Do you have a child who demonstrates extreme food selectivity (aka a “picky eater”)? Does prepping dinner or the thought of prepping dinner stress you out? Meal times are an integral part of one’s day and include opportunities for both social interactions and essential nutrition. If you or your child’s doctor is concerned about your child’s eating habits and medical concerns have been ruled out and/or are being monitored by your child's medical team, the next step is to identify a provider with experience in feeding therapy.
Feeding therapy may help to ensure your child consumes a variety of foods to maintain a healthy nutritional balance, increase opportunities for social interactions and reduce problem behaviors and family stress around mealtimes. The clinician will partner with parents to develop and implement an individualized treatment plan. Individualized treatment plans identify the function or contributing factors of food avoidance/refusal, target foods, how often to present food items, when and how to increase bite size, add an additional target food and how to maintain the consumption of that food in the future. Target foods are foods we are looking to increase and are identified by the family and clinical team to ensure a variety of foods are within the diet (i.e. vegetables, meats, grains, fruit, starches, etc.).
Here are 5 tips on how to set up your home for feeding therapy for successful treatment.
- Set up the Environment for Success
- Have all needed materials for each feeding session ready in advance, including: food targeted for introduction, reinforcer, utensils, plates, and a seat at the table. Set up materials prior to the starting the feeding therapy session, and be sure to sit between your child and the exit.
- Establish a feeding schedule. Limit meals to 20-30 minutes and snacks to 10-15 minutes, ensure the seat is age and size appropriate, and limit snacks and eating for at least 30 minutes prior to feeding sessions.
- Review the protocol provided by your clinician prior to the session.
- Remove distractions like toys and iPads, and have the TV off, etc.
- Stay Involved and Engaged
- Keep the lines of communication open with your providers and continue to advocate for collaboration (i.e., between SLP, OT, BCBA, doctors, etc.). Be sure to update the team on any medical or medication changes during treatment.
- Select times for feeding sessions that fit within your family routine. Actively participate in selecting the targeted foods across food groups.
- Choose High Value Reinforcement Foods
- Identify your child’s top 3 highly preferred foods/snacks. You can do this by setting up a time prior to starting any feeding sessions, and putting two snacks side by side and stating, “pick one”. You will want to present each snack with another snack twice and write down which ones were chosen most often. Limit access to a couple of selected highly preferred foods and/or items and offer them solely during feeding therapy sessions, as reinforcement after your child tries the new food.
- Provide reinforcement immediately after successful attempts, according to your feeding protocol, and offer praise when providing highly preferred items/food.
- Make it FUN
- Tell funny stories during mealtimes and engage in conversations while eating.
- Cut or make the food into fun shapes and be silly and engaged during the feeding session.
- Be Consistent
- Ensure all providers and family members are on the same page.
- Keep times of meals and snacks consistent and limit cancellations.
- Establish and maintain your mealtime expectations.
About the Author: Amanda Cowan is a BCBA with a range of experience within the ABA field ranging from in-home, schools, clinic based, and employment services. Originally from the Bronx, NY, Amanda received her Bachelors in upstate NY and her Masters at ASU. She has been working with individuals with developmental disabilities since 2011. Amanda has over 5 years of experience utilizing ABA techniques to conduct feeding therapy for a variety of feeding concerns. Amanda is the Greater Phoenix Regional Director at Kyo.