A bit over a year ago I started a full time community paediatric dysphagia post. Although I was really excited about all the new knowledge and skills I would develop in this role I also felt a sense of sadness that I would not be able to use VERVE as I had done in my previous job. 

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! 

Here's a short video of Amber and Natasha talking about VERVEing in  primary school. 

A post by Jo:
Take a look at this great website which also includes an app!
http://www.your-baby.org.uk/early-interactions.
It has some lovely videos showing how "Right from the beginning babies want to be social and interact" and that the interactions the baby sets up and experiences has a long-term impact on the way they develop. The theory underlining this research and outlined in the Warwick Infant and Family Wellbeing Unit, site is designed to help mums and dads become confident in what they notice about their own baby. 
The app includes short videos of babies in the sleep states – deep sleep, light sleep and drowsy sleep – and wake states – crying, unsettled and quiet alert so that you can identify your own babies patterns and you can personalise the app by uploading photos of your baby in each of the six states recording their 'likes and dislikes."
 
Of course if you are worried about your child's talking then what you may notice is that your child seems to have found it trickier to give clear signals than the babies in the videos on this site.  This made it harder for you to know how to respond and will have affected the balance of interaction between you. VERVEing helps your child  to show clearer signals and allows them to sort out their rhythm of interaction - firstly with you and then with others, slotting back to the synchrony of interaction outlined at your baby org.
 Posted by Jo

I've had some very interesting conversations with teachers about questioning children.  Teachers have said that avoiding questions (one of the strategies we use in VERVE) felt like going against their teacher training.  Fortunately, they have experimented with waiting and silence, and been fascinated by the exciting results (the children asking them more questions, for example!).
 
They're not the only ones coming to this conclusion, that less is more as far as questions are concerned - a deputy head in one of the schools where I worked showed me this interesting article, published in the TES magazine:  https://www.tes.co.uk/article.aspx?storycode=6455139
  
"Too many teachers turn classrooms into interrogation chambers hoping to engage pupils – but it’s more likely to lead to a dead end.
 
Each week, a teacher will typically ask their students some 1,000 questions, whereas a pupil can easily get away with asking the teacher just one knowledge-seeking query. You may be wincing at this gross imbalance. It is a big problem, of course, but it’s worse than that: the whole idea of teaching by questioning is flawed." 
 
which supports what what we've seen:
One of the main things about VERVE is giving each child time to think and organise their thoughts so that they can affect and manage what they want to say, do and learn.
 
If that's raised any questions for you, perhaps about how to apply the principles of VERVE in a classroom setting, get in touch.
Posted by Jo

Here's a short(ish!) video of me having a go at explaining what I love about my job. There are so many ways to answer this question - I could have made a video that went on for hours! Here's 8 minutes worth...

Here's my first video about why I love using VERVE.