Sensory Therapy is Delicious!

So, Tyler and I are working on his therapy. This is a picture of my favorite. Can you tell what is in the bowl? Orange Jello and whipped cream. Yummy!

Orange-flavored Cheerios were not so yummy. I had to bury Cheerios in the Jello and beg Tyler to feed them to me so that he would stick his hand in the Jello. But we had fun!

We also played in a rice box. I filled a fairly large tupperware bowl with rice and buried some items, like a small bath toy, some cotton balls, and some plastic bottle tops. (Please note that I mean caps to his bottles, not something small enough for him to swallow!)

We took advantage of the great weather and played outside with the rice box. Good thing as Tyler really just wanted to throw the rice.

I cleaned up as much of it as I could. How much uncooked rice does it take to kill a bird? (I've heard they eat a lot and it swells in their stomachs and kills them. That is why people don't use rice after weddings anymore. Is this true?) We have beautiful red birds on our back deck all the time. I am very concerned about them.

Speaking of ingesting uncooked rice, Tyler ate a few pieces. He loved chewing on them, crunching them between his front teeth. Really, it is hard to believe he doesn't know how to use his tongue if he can keep a tiny rice kernel in between those tiny front teeth. How much rice do you think would be harmful to an adorable bird-killing toddler?

He ate the rice and yet made no attempt to taste the Jello or the whipped cream (even though I sampled them extensively). However, that wasn't the purpose of the exercise. We were only playing with the textures in our hands. I wasn't trying to get him to eat anything.

The tongue exercises, on the other hand, are not going well. He's supposed to chew on a carrot to learn how to use his tongue and teeth. He only wants to throw the carrot. He refuses to put it near his mouth. And if I put it in my mouth, he tries to shove it down my throat!

But he's learned two new words. (As in, he recognizes the words and comes running. He can't say them yet.) "Chocolate." And "Vitamin." He loves both.

And we ordered pizza tonight. I took some of Brian's pepperoni, dried it off and toasted it in the toaster. Tyler LOVED it. Seriously, he gobbled it up. Brian has no pepperoni on his leftover piece of pizza.

I can't believe I fed my child pieces of pepperoni, but the nutritionist suggested it. She also suggested we add a teaspoon of sugar to his food twice a day, a teaspoon of olive oil to his food three times a day, a tablespoon of dry milk powder three times a day, a tablespoon of half and half once a day, a tablespoon of polycose powder four times a day. She also gave us some suggestions to make sure he's getting enough iron and recommended we keep giving him Carnation Instant Breakfast. If we can get him to eat an extra 300 calories/day, he should gain a half a pound each month.

And now, want to see what the monster was up to while I was taking pictures of Jello? Please note where his hands and feet are in this picture. So far he's only made it up two steps, but you can tell he wants to keep climbing.

The Dreaded Feeding Evaluation

It wasn't so bad... really.

Remember how we met with my friend's mom, who is a retired speech therapist, a few months ago? She offered us some advice regarding Tyler's eating problem and encouraged us to get therapy for him.

Well, that time Tyler cried and cried and REFUSED to eat for the rest of the day, so I was really dreading today.

But I guess because he's older, he handled things a little better this time, which kind of makes me glad that we put it off for a couple of months.

Anyway, we went to Children's Healthcare of Atlanta at Scottish Rite. They had a cancellation and were able to get us in 3 weeks earlier than we expected!

We met with Shahnoor, a young therapist. (I think she's of Indian descent, if you're wondering about her name, but she obviously grew up here in the U.S.)

Tyler played with some toys while Shahnoor asked me questions about his eating habits and health history. Then we got him to sit in a tiny little chair with a tray. I sat in a child's chair in front of him, and Shahnoor sat on the floor in front of him.

We tried to feed Tyler all the things he won't eat: banana, cantaloupe, Stage 3 baby food with chunks in it, peas & carrots.

I think I had an unrealistic hope that he would magically eat a pea while we were there, and that I would look ridiculous but we would realize that all of his problems had been solved.

This did not happen.

He would not eat the banana. He did not like the banana to touch his hand. He would not even hand me a piece of the banana.

He would not eat the peas and carrots. However, he did feed me a couple of peas.

He gagged on the Stage 3 baby food with chunks in it, and he threw up a little. Shahnor cleaned up after him. She was so sweet and patient with him.

He refused to touch the cantaloupe, until I put it in the mesh baby safe feeder. Even then, he really just wanted to throw it in the floor.

He did eat a little of the Stage 2 baby food, and he ate some Cheerios. He ate some dried banana and some dried strawberries. He gobbled down the dried blueberries, his favorite.

The whole time, he was throwing things in the floor, and Shahnoor would put it back on the tray and say, "No, Tyler, it has to stay on the tray." She would put the toys or food back on the tray, and she would try to catch it if he tried to throw it back off the tray.

Of course, I've always let him throw food, because he's so occupied by the throwing that I can sneak food into him. But Brian HATES it when Tyler throws food. He lets him so that we are "consistent" with Tyler, but it bothers hims.

Anyway, the diagnosis:

1) Tyler does not use his tongue properly to push food to his gums where he can chew it. Instead, he uses a sucking motion and tries to mash food with his tongue against the top of his mouth. This is called "delayed oral motor skills," or something along those lines.

2) Tyler has sensory integration issues. He doesn't even like the way the banana feels in his hand so there is no way he's going to put it in his mouth. We have to help him learn to accept the feel of certain foods in his hand so he will be more willing to eat them.

(There is a continuum of sensory integration issues. Some kids with sensory integration issues are very sensitive. Others are less sensitive than "average" kids. This could explain Tyler's high tolerance for pain and why he doesn't cry often when he falls down. Also the different senses are affected. Some kids hate loud noises. Some hate bright lights. Some have much worse "feel" issues than Tyler -- to the point where they can't stand the tags in shirts or won't wear new clothes because they feel scratchy.)

3) Tyler has "learned food aversions" due to the gagging episodes in the past. This will make it harder to get him to try new foods even as we improve his ability to eat other foods and accept different textures.

So we have homework:
1) put some of the pureed baby foods into the sides of Tyler's mouth and run the spoon along the side of his tongue.

2) Let Tyler chew on a full-size carrot. Not so that he eats any but so that he improves jaw strength and learns to move his tongue properly.

3) When Tyler is eating his dried fruits, we are to eat some with him watching and we have to use very exaggerated chewing motions with our mouths open so he sees food on the sides of our mouths.

4) We have a whole page of sensory integration exercises, like playing in a bowl of rice.

5) We are also supposed to stop letting Tyler throw food and toys in the floor while he eats. This will put us back in control of the feedings and will make it harder for Tyler to refuse foods in the future b/c he will know it isn't acceptable to throw it in the floor.


So Brian is very excited that food-throwing is one of the things we have to work on. I see the therapist's point. HOWEVER, this morning, I have not been able to get Tyler to eat even a half of a jar of baby food because I keep having to take away the toys because he only wants to throw them. And I think that telling him "no" is making the problem even worse actually. I swear he had a look of defiance as he threw things in two different directions at the same time this morning. He was mocking me: "Catch this!" Chunk. Chunk.

He is supposed to gain weight by Jan. 7 (our follow-up visit with the pediatrician), and I feel like we're regressing already! Aren't you supposed to take two steps forward before you take a step backward?

Barking Dogs and Ferocious, Flirty Little Girl

There are so many cute stories from the last few days that I don't know where to start.

On Saturday, we were invited to dinner with some family friends. They have two full-size poodles, which Tyler LOVED. He hardly stopped doing the "puppy" sign all night long. Denise said he probably would have done a sign for "horse" if he knew one — because the dogs are so big. They must be three times Tyler's size.

Bilbo took exception to Tyler's rolling, music-playing turtle and barked at it when Tyler would push it. At one point, Tyler crawled into basket, sat down in the basket and pushed turtle back and forth just beside the basket. Bilbo stood over him, barking at the turtle and jumping back (scared) if the turtle touched him.

Tyler was un-fazed by the barking but he did cringe a little when Bilbo's ears tickled his face!

The next day, however, Tyler was terrified of 17-month-old Keira (a human little girl his size). Eager to welcome a playmate to her house, she ran over to hug Tyler, who clung to his daddy for dear life! (The kids did end up playing together... or taking turns stealing toys from each other.)

Today, I was in the floor playing with Tyler, who invented a game. Here are the rules:

First, Tyler makes Mama think he's playing "spin Mama."
Then he runs behind Mama and pulls out a hair.
Then he runs around in front of Mama and hands the hair to her.

I was gullible enough to lose three hairs before I stood up so he couldn't reach any more.

In other news, we have an appointment tomorrow morning for Tyler's evaluation with Children's Healthcare of Atlanta. The evaluation will decide what sort of treatment he needs to deal with his texture/food issues. I'll keep you all posted...

French Toast Croutons, Anyone?

This morning I made French toast, with the futile hope that Tyler would eat some. I'm really trying to get some protein in him and French toast has eggs...

He refused to eat it. Piece by piece, he threw it in the floor and he wouldn't let me put any in his mouth.

So I put another piece in the oven at 170 degrees for an hour.

And then I left it sitting out until it cooled.

By this time, he was ready to eat again and I hoped the French toast was sufficiently crunchy.

He let me put one piece in his mouth! Yay! He chewed for the longest time and finally put another piece in his own mouth.

He threw all the pieces in various directions. His favorite was to see if he could throw it across the table. I kept giving them back to him and he kept throwing them. But he was having fun throwing them. This was different from the this-is-so-mushy-and-gross-I-can't-stand-to-have-it-on-my-tray throws.

Yes, I fed my child off the floor. I'm sorry, but I was limited on the amount of crunchy toast I had and I really wanted him to learn to eat it. All the experts say to let a picky child play with food. And how does Tyler play? He throws things. He might even eat a banana if I let him throw it down the stairs.

He loves to throw books and shoes down the stairs. Laundry baskets, too. He's figured out how to turn a laundry basket upside down to empty it and he runs to the top of the stairs and heaves it over the baby gate.

Anyway, about the French toast. Tyler insisted on having something to play with while he was eating. (He always has to be distracted in order to eat.) So he forgot to chew sometimes and it took him 30 minutes to eat 3 "croutons" of French toast. But he ate the second and third ones on his own! Success!

We then moved on to the staples: baby food and dried fruits and Cheerios. In all, it took him about an hour to eat. Between the two of us, Brian and I feed Tyler 5 times per day. Then we have to clean up the floor. I'd say we spend at least 5 hours a day on Tyler's meals.

Last night, we were even giving Tyler a milkshake while he was in the bathtub. Here's the conversation that went with that one:

Brian: How many kids do you think get milkshakes right before bedtime? In the bathtub, no less!

Jaime: We're awesome parents, aren't we?

Brian: Too bad he doesn't know it!

And Tyler was frantically doing the sign for "milk" and grunting so he could have more milkshake.

From the Mother of a Picky Eater to the Mother of a Picky Eater

Mama,

I am so sorry for what I put you through.

I don't remember what I was like when I was a baby, but I've heard you say before that I refused to eat bananas even though the baby food I liked best was banana.

I now understand your frustration.

(I still don't like bananas, even though I let Tyler feed them to me in the hopes he'll stick some in his mouth!)

At the doctor's suggestion, I was giving Tyler chocolate Carnation Instant Breakfast in his milk this morning, and I remembered all the mornings you cajoled me to eat something before school: instant breakfast, milkshake, anything?

I remembered how you said, "At least you're getting calcium," when we'd eat ice cream even though we hadn't eaten much supper.

I remembered how a mother of a high school friend approached you, concerned I was anorexic when I refused an afternoon snack. I had told her I wasn't hungry. In truth, I just didn't like what she was serving.

I remembered how people said we were spoiled because you would fix two or three dinners so everyone would eat. We were spoiled, but probably no one realized how desperate you were to get your kids to eat.

I remembered that you packed my lunch every day before school. How many PB&J sandwiches do you think you made over the years? I only ever ate PB&J or turkey, when I got older.

I'm starting to understand, and I'm so sorry for putting you through that!

I just hope I can be as patient and creative while feeding Tyler over the next 18 years as you were. Surely, I'll be empathetic, seeing as how he gets his pickiness from me!

I love you!

15-Month Check-up and Never-ending Dr. Seuss

Tyler went for his 15-month check-up this morning.

In the last 3 months, he has grown almost 2 inches and is now 31 1/4 inches tall. His head circumference is 48.8 cm.

However, he LOST 4 ounces and now weighs only 22 pounds. We're going to see a nutritionist and a specialist who can help him learn to eat mushy foods.

He is in the 75th percentile for head circumference, the 50th percentile for height, and the 25th percentile for weight.

(To see his previous stats, click here.)

On the way to the doctor's office, Tyler got a little fussy. After several renditions of "The Itsy-Bitsy Spider," I tried to think of something else to "sing" to him. I ran through the alphabet song a few times and still needed something else.

One of his favorite books right now is a Dr. Seuss book, and so I tried to remember bits of it. Believe it or not, I have memorized the whole book from

"Big A, little a, what begins with A? Aunt Annie's alligator. A, a, A"

all the way to

"Big Z, little z, what begins with Z? A Zizzer-zazzer-zuzz, as you can plainly see."

And now, after reciting it at least 7 times, I can't get it out of my head!!!