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Session overviewThe session will provide an overview of feeding development and difficulties from the perspective of parents of young children with disabilities. Recommendations for ECSE professionals and trainers will be shared along with feeding-related resources to increase and supplement content knowledge and related strategies and specialized interventions.
Background • Literature indicates that 40-75% of young children with
disabilities demonstrate feeding difficulties (Arvedson & Brodsky, 2002; Bernard-Bonnin, 2006; Bruns & Thompson, 2011; Kuhn, Girolami, & Gulotta, 2007; Manikam & Perman, 2000; Rudolph & Link, 2002; Schwarz, 2003).
• Issues may resolve during infancy or continue throughout the early childhood years such as • food selectivity or refusal, • inability to meet nutritional needs• limited skills for self-feeding (Bruns & Thompson, 2010,
2012; Manno, Fox, Eicher & Kerwin, 2005; Thompson, Bruns & Rains, 2010).
Background continued• Studies have been conducted examining specific
interventions, however, there is little evidence-based practice in this area. • For example, there is literature describing
anatomical issues related to feeding such as cleft lip and palate (e.g., Reid, Kilpatrick, & Reilly, 2007) but little information to support ECSE (birth to five) providers.
• To build evidence-based practices, there needs to be efforts to further investigate feeding difficulties of young children with disabilities and the methods to their resolution.
• Therefore, a place to begin is by gaining a better understanding of the parent’s perspective.
Parents’ Perspectives• Parents often identify early feeding difficulties and are
primary participants in their resolution by implementing strategies and specialized interventions (Burklow, McGrath, Allred, & Rudolph, 2002; Johnson, Handen, Mayer-Costa, & Sacco, 2008; Schreck, Williams, & Smith, 2004).
• It is critical to understand parent perspectives on successful strategies and specialized interventions to meet feeding needs.
• Members of a child’s ECSE team must work with parents in order to facilitate positive feeding outcomes.
Parents’ Perspectives continued
• Parent perspectives can be utilized to inform pre-service training & professional development on feeding development and specific feeding difficulties especially in view of limited discussion of this topic across ECSE provider disciplines (Lefton-Greif, & Arvedson, 2008; McKirdy, Sheppard, Osborne, & Payne, 2008).
Audience?
• Parents and family members• EI providers• ECSE teachers• Therapists • University faculty• Professional development
/Technical assistance trainers
Introduction of Parents
Parent panel• Laura Bishop / Molly (Down
syndrome)• Michelle Wilson / Faren (trisomy 18)• Jim Jordan / Aidan (trisomy 9 mosaic)• Marissa Baxter / Piper & Sawyer
(visual impairment)• Evelyn Barrientos-Perkins / Avery
(autism)
Child’s Feeding Issues
• In the past, what were your child’s most pressing feeding issue(s)? How were they resolved?
• Currently, what are your child’s most pressing feeding issue(s)?
Need for a Specialized Diet
• What is the diet?• What changes have you needed to
make to accommodate the diet such as cost of specialized items and family mealtimes?
Strategies and Techniques for Feeding Your Child
• Food (introduction, textures etc.)• Liquids• Positioning • Mealtimes
Communicating Your Child’s Feeding Skills and Needs
• To caregivers?• At child care?• To EI providers?• At preschool and school age settings
including ECSE teachers and aides?
IFSP outcomes related to feeding IEP goals and objectives
• If yes, please describe• If no, is there a need?
Describe supportive professionals
• Please share examples of how professionals have assisted you and your child to address feeding issues.
Advice for feeding young children with special feeding needs
• EI providers• ECSE teachers and aides• Therapists • University faculty• Professional development
/Technical assistance trainers
Recommendations• Family preferences must be used as the basis
for team decisions• Promote child-parent relationship
(e.g., reciprocal interactions at mealtimes)• Encourage parent confidence and competence
around feeding interactions, oral intake etc. • Feeding strategies must promote, to the
maximum extent possible, age-appropriate, functional skills as well as independence
• Team members remain up-to-date on feeding literature and recommended practices
DEC Recommended Practices (2014)
• Link feeding interventions and collaboration with DEC Recommended Practices (2014):
• LEADERSHIP3. Leaders develop and implement policies, structures, and practices that promote shared decision making with practitioners and families.
DEC Recommended Practices
• LEADERSHIP13. Leaders promote efficient and coordinated service delivery for children and families by creating the conditions for practitioners from multiple disciplines and the family to work together as a team.
DEC Recommended Practices
• ASSESSMENT6. Practitioners use a variety of methods, including observation and interviews, to gather assessment information from multiple sources, including the child’s family and other significant individuals in the child’s life.
DEC Recommended Practices
• ASSESSMENT11. Practitioners report assessment results so that they are understandable and useful to families.
• FAMILY4. Practitioners and the family work together to create outcomes or goals, develop individualized plans, and implement practices that address the family’s priorities and concerns and the child’s strengths and needs.
Recommendations continued
• FAMILY7. Practitioners work with the family to identify, access, and use formal and informal resources and supports to achieve family-identified outcomes or goals.
DEC Recommended Practices
• INSTRUCTION2. Practitioners, with the family, identify skills to target for instruction that help a child become adaptive, competent, socially connected, and engaged and that promote learning in natural and inclusive environments.
DEC Recommended Practices
• INSTRUCTION13. Practitioners use coaching or consultation strategies with primary caregivers or other adults to facilitate positive adult-child interactions and instruction intentionally designed to promote child learning and development.
DEC Recommended Practices
• TEAMING AND COLLABORATION1. Practitioners representing multiple disciplines and families work together as a team to plan and implement supports and services to meet the unique needs of each child and family.
DEC Recommended Practices
• TEAMING AND COLLABORATION2. Practitioners and families work together as a team to systematically and regularly exchange expertise, knowledge, and information to build team capacity and jointly solve problems, plan, and implement interventions.
Resources
• Bruns, D. A. & Thompson, S. D. (2012). Feeding challenges in young children: Strategies and specialized interventions for success. Baltimore, MD: Brookes.
http://products.brookespublishing.com/Feeding-Challenges-in-Young-Children-P246.aspx
• Website: http://eateducationandtra.wix.com/eatfeeding
Resources continued• Ernsperger, L. & Stegen-Hanson, T. (2004). Just take a
bite: Easy, effective answers to food aversions and eating challenges. Arlington, TX: Future Horizons.
• Morris, S. E. & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for mealtime development (Second edition). San Antonio, TX: Therapy Skills Builders.
• Williams, K. E. (2007). Treating eating problems of children with autism spectrum disorders and developmental disabilities: Interventions for professionals and parents. Austin, TX: PRO-ED.
Resources continued• Online resources
• Meal Time Notions http://mealtimenotions.com/index.htm
• New Visions: http://www.new-vis.com/ • Food chaining with Cheri Fraker and Laura Walbert
http://cheriandlaura.blogspot.com/• Resource handbook for parents of young children
with autism who struggle at mealtime• http://w3.mealtimeconnections.com/documents/
handbook_compiled.pdf
