Tag Archives: utensil grip for toddlers and preschoolers

Hypermobility Or Low Tone? Three Solutions to Mealtime Problems

 

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Many young hypermobile kids, with and without low muscle tone, struggle at mealtimes. Even after they have received skilled feeding therapy and can chew and swallow safely, they may continue to slide off their chair, spill food on the table (and on their body!) and refuse to use utensils.

It doesn’t have to be such a challenge.  In my new e-book coming out this year, I will address mealtime struggles.  But before the book is out there, I want to share three general solutions that can make self-feeding a lot easier for everyone:

  1. Teach self-feeding skills early and with optimism.  Even the youngest child can be taught that their hands must be near the bottle or cup, even when an adult is doing most of the work of holding it.  Allowing your infant to look around, play with your hair, etc. is telling them “This isn’t something you need to pay attention to.  This is my job, not yours.”  If your child has developmental delays for any reason, then I can assure you that they need to be more involved, not less.  It is going to take more effort for them to learn feeding skills, and they need your help to become interested and involved.  Right now.  That doesn’t mean you expect too much from them.  It means that you expect them to be part of the experience.  With a lot of positivity and good training from your OT or SLP, you will feel confident that you are asking for the right amount of involvement. Read Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child and Teach Utensil Grasp and Control…Without the Food! for some good strategies to get things going.
  2. Use excellent positioning.  Your child needs a balance of stability and mobility.  Too much restriction means not enough movement for reach and grasp.  Too much movement would be like eating a steak while sitting in the back seat of your car doing 90 mph.  This may mean that they need a special booster seat, but more likely it means that they need to be sitting better in whatever seat they are in.  Read Kids With Low Muscle Tone Can Sit For Dinner: A Multi-Course Strategy for more ideas on this subject.  Chairs with footplates are a big fave with therapists, but only if a child has enough stability to sit in one without sliding about and can actively use their lower legs and hips for stabilization.  Again, ask your therapist so that you know that you have the right seat for the right stage of development.
  3. Use good tableware and utensils.  If your child is well trained and well supported, but their plates are sliding and their cups and utensils slide out of their hands, you still have a problem.  Picking out the best table tools is important and can be easier than you think.  Items that increase surface texture and fill the child’s grasping hand well are easiest to hold.  Read The Not-So-Secret Solution for Your Child With Motor And Sensory Issues: Dycem and OXO for Kids: Great Tableware For Older Kids With Sensory and Motor Issues for some good sources.  Getting branded tableware can be appealing to young children, and even picking out their favorite color will improve their cooperation.  Finally, using these tools for food preparation can be very motivating.  Children over 18 months of age can get excited about tearing lettuce leaves and pouring cereal from a small plastic pitcher.  Be creative and have fun!

 

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Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child

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Whether you are teaching a younger child to grip a toddler spoon or teaching an older child to hold a spoon in the mature pattern, kids can resist practicing this important skill.  I created a game that makes it really fun and builds a warm connection with your child.  You share a laugh and allow your toddler or preschooler to be “the baby” for a few minutes instead of giving in to all the whining that children can generate when they are challenged.  This is especially important if your child has motor delays, is on the spectrum, or has a spirited temperament.  Let me explain why developing self-feeding skills are important, and then I will describe the game.

Mealtime utensil use is the first time that your child uses a tool to obtain something.  Tool use is a visual-motor skill milestone.  Some children grab the spoon from you at 8-9 months.  Some avoid even trying, preferring to be fed.  Take a look at  Want Pincer Grasp Before Her First Birthday? Bet You’ll Be Surprised At What Moves (Hint) Build Hand Control!  for some hidden (but not to OTs and PTs!) activities that build pincer grasp for self-feeding before 12 months.  And some older kids with fine motor challenges will use that “fisted” grasp well into preschool and kindergarten.  Here is a thought:  Your child’s fine motor skills can expand daily when mealtime gives them a chance to practice grasp and grading movement!  Want more motivation?  Take a look at this recent post Using Utensils To Eat Prepares Your Child To Write .  Feeding yourself gives you clear feedback on your success or failure.  You either get your food in your mouth or not, get the spoon into your mouth smoothly or awkwardly, etc.  All immediate feedback, and not from an adult.  No criticism, no pressure from anyone.  I love it when I can recommend strategies that don’t involve an adult making judgements or demands!  In this case, the circumstances and the game do all the work.  You are going to add a social component and make practice really fun!

You need: two plastic bowls and two spoons and a scoop-able food.  Use toddler spoons if you have them for better grasp and control.  Toddler spoons typically have a non-slip handle and a slightly smaller “bowl” (where the food rests.)  Metal spoons with thin handles are the most challenging, and we are trying to make this easy and fun, remember?  The only reason to use a larger utensil would be if your child is older and their hand clearly is too large for a toddler spoon. Choose a bowl that is shallow and has straighter sides, the better to scoop up a spoonful.  They also tend to be less tippy than a deeper bowl with angled sides.  Select a food that your child likes, and one that stays on the spoon easily.  A bad choice?  Peas or dry cooked macaroni.  A good choice?  Oatmeal, mashed potatoes, Greek yogurt, pudding, ice cream.  You might want a few damp paper towels as well.

Your approach:  this is fun but it could be messy.  Don’t wear your best clothes, and don’t react immediately or negatively to a bit of dripping.  Wipe it if you need to for your child’s comfort, but try not to give the impression that spillage is bad.  What child would try this if failure was embarrassing or distressing?  This is going to be silly, so get ready to smile and laugh at yourself.  Most of us need to do more of that anyway.

Help your child by placing his hand on the spoon in the fisted grasp for a small child or the mature grasp (thumb on top, all fingers curled slightly under the handle, index finger may come on the side of the handle) for a 3 year-old child with fair control or an older child with motor issues.  Hold your spoon in a mature grip even if they are not ready yet, because modeling the advanced skill is usually best.  You feed your child a scoop from their bowl, THEN YOU ASK YOUR CHILD TO FEED YOU!!  Open wide but let them work on their aim.  Now you know why you need to wear washable clothes for this one!

Most kids over 2.5 years get the joke and laugh with glee!  Go ahead and make baby sounds or use baby talk, and allow them to be “the baby” when you feed them.  Children sometimes long for those days when life was easier, when they were fed and carried.  Some kids will insist on being carried or behave in an immature way when they feel they need more attention.  This is a chance to pretend and remember, but to do it in play and to do it in fun.

Enjoy this little game a few times, and watch spoon grasp just explode!

Looking for more mealtime ideas?  Check out OXO for Kids: Great Tableware For Older Kids With Sensory and Motor Issues and Which Spoon Is Best To Teach Grown-Up Grasp?.