, parents often expect their children to go straight to eating the food without first having an opportunity to explore it. No wonder mealtimes end up stressful!
This leads me to my top tips for supporting mealtimes at home:
- Ensure your child has a supportive seat during mealtimes. This means they are sitting upright, knees bent at 90 degrees, and feet flat on a footrest. Good seating means that your child is able to focus on eating rather than on keeping their body balanced and upright.
- Teach your child that just because a new food is put on their plate, they are not expected to eat it. Show them how to have fun and learn about food! You can practice stirring custard with a spoon, drawing on the table in it, or painting your fingernails with it. You could blow a potato chip across the table or try to balance it on your arm or nose. If your child is uncomfortable with a banana being on the table, you could cover it with a napkin and play peekaboo. Like in my century egg example, these are vital steps. Your child won’t eat the food unless they are comfortable with it first!
- It is not helpful to ask your child to put the food in their mouth or tell them to eat it. If they do, that’s a bonus! If they put it in and want to spit it out that’s great too. Play rockets and spit into a bowl! Children will be more likely to try a food if they know they have an out.
- Try to refrain from wiping your child’s hands and face during mealtimes. It is okay to be messy!
- Be careful about the language you use. If your child appears interested when you are tapping your carrot stick on your plate, say “you can tap yours too!” rather than asking “can you tap yours?” which invites them to say no. You do fun things, and they will copy you if they feel comfortable.
- Talk about the properties of food rather than it being ‘yummy’ or ‘yucky’. For example, a food might be cold, squishy, hard, or chewy. This helps your child know what to expect when they touch the food or put it in their mouth.
- If your child rejects a food or becomes uncomfortable, they are still learning about it. Don’t give up – try the same food again next time. It took me more than one exposure to century eggs to have a tiny taste with the tip of my tongue, and I’m sure it would take many more for me to actually eat one.
- If your child is having trouble chewing their food, use exaggerated movements to show them how you do it. “I put it on my big back teeth and go crunch, crunch, crunch!”
Most importantly, take the pressure off yourself and your child and just get comfortable with food. If mealtimes are still stressful in your house or you are concerned about your child’s eating, you can seek help from a speech pathologist or occupational therapist. To find one near you, head to www.speechpathologyaustralia.org.au or www.otaus.com.au .
Alison is a Certified Practicing Speech Pathologist with a passion for supporting the development of communication and feeding in children with disabilities. She owns ‘I Have Something to Say’, a private speech pathology practice on the Northside of Brisbane. Feel free to get in touch via the website, email and follow her on Facebook.