A few months into my new job I started thinking about using video to support assessment and therapy for children who have eating and drinking difficulties.
So many of the children I was seeing seemed to have aversive feeding behaviours above and beyond those that could be explained by their dysphagia. I also met many children who had significant sensory elements to their feeding difficulties due to their experience of medical issues (e.g., significant vomiting).
I read Keena’s chapter in Speech and Language Therapy – Challenging received wisdom and this quote stuck out to me:
“Through video, researchers have been able to see just how balanced and actively involved the developing infant is, and how bidirectional or ‘intersubjective’ parent-child relationships are…Child and parent regulate one another in their “intricate rhythmic patterns” (Trevarthen & Aitken, 2001, p.5) of interaction that is predominantly non-verbal, a two-way sharing of control…It is this success in synchrony ‘balance of control’ and uniqueness in interaction that supports the child in perceiving themselves as equal and significant and gives them the confidence to establish, explore and maintain relationships and opportunities within other contexts and with other people” (Cummins, 2015, p. 83).
This got me thinking about the fundamental role of being calm/self-regulation (adult and child) in supporting children to feel confident to touch, lick, taste, chew and swallow new foods.
It made me wonder that if I could (with video) support parents to…
- Let the child choose the food;
- Sit where the child could see their face;
- Wait and watch / give extra silence;
- Wait for the child to look (face-watch) before providing non-verbal reinforcement (e.g., a smile, a nod, a wink, having a bite of their own food); and
- Copy the child’s actions…
Would this support a child’s confidence to initiate new experiences with food (i.e., touch, smell, lick, bite, chew, swallow)?
The answer is – yes! Over each four week course of VERVE we witnessed (with great excitement)…
- A 2 years; 9 month old girl with severe aversion (syringe fed supplements only prior to therapy) started biting and chewing crisps, bread, chips and bananas
- A 3 1/2 year old boy with severe aversion due to a history of chronic vomiting tasted, chewed and tried to swallow crisps. He also was demanding his own (full!) plate of food at the dinner table every night instead of running away at meal times
- A 4 year old boy with complex medical needs (predominantly PEJ fed) stopped spitting everything out that he tasted and started consistently chewing and then swallowing food for the first time in his life
Have you used VERVE in your work with children who have feeding difficulties? If so we'd love to hear how it's going!