Thursday, March 20, 2008

Mealtime Therapy and Food Sampling

For ages I have been meaning to reply to Melissa’s comment on the mealtime therapy we have been doing with Thane. The problem we have run into is that he has been very self-limiting in what he eats and his first response has been to push things away or throw them, unless they were things he requested. Of course, he was apt to ask for popcorn, cookies or popsicles!

When we asked for help getting him to try new foods, we weren’t really expecting the whole finish everything on your plate thing, or even having to have all meals and snacks at the table. We’re not that regimented around here, though we could see something positive about the process especially because of weight issues in the house.

It was so time-consuming: preparing things, all the separate dishes, sitting until he finished cooperatively, etc. Some days, it was too much. I noticed a pattern for myself where by Wednesday evening I was just done with it all. I was tired of driving around, getting stuck at the table, and having what didn’t feel like a lot of fun with Thane. It was work. It was stress. Even if it went well it just wasn’t natural.

Thane is a visual learner, which I think is part of what the behavioral therapist was looking at when making the plan. Thane also likes predictability . . . though he also wants to control his world. It was clear that he appreciated lunch right after getting home from school – it was his best meal of the day. Afternoon snack went pretty well, but dinner, when I truly wanted the whole family together, was usually pretty awful. The tension spilled over to everyone, and being tired we were all less able to deal with it.

The goal was to get Thane used to finishing his plate of food and drink – even if that was one bite and one sip. That way when we move to sampling, it’s predictable. If you finish that one pea-size bite on your plate, you’re done. You don’t have to eat more than that, but you do need to try it.

I thought long and hard about what Melissa said – is it worth it? Should we let go? It’s not like he is still failure to thrive. This is where ABA and I don’t mix well. I believe in positive parenting and punishing is very uncomfortable to me. Forcing Thane to sit at the table five times a day seemed like punishment because he didn’t want to do it. The only good part was no half-eaten grapes stuck to the furniture in the living room!

The therapist has always been clear that his job is to work with our family – not to tell us what to do . . . he gives us a plan and we decide if it is comfortable. What I realized is that I wasn’t fully honest with him, or I wasn’t realizing that I wouldn’t like it until I got into the treatment. I can be very agreeable at first and then start over-thinking everything afterward.

What we decided was that we did need to back off . . . not back off on the goal of sampling new foods, but back off on the regimented eating plan. We reduced to meals at the table and snacks could be eaten elsewhere without having to finish everything. It was easier on all of us. Thane was even choosing to come to the table and ask for meals and such.

On Monday, we learned how to do the sampling and it went pretty well. We’re going to try a rotation of a few different foods to sample. My problem is that in the process I worry about allergies rearing up again. We’ve had so much trouble with him being ill this winter and he seems like when his body is fighting allergies he’s more likely to get sick. This week may be the first time he gets to school each day since November.

I got paperwork in for a different preschool starting in summer – Thane’s ESY calls for 5 days per week over the summer, pretty much the same services we have during the school year. I also got all our paperwork in for Freedom Riders, so hopefully we’ll get a spot and start that in May. I am very excited about that.

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