Feeding Therapy with SOS

 

chef cooking in kitchen
uyPhoto by Rene Asmussen on Pexels.com

Continuing from the theme of earlier this week in terms of preparing for the holidays, part of doing so is to think about meals and what will be served, how many people are coming, what ingredients you will need and then cooking.  If you have a child who can’t tolerate eating different foods then YOU have an additional layer that is so emotionally ridden.  If you have a child who cannot tolerate the smell of foods cooking or the site of those which you have on the counter how will you prepare them?  Food is such a basic thing that we need for every day.  Working with parents each week with children who have feeding challenges reminds me of the emotional influence that problems in this area pose to families. Having taken Dr. Toomey’s training this past fall, I became aware of information that might be able to help you and I have already found its benefit during my daily practice:

“The SOS Approach to Feeding program was developed by and copyrighted by Dr. Kay Toomey.  Please note, all materials, documents and forms taken from the SOS Approach to Feeding program are copyrighted and cannot be reproduced in any form without the written permission of Dr. Kay Toomey. For more information on the SOS Approach to Feeding program, please visit www.sosapproach.com.”     

This article can describe what can be done When-Children-Wont-Eat-Understanding-the-Whys-and-How-to-Help.pdf

and in her blog post, a parent relates how her child benefitted from its use https://singingthroughtherain.net/2013/03/tips-for-children-with-feeding-disorders.html

The SOS Feeding approach is appropriate for children that are “problem feeders” and not “picky eaters”, which can sometimes be difficult to distinguish between. Picky eaters are those that have a limited variety of foods and will not easily eat, but they often will reluctantly touch or taste a new food. Picky eaters do not need SOS feeding therapy. A problem feeder, however, has an even more restricted variety of foods with more severe reactions to interacting with non-preferred foods and is a candidate for SOS feeding therapy. Here are some questions to consider if you are concerned about your child’s eating:

  • Does your child have a decreased range or variety of foods (less than 20)?
  • If your child gets “burned out” on food and takes a break from it, will they refuse that food still, after the break?
  • Does your child refuse entire categories of food groups (proteins, vegetables, etc.) or texture groups (hard foods, soft cubes, puree textures)?
  • Does your child almost always eat different foods at a meal than the rest of the family?
  • Have you reported concerns about your child’s feeding across multiple well-child check-ups?
  • If you answered “yes” to several of the above questions, talk to your child’s pediatrician about a referral for an evaluation to determine if feeding therapy would be warranted for your child.

Please note, the term “problem feeder” is used by the SOS Feeding approach program to delineate children who are outside the normal range of age-appropriate feeding behaviors, i.e. only being a “picky eater”.

Is your child a red flag for a referral?  Know that in this season of giving that you can be given the hope of improved ability to help your child enjoy eating!

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Technology

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New and profound diagnostic terms are emerging that diagnose actual addiction in this area. It’s called “Internet Addiction Disorder” according to the diagnostic manual used by physicians and other healthcare professionals.  If you want the codes here they are: https://www.aihc-assn.org/Blog/tabid/1676/ArticleID/379/Internet-Addiction-A-Digital-Problem-in-the-Real-World.aspx

IAD will display distinct habits. According to the journal Current Psychiatry ReviewsTrusted Source, someone with an IAD will:

  • have mood changes
  • focus on the internet and digital media
  • be unable to control how much time they spend
  • need more time or a new game to be happy
  • show withdrawal symptoms when not using the internet or technology
  • continue using the internet or technology even when it affects their relationships
  • neglect their social, work, or school life

How it is diagnosed is complex. Here is a link  https://www.psycom.net/iadcriteria.html for you so consider your own habits and that of the medical community https://www.aihc-assn.org/Blog/tabid/1676/ArticleID/379/Internet-Addiction-A-Digital-Problem-in-the-Real-World.aspx. Can you list 25 things that you do each day that does not involve technology?  I asked a group of graduate students studying to become speech-language pathologists and they had trouble.  How about you?

There are good and unfortunate impacts that technology has had to date based on a variety of sources.  Think about the last time that you tried to talk to someone to find that they could not answerer yo.  They had earbuds in their ears, were not looking up at you – just at a machine and appeared to be in an entirely non-face-to face world.  The effect on communication in this century is both astounding and profoundly changing us.

https://www.cnn.com/2019/11/04/health/screen-time-lower-brain-development-preschoolers-wellness/index.html?utm_medium=social&utm_source=fbCNN&utm_content=2019-11-04T22%3A00%3A09&utm_term=link&fbclid=IwAR2kl7JF5e1BDeY6-j-BGQiGqpT1t5BA4dVM4yVIpZsbSpNZ7pZRuopXkQ0

https://www.today.com/video/screen-time-may-be-reshaping-preschoolers-brains-new-study-says-72848453586?fbclid=IwAR0rorh-QKQcF0r8KFkYOmmSK9DGoQbP2CkRXT-1RhYg0qywY8lGoQDwrxo

https://www-nytimes-com.cdn.ampproject.org/c/s/www.nytimes.com/2019/11/04/well/family/screen-use-tied-to-childrens-brain-development.amp.html9142354-home-phone-internet-and-email-icon-set

GOOD NEWS!

The good news is that there are positive things that we can use computers for, as noted in an example of a few resources below. There are others if you search by grade level which yields similar listings so look at those as well.

https://download.cnet.com/news/best-apps-to-educate-and-entertain-preschool-and-kindergarten-age-kids/

28 of the Best Apps for Kids in the First Grade

American Academy of Pediatrics advises families is that used in moderation can be helpful.  https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Media-and-Children.aspx    History is repeating itself. The transition from oral to written language posed challenges for those living through that period.  We all need to embrace the change and recognize that things are not all bad with this new change in communication.

ADHD Cases on the Rise According to ABC News….Now What do we do???

ADHD Cases on the Rise – ABC News.

WOW….this is now being realized and you can read this article or search for others as they are being written in a number of publications recently.  That is not the point of this post.  Please read on..now that I have your attention….let’s focus 🙂

Given this recent finding,  I think that it is going to be so important for people to know more from those of us involved in raising children with the problem, those of us who actually work with these individuals in our professional lives, those of us who may actually diagnose the condition and have to discuss the signs and symptoms to the adult or the parents of a child. I am not convinced that people truly understand this disorder.  Knowledge is power and if we empower others with more information about what makes the ADHD brain tick,,,what makes it unique and what struggles and strengths it brings to the lives of those who live with it day to day then it will make it so much easier for them.  I believe that this goes for most medical problems or differences with which a person lives.  The more you understand the easier a time you will have in life.  You will be able  to learn to compensate and perhaps even overcome the obstacles.  

With this in mind….

Please….. Tell – the parent, the adult, the child  who is old enough to understand…what the struggles will be that they may face.  Please – help them to understand the signs and symptoms of ADHD that may affect them in their day to day lives.  What resources are available to assist them.  What some of the conditions are that may potentially coexist with this such as oppositional defiant disorder, conduct disorder, mood disorders, anxiety.  The impact of medication – including  its side effects is extremely important to relate.

I have heard comments like: I do not understand why my skin gets itchy if i put cream on it, why does this fabric bother me? he only eats soft spicy food….nothing else!  it is so hard to find foods that my son/daughter can eat because he is so fussy.  my child cannot fall asleep, “i have insomnia”, another says.  “turn off all the lights …it is too bright in here”, “i can’t eat this (maybe it is the texture of the food), “he won’t let me brush his teeth and washing his hair is a struggle because he pulls away”.  Educate people about the sensory integration and regulation difficulties like these.  Let them know that this is just a part of their make-up.   

Years ago I went with my son to the circus…..never again! He was overcome by the loud noise.  Neither the sensory overload during a vacation such as Disneyworld nor the quiet and peaceful setting where all slowed down on a dude ranch would work as vacation sites.  The predictability of a setting like Club Med – where the transitions from one activity to another could be planned in advance and known – no unexpected changes was a better fit…albeit not perfect.  A trip like a cruise may or may not work….yes it is predctable and there is a structure in place before you go; but, would the pace of getting from stop to stop during the vacation be too slow?  I do not have ADHD but would find this an issue.  Something to think about ….

For parents of children both camp settings and schools need to be considered.  A play ground of five hundred students waiting to start the day standing in line, then heading like a stampede, running up the staircases in a loud and echoing stairwell to the classroom…. by the time upstairs in the class, the ADHD student would be ready for time out to de-stress from the experience of even preparing for the classroom setting. There are specialized camps for children and programs for teens with ADHD.  Teachers at school and counselors in a camp setting need to understand the problems that may occur.  

College students with ADHD will have to advocate for themselves and also be aware that there may be better programs for them then others that may not be geared to the learning differences with which they come to school. Research the programs that are available.  Talk with organizations that cater to the person with ADHD and join a support group so that you can gain resources.

We need to be advocates – for ourselves, our patients, our children.  Please help…..

Autistic Wandering: a new ICD-9 code as of 10/1/11: Think about it from different perspectives!

I look at this code from a few different perspectives.  Let me share with you, if you have the time to take a look at this post. 

As a child; if I am recalling this correctly, my cousin who is six months younger than I had wandered out from his home in New Jersey.  People were looking for him.  Yes, he was finally found; but, this now autistic adult could not relate to you his name.  At least, that was at the point that I last saw him which was some time ago.  I do not think that he had the acuity of expressing general knowledge that included his address or phone number.  I doubt that he could have been able to relate to another person that he was indeed lost.  We are out of touch now, but the disorder is not. 

My colleagues have written questions about what the practical implications of imposing a label such as this on autistic persons will have.  I respond with a question:  How would an autistic person who wanders off, a person who could not even communicate that he was lost, could not give them his or her name to another people feel.  He or she would  most likely be scared.  When a person who is autistic becomes that way he or she generally has difficulty managing their own behavior.  I remember seeing that.  In layman’s terms, you may call it being confused and visualize it in the form of a tantrum. So, what does alerting others to the tendency for a person to wander off do. Think about this from a practical standpoint, the viewpoint of the person who is experiencing this.   I think this is an incredibly helpful move on the part of the mental health community and a way of keeping people who are autistic safe. As well, defining this for people who suffer from dementia has the same meaning to me.  I applaud their efforts. 

As an add-on thought to this “issue of the week”, so to speak, I wonder how others literally on the street would hear about this disorder were they to find someone “wandering”.  Rather than thinking of them as potentially drunk or as having consumed illegal drugs i think it would also be helpful if these people were automatically given a bracelet that identifies them out in public as having this condition. One could consider this as a safety precaution.  Some people wear medic alert jewelry or watches to identify themselves and their medical condition, in the event of an emergency.  It would be helpful for all of us.  It is just a thought and if you are a healthcare provider, a parent or caregiver in my opinion it would becould to consider using this type of “identification system”, for lack of a better word..   

I keep reading about this announcement within various social networking venues.  As I wrote in my post of last week, describing the symptoms of a problem very specifically; defining the label will only help others to understand the condition and perhaps drop some prejudice towards these people. This is my opinion and one that I recall was actually discussed years ago during graduate school, as a part of a diagnostics class in which we were writing evaluations.  I learned to describe exactly what I saw instead of putting a label on it.  Interestingly, it seems that history is repeating itself.  Now it is coming out in public, outside of the classroom and into the “real world” where I think most of us learn how to do our jobs.  I wonder what parents  and caregivers think? If you are reading this i would be interested in hearing.  I think my colleagues too would be interested in hearing from you. Please reply.