It's okay to spit at the table.

This post may fall under the category of TMI...too much information!  It might make you a little queasy.  It made me queasy just to join my family for dinner tonight. 

There is an activity in my favorite eating aversion book, Just Take A Bite. The activity is about making a "spit bucket".  What in the world is a "spit bucket"?  But really this is ingenious as are many of the activities in the book.  The idea is that children with severe eating aversions due to autism, developmental disabilities, food allergies, or medical issues related to the mechanics of eating, need to take small steps towards accepting new foods.  The steps to eating a new food go something like the following, but please note that even though some of these behaviors sounds comical, this is very serious.  Children with severe food aversions don't even like to sit at the table with new foods.

1. Screams and refuses to sit at the table when the new food is on his/her dinner plate.
2. Calmly sits close to the new food. 
3. Smells the new food.
4. Touches the new food with a fork or spoon.
5. Touches or "plays" with the new food with fingers.
6. Kisses the new food. (our therapist worked hard on this step)
7. Licks or tastes the new food.
8. Puts the new food in his/her mouth and then spits it out.
9. Swallows the new food.

So in relation to step number 8, there needs to be a way for Jillian to spit her food out without making the rest of us sick.  Thus...the spit bucket.  We took the girls to our favorite place to paint pottery and let Jillian pick out her very own spit bucket to decorate any way she desired.  I really wanted something with a lid and luckily, Jillian loved this ice cream cone with a removable ice cream lid.  Perfect for hiding the partially chewed food.

Painting was fun!

Ella painted a mug and wanted to make clear it was just for hot chocolate and she wasn't going to spit anything it her creation.  Good plan!

Tonight we picked up the finished pieces.

It's really unbelievable, but tonight I ate dinner sitting across from Jillian and her ice cream cone spit container.  She was excited!  Her eyes lit up at the mention of trying the rice that was on her plate with the option of immediately spitting it out.  She didn't use it tonight and did not try the rice, but she understands the concept and is excited about it.  For now, that is good enough for me! 

Progress

J has had physical, speech, occupational and feeding therapy off and on from the time she was 8 weeks old at Mighty Oaks Children's Therapy Center. The therapists are amazing! Heather was J's feeding and speech therapist and we did get very attached. We both looked forward to seeing her each week. Deciding to end our therapy at Mighty Oaks was a very difficult decision. A decision I made in order to take a completely new direction with regard to J's eating. It was time to try something new.

Now here we are...two months later. During the height of J's eating aversion phase, she ate the following...

peanut butter (scraping it off bread to eat it)
milk
strawberries
cheese pizza
macaroni and cheese
crackers (limited to goldfish, ritz)
cookies (that melt in your mouth)
whipped cream
ice cream

I was really in a panic and started following a brand new way of dealing with severe food aversions by following suggestions in the book Just Take A Bite, by Ernsperger and Stegen-Hanson. I've not just taken some suggestions and implemented the changes, but I have been following the book religiously.

The result?  This is what J ate for breakfast this morning...

scrambled eggs
strawberries
milk
string cheese
a whole apple (minus the peel)

And she is no longer scraping the peanut butter and cream cheese off bread. She is eating whole wheat bread!

So just to illustrate the difference further than just what she has eaten today, this is currently her list of acceptable foods.

eggs
cheese (many different kinds)
pasta in a number of forms (not just Kraft Mac N Cheese)
bread
string cheese
yogurt
hot dog in a bun
chicken nuggets (Kirkland brand)
cereal (sugary, but fortified with vitamins!)
pancakes
whole wheat quesadillas
black beans
any cracker or chip
granola bar
strawberries
applesauce and apples (no peel)
mandarin oranges
bananas
grapes
carrots
jello
any cookie (without coconut or nuts)
milk
juice
water

It just excites me to know I can give her some juice or water to drink rather than having her go through huge amounts of milk which contributes to her anemia. And I have fun making jello jigglers, so for selfish reasons, I love that she is eating jello. There is nothing that makes me happier than to see her eat a new food. And it's starting to happen on a more regular basis. Not a daily occurance, but we are making progress.

For most children, feeding therapy works wonders and is absolutely necessary. As an infant, Heather and an occupational therapist at Mighty Oaks were very successful in getting J to eat her very first food, vanilla pudding. J was 15 months old when she ate her first solid food. Therapy was essential at that time. Maybe because of her unique personality or the fact that she is four, we weren't having the same successes. So now I am her therapist which makes sense because I am also the person who feeds her three meals and two snacks per day. Consistency for her is so critical.

Food Pyramid

We absolutely love J's Speech and Feeding Therapist, Heather. She has known J since she was a tiny baby. Heather is tremendously kind and talented in her field. Everything you want from a therapist. Regardless of these facts, therapy wasn't working for J. It's just too stressful and stress is counterproductive to eating and trying new foods when you are a child with severe food aversions. This is one of those times when a parent has to make a decision. Do we continue with therapy with a highly trained specialist that we adore?  Or can I get her to eat myself? I usually choose to stick with the specialists. They do have the techniques and knowledge from years of specialized education to treat a child like mine. But this is a unique situation that is going to require a unique plan. So we have officially ended our therapy appointments. And I'm it! Time to get my girl to eat.

Have you ever found something so fabulous that you want to share it with everyone you know? Shout it from the roof tops? Or write about it in a blog? :)

This is one fabulous book....

Just Take A Bite by Lori Ernsperger, PhD and Tania Stegen-Hanson, OTR/L

I'm going to be writing a lot about this book, but right now, I will just share one activity J and I worked on today.

We created a food pyramid. This is to get J to recognize what foods go in different catagories and will also help her to see how different foods are important for a growing body.

We started with a piece of butcher paper. I drew the basic pyramid and added the labels to each section.

As I cut food pictures out of magazines, J glued them into the right section of our pyramid.

She had a good time with the glue! In the end, we had a very nice food pyramid showing all foods that I would love for her to eat along with some familiar favorites.

This led to a short discussion about the cookie on the top. "It's the smallest part of the pyramid for a reason. You should eat just a little." I hope she got the message.

This activity introduced J to food groups. One small part of our "plan" in my new role as therapist is to increase J's knowledge of foods and digestion. I have put the pyramid on our pantry door and we'll continue to discuss food catagories. And I'm sure we'll continue to argue about why cookies aren't located further down the pyramid.

Eat this, please.

I have this cereal in my pantry...

I would like to meet the person who decided it would be a good idea to make cereal out of a candy bar. Serious sicko! And I know you're thinking I'm encouraging the sicko's behavior by buying it. Before you throw more guilt my way, let me tell you this. Reese's Puffs cereal is loaded with vitamins and minerals. Some of which are difficult to get enough of even with a nutritious balanced diet. 

Dr Sears says this about choosing cereals for your child.

Yes, cereal is a favorite family breakfast food, but think about what nutrients cereals are the best source of. The list includes: fiber, protein, folic acid, zinc, iron, and B-vitamins. Most other nutrients can be found just as readily, if not more easily, in other foods. You don't need to get your daily vitamin C or calcium from your cereal bowl. Choose cereals that are highest in the nutrients cereals do best. 

I have a child who is seriously anemic. She needs iron in large quantities and Ferrous Sulfate drops don't work for her in the quantity that she would require to raise her iron levels. Since she won't eat iron-rich foods or take vitamins, I'm stuck sneaking it in tempting sugary cereals and slipping some iron drops in her hot chocolate. (Yes, she gets a hot chocolate a day. Don't get me started on that one. It's the only way I've been able to hide the terrible tasting iron drops.) But it's working! She is eating this cereal every morning. It gives the average adult 25% of the recommended daily allowance of iron. That's huge for my little girl and will, along with the hidden drops, hopefully get her out of the deficiency she is in. It's not as good as a vitamin or ferrous sulfate drops, but it's the best we can do. One thing I've learned about raising a child with special needs...things aren't always what they seem. I wouldn't have touched this cereal with a ten foot pole before J came along. And now it's breakfast!

The Pantry is Closed!!!

Do you have one of these on your pantry door???

I highly recommend installing one if you have children like mine. 

Children who could graze all day long if allowed. 

Independent little children who like to help themselves. 

Carb loving little children like my four year old. 

Children who have hungry little friends over every day after school.


If you answered yes to any of the above, I highly suggest you get a flip lock for your pantry. It does not exactly keep out seven year olds, but does make them think twice before unlocking the door.


Aside from J's eating aversions, I think I've done a pretty good job of educating my children about healthy food and treats. Treats are anything with sugar! I've given up trying to keep sugary treats out of my pantry because of J's eating issues (I'll blog about that another day). So they are in there and there isn't anything I can do about it right now! Those sugary little cereals and granola bars are just tempting my little ones to no end. 


So I made this...

A sign placed at a child's eye level with pictures of healthy snacks. We have pictures of a plate of fruit, vegetables (carrot), yogurt, cheese, crackers, sandwich or sugar free gum. So I informed my children when they are hungry and I say, "Healthy snack, please", they can choose a snack from this sign. I get kind of tired of the same old questions..."what can I have for snack?" And then I have to name the exact same types of healthy foods several times a day.


I'm hoping this will also help guide J to better eating choices and encourage her to try a new food. Although she still needs that sugary cereal. Crazy, isn't it?!?!  That one would NEED sugary cereal. But I'll blog about that tomorrow.