Saturday, August 07, 2010

Happy Saturday everyone! It's nap time right now and so I am going to try and sneak in a little update on our girl. So I am sure the million dollar question you all are wondering is "how are they getting her to eat?" I had the same one! Well, it's all about CONSISTENCY!!!!! The reason that I have to be here the entire 3 weeks is because I am the main "feeder" at home. And this program is teaching me how to help and encourage her to eat as much as it is teaching her to learn to eat. So this first week, they had me observe all of the feeding sessions while the therapist ran the show, except for the am snack and dinner, where they encouraged me to try some of the tactics they were using in their sessions. This first week was about them really getting to know what worked for Abby, how the sessions affected her behaviors, what kind of volume she would take, etc. And Ryan also came as often as he could so that he could learn the techniques too.

Well, as you all know our little Abby is a fiesty, stubborn and extremely willful child. She is not a scream and throw a tantrum kid but when you want to get into a power or control struggle with her, she is ready to fight you to the end. (Let me be clear, that we are sooo grateful that our little girl has these qualities, we truly believe that is the reason that she is still on this earth today with us. She wanted to stay and she fought tooth and nail to do so!) So if Abby doesn't want to do something, she doesn't. And the docs explained it this way...... for the last 4 years Abby has been in complete control of her eating. When she wanted a bite of a cookie she had one, when she wanted to sit at the table with a huge bag of doritos and eat till her heart was content we let her. If she took 2 bites of lunch and then got up out of her chair because she was done we let her. If she wanted yogurt for dinner when we were eating chicken and potatoes we let her, all because we welcomed ANYTHING at ANY time she was willing to put something in her mouth. In fact, we got those tips from the professionals themselves. They wanted eating to be such a happy, positive thing so that maybe she would continue to eat more and more on her own. Well, obviously that didn't happen and now we are here, completely taking all the control away from her when it comes to food, well most of it anyway. And they warned us that we would be seeing some definate behavioral changes because of it.

So everyday I turn in a menu to the dietician that I fill out of food for the following day. They have her on a high calorie flavored milk, (choc, straw, or vanilla, they trade off) for her main meals and a high calorie juice, (peach, orange or wild berry, also alternating) and beyond that I get to pick things that we know she likes. And new things to try....different consistencies, textures, tastes, etc. So a typical day would be....

Breakfast:
pancakes with syrup
hash browns
yogurt
cheerios
straw. milk

AM snack:
banana
string cheese
pretzels
peach juice

Lunch:
Turkey Sandwich with cheese and avocado
bag of chips
watermelon
cookie
choc. milk

PM snack:
cinnamon teddy grahams
fruit yogurt
peaches
wild berry juice

Dinner:
Alfredo pasta with cream sauce
dinner roll
applesauce
choc. cake
vanilla milk

Lots of food, huh?!!! That's what I said. But she never ends up even trying all the things ordered and that is expected. But they want choices for her and variety.

So the meal is delivered about 15 minutes before our scheduled eating times and if we are with a therapist we put the tray in the wagon and take it down to the basement where the feeding clinic is.

They have her sit down in HER chair with a therapist next to her and they place two different choices in front of her. They then let her decide what she would like first. Then they let her eat on her own with lots of praise, "what great chewing Abby! Wow, that was a great bite!, etc...) and then when she slows down or starts to show resistance, they start taking more control. So when she says she's done, after her typical few bites, they quickly say, in a very happy and cheerful voice, "oh Abby, we are not done with lunch yet! We have more bites of our sandwich to eat!" She usually complies with another bite or two but then stands up while saying, "I'm all done." "Abby, we are not done with our lunch yet, please sit down." Again, all said as sweet as pie. Then it is usually followed by a choice question...."Abby would you like another bite of your sandwich or a bite of your chip? She will usually answer, "a chip" and then she takes a bite. But then she will quickly stand up and get out of her chair again. And calmly and kindly they ask her to sit down.

On a side note......
They told us that there should be nothing negatively said or done while eating. "The table is not a place for disciplining." So every reaction or respond to her action needs to be a calm and positive one. WOW! This is where I am learning.....more specifically, learning PATIENCE!!!! Because when she gets up out of her chair 30 times in one snack session in the room with me, it takes everything out of me not to just yell at her, "SIT YOUR BUTT DOWN!!!!" Instead it is an "Abby, please sit down....Abby, where are you suppose to sit while we eat our food? Abby, you need to sit in your chair...all the while with a calm, sometimes firm but loving voice. OH MY GOSH....learning, yes I am definately learning and growing!!!!

So that is where the consistency comes into play. They do not let her get up from the table until she is done...and not when she wants to be done, it's when they think she's done.

So back to the typical meal....

Actually, there is just sooo much more to share and nap time is over so I will have to share on the next post.......

Much love,

Kelly

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