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?