The Timer, The Chart and New Therapist

The sticker reward chart is working, to an extent.  He's more motivated to eat.  But, it's still taking AAAGGGGEEEEESSSS.  Painful lengths of time.  Plus, I'm still hand feeding him a good portion of his meal.  He is willing to eat but he just won't do it.  He'll sit there forever and just not put a bite in his mouth.  If I do it for him, he'll eat without argument.  I really want to get away from this.  I need him to eat his meals on his own.  He needs it too, whether he knows it or not.  I think he'll feel more accomplished (and therefore more motivated) when he's eating meals with no help.

(*Simple chart...I do not claim to be Martha Stewart.  I know where the craft store is but I can't use 85% of the things they sell.)

So, in the interest of pushing him we've added a timer to meal times.  In the past, I've been opposed to limiting his time and just wanted to get as much food into him as I could.  Now, if I don't rock this boat...I'm going to be sitting in the same boat for a very long time.  I WANT A NEW BOAT!  Hence, the timer.  We're using it for lunch and dinner but not breakfast.  Morning is still too volatile a meal and we have less time on preschool mornings anyway.  He gets Pediasure for breakfast along with something he'll eat with less fuss...pancakes, toast, yogurt.  Maybe some fruit on a really good day.

(This timer is great for the younger kids.  Visual and audio cues for time running out.)

He gets 45 minutes to eat.  When the timer turns red, meal time is over.  That's it.  No more food.  No more time to earn stickers or dessert.  We've only been at this a few days so I'll let you know if it's working in another week or so.  I'm also being very strict about snack time.  It's 3pm on the nose.  If his snack isn't eaten by 3:30, I take it away.  I used to let it sit and he munched when he wanted.  Now he's old enough to understand that he needs to eat when it's offered or it's gone and he can't eat until meal time.  I feed him dinner at 6pm and he tends to get a little noshy around 5.  So I'm hoping he begins to recognize the "hungry feeling".

Not that this is really a huge help but I did try to "fun" things up a little and he and I went to Bed Bath and Beyond where he picked out a couple of fun plastic place mats (farm animals, forest animals, etc).  I figure as much as I can do to get him to want to sit down at the table, I will do.  So he gets cups, plates and cutlery that he really likes.

We also started therapy with the new occupation therapist last week.  I have to tell you, I'm optimistic.  We went through three occupation therapist during our time in Early Intervention and I didn't think any of them were very helpful.  (Lovely people but I didn't see any changes with Buster as a result of them.)  Our new therapist gave me more information in 45 minutes while working with Buster than I got in 2 years with the others.  She has a lot of experience with sensory kids.  Exactly what we need.  She told me what she thinks she knows so far about Buster's needs, how she needs to learn more, that we are going to teach him to modulate his responses to sensory input and THEN we'll get to specifically address his eating.  I am once again reminded that this is a marathon, not a sprint.  Anyway, my point is, I like her.  I fee like she gets me as his parent and she's dealt with a lot parents.   Most importantly, Buster warmed up to her instantly.  The kid didn't skip a beat.  He played with her right away.  He even spoke loudly enough to her that she could hear him and he told her what he did and didn't want to do.  That's pretty huge for him.  Especially with a new person.

I've updated the resources page with some new books.

I'll most some more detailed therapy info after another session and we get some "homework".  In the meantime, a few pages of information from this past week.

Buster Muffins

I'm on a muffin quest.  After a weekend jaunt through Costco where Buster taste tested a pumpkin muffin and loved it, I'm working on muffin recipes.

So, here's the first one that's been reasonably successful.  I am trying to do come up with healthy muffins as opposed to muffins with nothing in them that's helpful to his dietary needs.  I've combed through all the "toddler" muffin recipes out there and I'm changing and adapting as I go.  The first batch I made failed the Buster test but this recipe worked.  Next on the list will be a banana muffin recipe...because I have a bunch of bananas on my counter that are not going to be eaten before they get too ripe.  That's the problem with Costco...yes, I'm happy I got a load of bananas for $1.39 but seriously, who can eat a dozen bananas in a few days?  Not a house with a feeding averse child!!

BUSTER'S SQUASH & CARROT MUFFINS

(This would be good with any kind of squash...pumpkin, acorn, zucchini.  I just happened to have a butternut squash on hand so that's what I used.  Also, I did try to use 1/2 whole wheat flour the first time I tried this but the muffins were really dense.)

1 cup unbleached flour
2/3 cup brown sugar
1 tsp baking powder
1 tsp salt
1 tsp cinnamon
1/4 tsp allspice
1/4 tsp nutmeg
1/2 cup plain Greek yogurt
2 eggs (lightly beaten)
2 carrots
1/2 cup butternut squash

Preheat oven to 350 degrees (Fahrenheit).

Line small muffin cup tins with liners or use baking spray.  (I use small, not mini, muffin tins.)

Peel and chop carrots and squash into similar size pieces and boil, bake or microwave until fork tender. Puree until smooth.

Combine all dry ingredients in mixing bowl.  Then add yogurt, eggs and vegetable mixture.  Mix until combined.  Do not over mix.

Pour muffin tins 3/4 of the way full and bake for 15 to 18 minutes until tooth pick comes out clean.  Allow to cool COMPLETELY before covering to store in order to avoid the muffins becoming too sticky (therefore unappealing to kiddos who don't want to touch sticky things).

It Takes A Village...

...and I am not a village.  No parent equals a trained feeding professional.  (Unless of course, you are a trained feeding professional but you aren't the people I'm talking about.)

First, my apologies for a waaaay longer than intended hiatus from writing this blog.  I won't bore you with the details but the super abridged version of why I didn't get to write it this:  high risk pregnancy, bought new house in new town, birth of precious daughter (full term this time!!!), Buster started preschool and life just got away from me for a bit.  Now, I am back and I'm so grateful for all of the mommies who have been in touch with me through this blog...I am recommitting to continuing to share out story.

So, after so much progress with Buster's eating last year we made a few choices I now regret.  At the end of July (2013) he was doing well trying new foods.  He was not eating the volume of food we wanted but we were making slow and steady progress.  We bought a house in a new school district that we were more comfortable with because Buster was due to begin Early Childhood Special Education (the next step after Early Intervention in Illinois) Preschool in September.  At age 3, they move from EI to ECSE.  We made a GREAT choice...we could not be happier with his school.  But it did move us far enough away from our therapists that we weren't able to continue services with them.  ECSE preschool is for children who require special education or are at risk for learning/developmental impairments once they are in "real school".  Buster is receiving speech therapy and physical therapy at school.  He isn't getting occupational therapy because his fine motor skills are good and in the way that the school district looks at it, his ability to learn isn't impaired by any occupational needs.  (This is something I am going to address with them as we make his Individual Education Plan (IEP) for next year's preschool year).  He's also getting some help with his social skills...he's a painfully shy kid.  He really shuts down in groups of kids.  So, they are helping work on that.  Something that the school's therapy does NOT offer is help with his feeding.  It doesn't effect him academically so (understandably) it's something they don't deal with.

My husband and I decided we would see how it goes without therapy beyond what he was getting at school.  We had a newborn, Buster was doing reasonably well...we just thought it was time to try it alone.  But at some point in the chaos of moving, bringing our daughter into the world, Buster starting preschool, holidays, blah, blah, blah....feeding progress stopped.  He really does eat a pretty nice variety of fruits, vegetable and grains.  Proteins are not his strong suit.  Cottage cheese, yogurt, peanut butter, cheese...those are things he likes and his main sources of protein.  He will eat some deli turkey and ham.  He'll eat hot dogs (don't judge me...I get the preservative free kind).  And he will eat chicken nuggets.  But he won't eat any other meat in any form.  He will SOMETIMES eat scrambled eggs.  Sometimes.

Here's the problem, it's not that he won't eat things...he just won't eat ENOUGH of anything.  He'll happily take a few bites of lots of foods but to get an entire meal into him takes, at minimum, an hour and a lot of struggle.  He feeds himself a few bites but I still feed him the majority of his meals.  This HAS TO STOP, he will be four this summer.  We are much better about yelling than we were two years ago.  Occasionally, it still happens.  But, even without yelling, there is frustration, pleading and general discontent from all parties at the table.  Particularly our nearly 8 month old daughter who does not want to be in the kitchen for an hour and a half every night while her brother refuses bites of food.  One of us will usually take her in another room while the other works with Buster but if it's only one of us home at a meal time, she's stuck and it isn't fair to her.

Somewhere along the way we also stopped the rewards charts.  (SHAME ON US!)  He was putting a sticker on a chart for each bite.  The sticker itself was the reward because the kids loves stickers.  As of today, I have brought the rewards chart back but in a new way.  He's outgrown the old system.  He's going to get a sticker for each item he eats in its entirety on his plate...eat all of your peaches, get a sticker.  And after 10 stickers he will get a "prize".  I bought a basket full of inexpensive toys/stickers/crafty things to entice him.  I am also going to add cards for things like "go to the library", "go to the park", "ride your bike for 15 minutes", "play with the water table"...all things that we would probably do anyway but things he loves so he'll work for them (I hope) and as this brutal winter ends, the list of prizes can get longer because we can spend more time outside doing fun things.  On Halloween we discovered that he likes some candy...M&M's specifically.  So we always offer him 4 or 5 M&M's to get those last few bites in him at the end of a meal.  We'll keep doing that.  He'll have a longer term goal (10 stickers) and an immediate goal for that meal (M&M's).

TV...I think it's become a hindrance.  It used to be the only was we could distract him enough to get him to eat.  Now, he's more interested in TV than eating.  I've been playing a game of "take a bite or I'm pausing your show" but I'm getting REALLY tired of pausing Curious George 100 times a meal.  I think instead we are going to slowly take it away.  He'll get one episode per meal and then it gets shut off.  Last night I shut it off and told him it was because he needed to concentrate on eating.  He wasn't happy about it but after a few minutes of a fit, the rest of the meal MAY have went a little faster.  Maybe.

Anyway, I've made a long story long and here's the end result.  Yesterday, we went to a pediatric therapy facility in our new home town and had him assessed.  I've already talked in previous posts about Buster having Sensory Processing Disorder.  It is so, so different from child to child.  Buster's sensory problems are much less obvious than they used to be.  He will cover his ears from time to time with loud noises and he doesn't like the tv too loud.  But, he doesn't flip out if the vacuum is running anymore.  He is happy to have wet, sticky paint on his hands for art projects now...that didn't used to be the case.  I can pour bath paint all over him in the tub and he thinks it's great.  BUT, the SPD remains.  There are still things he doesn't want to eat because he doesn't like the feel of it...a muffin with a sticky top, peanut butter and jelly if it squeezes too much outside of the bread...things like that.  He still HATES to be upside down.  He doesn't like swings at the park, never has.  He has "low tone" which essentially means general muscle weakness.  He is easily frustrated with himself when he is trying to accomplish a task...he's too hard on himself.  He will often yell "it's not perfect!!!" when he doesn't trace a letter perfectly or paint something as well as he wants.  I'm trying to stop myself from saying things are "perfect".  He doesn't need to be perfect, he just needs to try hard!  That's really all that matters.  I'm trying to get him to understand that idea.

All of these (plus more) things still add up to SPD which is at the root of his feeding problem.  So, back to occupational therapy we go!  And I'm THRILLED.  I thought we could do it without help.  I thought we were to a point that it was manageable.  But, I'm here to tell ya...we can't.  We aren't there.  So woooohoooo for therapists!  BRING IT ON!  I need help.  I need support.  I need my kid to eat and I can't make it happen so I will do everything in my power to help my child.  I need more village, so I found it.

PS: The OT also said his shyness might be part SPD.  I think 50% of it is just his personality.  He is a shy kid.  His dad was a shy kid too.  I also think 50% may be sensory overload and he gets overwhelmed and shuts down around groups of people/kids.  So, I'm hopeful beginning therapy again will help him overcome social anxiety as well.  Fingers crossed.