These pictures say it all!
GROW a garden, EAT your garden, TEACH someone about your garden, ENJOY food, Be Princess Nugget if you wish! DISH OUT a bowl of chocolate pudding for your little one learning about food, DONT BE AFRAID to get messy! HAVE SOME FRIES in your hospital bed because you want something you know you like..salt! MAKE A BOWL out of your own avocado and dig in! POPSICLES in the yard with your friends! BE CONSISTENT with your meals and snacks and pick out a fun dinosaur placemat if you wish! GO AHEAD and buy that cotton candy at the fair..gotta love the experience!
Fun with Food!
As a speech-language pathologist specializing in pediatric feeding and swallowing disorders, I encounter many children who have experienced negative associations surrounding food. These children often have accompanying oral motor feeding difficulties and sensory processing difficulties--making eating a very stressful experience instead of an enjoyable one.
This website will hopefully serve as an "idea place" for meals as well as questions and support from other parents and caregivers. Enjoy!
Tuesday, September 29, 2009
These pictures say it all!
Posted by Kristina--Picky Tots at 1:41 PM
Monday, September 28, 2009
After attending an awesome Food Chaining workshop with presenters Cheri Fraker, Laura Walbert and Sibyl Cox I felt compelled to share some of my own home video clips of me working on some new foods with my daughter. I have said to my families many times that the kids I work with often surpass my own child in terms of food repertoire simply because I do not take the time to work one on one with some difficult 'new' foods! Aren't we parents all guilty of that? Despite what we know we sometimes like to take the easy way out. On a good week I love to have Adalyn help in the kitchen (especially where new foods are concerned) and we make an effort to sit down and eat as a family in the evenings to enjoy each other and our meal. In this video we are using an activity for positive reinforcement, but it is not an expectation for the food to have to be eaten--however the foods are a variation of something she already accepts so it is likely that she will want to try them. For example Adalyn loves pancakes and loves frozen blueberries but will typically refuse a blueberry pancake. In this video she chooses a blueberry pancake cut into a butterfly shape (cookie cutter) and is also given some other new food choices such as sweet potato fries, spinach artichoke nugget and veggie mac pasta with spaghetti sauce. My therapy tools are novel to her as they usually stay in my office or car, so that was a bonus in her willingness to try new foods.
Aside from my training and experience at Carolina Pediatric Dysphagia in Raleigh I came across a great resource, a gigantic book entitled Pre-Feeding skills. I was familiar with the book from my time at Arkansas Children's hospital as a graduate student, but I really grew to use this resource when I had 8 feeding patients per day in Raleigh, all with varying needs. The more I read and practiced this in daily therapies or evaluations, the more it just made sense to me and the easier it was for me to sort of 'weed out' other beliefs and practices from various feeding experts, but incorporate certain aspects of other therapies into my own. It was clear to me that the clinic in Raleigh practiced in this same way and we all learned from each other, sharing ideas and techniques. The authors Marsha Dunn Klein and Suzanne Evans Morris' outlook on feeding and the whole child approach is one that I have come to feel is necessary and have since felt about very passionately. As I am sure my Myer's Briggs "INFP" description (the idealist) would justify this calling! The truth is, folks, it is real and if I didn't feel it was right I would not be able to freely write without having 'writer's block'. I am sure there are many grammatical errors--please ignore!
When I worked in Raleigh I caught on to the fact that a child had less anxiety with foods that were similar in some ways to foods that they already accepted. I was also directing families to the article Expanding Children's Diets on a regular basis as I felt it was important for them to understand the need for a child to feel that comfort and safety with foods and approach their feeding concerns in a non threatening way. There is of course more to it than this and I strongly encourage anyone who has a child with feeding difficulties to seek out help from a speech-language pathologist and/or occupational therapist who has a similar philosophy as hopefully you will find on this site and others. So...Later I find out that these 'similar properties' are the same concepts in Food Chaining. I KNOW this because I attended a course over the weekend! So if you happen upon my site please check out their book and website at cheriandlaura.blogspot.com.
I hope you enjoy the video clips! Please don't wait for help if you find you really need it. Another point that was reiterated at the conference I attended...one that also stood out to me at a Kay Toomey conference and I feel has become part of my 'evaluation speech' and training for other feeding therapists for the last 5 years is "Only 3 percent of children with feeding difficulties are truly behavioral in nature. 3 percent" So find your support team, they are out there! Althoug I miss my time in a pediatric feeding clinic in Raleigh and am so grateful for my experience there, I now work with a fantastic team at Carolina Pediatric Therapy and we all turn to each other for consulting and help within the various disciplines!
Here we are collecting items for our 'lunchbox'--a cute game one of my therapy families found and laminated for us to use!
Posted by Kristina--Picky Tots at 2:29 PM
Friday, September 18, 2009
Seasoned Butterbean dip
Savory Veggie Waffles
Crunchy munchy peppers for dipping
Oven Baked Squash Fries
Crunchy vidalia onion dressing chicken
Samurai veggie meatballs
Veggie Surprise mashed potatoes
Fun "sushi" rolls
Crunchy spinach cakes
Indian inspired Squash recipes
Easy Dairy Free cupcakes
Posted by Kristina--Picky Tots at 8:39 AM
As a first time gardener this year I grew an abundance of 'accidental' garden surprises...including pumpkins. Many many pumpkins! This first recipe was inspired by a friend of mine, Tina, who told me about the wonderful squash fritters she made for her family. Tina is one of my most creative friends and she and her husband are always coming up with the greatest ideas whether it be a recipe, party theme, creative art or halloween costumes for themselves and their children---as evidenced by last Halloween's costume, can you guess which soft drink she is representing?
I have adapted the recipe in order to make use of one of our pumpkins as well as satisfy my craving for curry that day. Tina says there are several squash fritter recipes online and you can change them up to fit any mood including Italian, Indian or Seafood. These fritters do resemble a crab cake so she and I were thinking of making a seafood feast one night during one of our get togethers--just substitute the other spices for some Old Bay for a seafood twist!
Indian inspired Spaghetti Squash and Pumpkin Fritters
½ small pumpkin (approximately ½ cup)
½ large spaghetti squash (approximately 1 cup)
Salt and pepper to taste
2 tbsp Indian seasoning (I had Kohinoor brand Sheek Kebab Special in the pantry)
¼ cup egg beaters or 1 egg
¼ cup whole wheat flour
Mix all ingredients together. Form into patties and roll in breadcrumbs. Pan fry in tbsp of olive oil, flip after approximately 3-4 minutes on each side. Serve warm and crispy!
Well I didn't stop 'squishing squash' there since I wanted to use the remaining half of the spaghetti squash. I plugged in the Magic Bullet and made a great curried squash bisque--without the use of any dairy. This was very simple and very tasty! Adalyn had a few spoonfuls but I actually had myself in mind for this recipe. I know one of my favorite little patients will like this one though!
1 cup spaghetti squash
2 tbsp water (add more or less depending on desired consistency)
½-1 tsp yellow curry (depends on your taste!)
1/4 teaspoon coarse sea salt or kosher salt
Blend first 3 ingredients (I used magic bullet), add seasonings
Posted by Kristina--Picky Tots at 6:47 AM
Wednesday, September 9, 2009
Who doesn't love a happy meal every now and then? We thought it would be fun to create our own happy little box and fill it with some food samplings for a picnic! Our box--a cupcake box-- is very simple with some hearts and butterflies but you could go crazy with characters and personalize this in whichever way you please. In the next few weeks I will be personalizing a few boxes for feeding therapy patients and will include small portions of their new foods. Adalyn's box had a small dish of boca burger, blueberries, cheese and a fruitaboo. Happy Eating!
Posted by Kristina--Picky Tots at 12:46 PM
Tuesday, September 8, 2009
We all love breakthrough moments whether it be in therapy or just in the experiences of life! Lets take the first acceptance of more than one bite of an apple for example. What was 'ok' about the apple or the experience this time around? First of all most of the children seen for feeding therapy do have some inefficient compensatory strategies that are used to manipulate foods and in many cases those patterns appear to develop secondary to abnormal sensory experiences.
Of course some children do have limitations due to issues surrounding strength, tone or range of motion but in this post I am specifically referring to the child who has learned to 'chew' with lips closed, rolling food across the mouth, tongue mashing, 'suckling' food as a result of a combination of factors...not just oral motor. I feel this is sometimes overlooked as a child is put into a category of "sensory" or "oral motor" or strictly "behavioral"....when in fact there is likely many factors contributing.
A child who refuses an apple chunk may readily accept a very thin slice of apple. When looking at strictly sensory you may think "Well, it is visually more appealing, he likes the flat shape" or something to that affect. When looking at strictly oral motor one may say "This is easier to handle from an oral motor standpoint as the flatter, thinner shape is easier to chew".....when applying both sensory and oral motor I can see that the following is also true "The appearance is not only appealing, thus decreasing his anxiety, but he also knows that he can bite AND consistently chew this food creating a more normalized sensory response" The thickness of chunks may be overwhelming from both oral motor and sensory viewpoints resulting in "This is too hard to chew, too yucky feeling in my mouth, too painful to swallow whole...i'll either spit it out or refuse it all together!"
Point being...explore all possibilities and different angles before landing on your own conclusion prematurely! Know your child, observe his whole being, his reactions to sensory stimuli, the types of foods accepted vs the types of foods avoided. This does not always result in a clear pattern and despite identifying your child's favorite spices, flavors, textures, shapes, environments, etc underlying conditions play a role as well. Inconsistent feeding behaviors varying from accepting wide ranges of food one day and next to nothing the next or on another day could indicate gastrointestinal discomfort. This brings me back to the importance of NEVER assuming a child's feeding complication is strictly sensory, behavioral or oral motor. Those who know me know that I am opposed to some of the intensive feeding programs that are out there or behavior approaches that reinforce having to swallow food that is spit out or waiting the entire hour for a 'breakthrough' in which the child is broken down to try a bite. This is not the kind of breakthrough moment I like to experience with my own child or with any child in treatment! I realize each child is different and there is probably a basis for choosing that type of treatment, I hope to encourage parents to have patience as their child learns to eat in a happy and healthy way!
A breakthrough moment for one child may simply be pretending with the food
For another, it is dipping a food into a new sauce!
I wanted to share a sweet story of a little boy and his own breakthrough moment! The fact that these 'new finds' were carried over from the hospital to his home is a very big deal for Jackson and his family, way to go Jackson! Click on Marbles from Heaven to hear about his success!
Posted by Kristina--Picky Tots at 3:10 PM
This week I wanted to spotlight a local bakery which provides an option of gluten free, dairy free and vegan goodies! So if you live in Asheville head on over to 225 Haywood Street where you will find Jodi Rhoden and her talented crew at Short Street Cakes ---not to mention a variety of yummy goodness.
When a child (or parent) has made the decision to eliminate dairy, gluten or eggs from their diet for their own elimination trial it is always a good idea to have some exciting and delicious alternatives on hand. Treat yourself to a dairy free cupcake for instance! Having a substitute treat makes the dairy free (or gluten free, egg free, etc) transition much easier. Bring on the Cake!
Photo credit: Becca Johnson, courtesy of My Life in Cake
***A message from Short Street Cakes: because we do bake with dairy and wheat on a daily basis, we are not a dedicated kitchen and cannot guarantee a 100% “sterile” gluten-free or vegan product.
Posted by Kristina--Picky Tots at 11:56 AM
Thursday, September 3, 2009
If you are asking yourself "Are those skewered green beans?!" the answer is Yes! They are. Sometimes it pays to be weird--or non-traditional I should say-- and when it comes to new food for your cautious child food kabobs can be a wonderful thing! Not only is the food presentation novel and fun, but eating food in this manner is also easier for a child who has a difficult time with food textures on hands. Sure you are working on goals to help your child tolerate food on hands, but for introducing very new foods just the simple novelty of the way in which a food is presented can help decrease anxieties.
Try this at home: Does your child have a favorite food? How about a certain food you are trying to introduce? Why not take those 2 foods and make a kabob? In this picture you can see the cheese, representing the favorite, and the blackberry, representing the new food. I'm going to pretend the child already eats something similar to a blackberry, maybe a blueberry or other berry, so it is not too scary for him when he sees it. The blackberry is placed in the middle so that after the favorite food is eaten off of the end, he somehow has to bypass the blackberry to get to the rest of the cheese! Maybe he'll eat it, but more than likely he will slide it off as quickly as possible :) How bad does he want the cheese? Bad enough to slide it through the blackberry juice? See where I am going with this? If he eats the cheese off of the skewer that is considered success because the blackberry is on the very same toothpick. If he slides it through the blackberry juice then eats the cheese that is HUGE. Remember the older post about seeing the Bigger Picture? Well this is a step toward getting there!
If you have a great food presentation idea I'd love to hear about it! As you may have noticed with your own child, many babies have aversions to utensils and shudder at the sight of a spoon. Try using graham cracker sticks or other foods as a 'spoon' to dip into other foods or dips. My daughter likes to use a little appetizer fork that we purchased at World Market. Its metal just like she sees mommy and daddy use all the time and it is her 'fancy' fork so that makes it extra special. The bamboo forks and toothpicks in my pictures are also from World Market. In the spirit of non-traditional food presentations and utensils I used the wine bottle cheese tray just for the pictures! My mother makes these in her kiln using recycled wine bottles and I wanted to show mine!
Posted by Kristina--Picky Tots at 2:02 PM