We start off doing big body prep in the gym. There the feeding therapist, who's name is Lainy, had set up an obstacle course. This is to help with three different areas:-
- proprioception - (Proprioception doesn't come from any specific organ, but from the nervous system as a whole. Its input comes from sensory receptors distinct from tactile receptors — nerves from inside the body rather than on the surface. Proprioceptive ability can be trained, as can any motor activity)
- core strengthening, and
- tactile sense
The first thing we do when seated in the feeding room is blowing some bubbles. This is to help with her breathing and her oral motor skills. It also helps with endorphin production. It is important to get the endorphins flowing so they can help counteract adrenaline which is created by the fight/flight response. This fight/flight response is a common reaction to children with SPD, but the problem is that it causes adrenaline to be produced which shuts down the appetite. So you can see how important it is to make sure that Emma does not get stressed or worried or want to escape.
We move from blowing bubbles to table bubbles and hand washing. So it is all tactile - allowing Emma to play with the bubbles and clap her hands and get involved and enjoy the bubble blowing activity. A face washer was then introduced which gives Emma an escape outlet when things get too stressful for her.
The face washer is an important aspect of the feeding therapy, as they are trying to teach Emma how to do "sensory based problem solving". There are three steps for this
- reassure - we need to verbalise to Emma, its okay, you are doing well - you have your face washer to help you. She should then start to internalise these thoughts.
- Label the sensory issue / problem - is it too wet, too bright, too big or too small.
- Give a better solution - wipe off, cover up, change it, blow away
Nine different foods were introduced to Emma, and it was interesting watching her response to it. We found that large food items in her personal space was distressing for her - she exhibited stressful actions such as wide eyes, splayed fingers, no eye contact, but once broken up into pieces she was able to tolerate it in her space.
At no stage today was she encouraged to put food to her mouth, it was just play based. When she got upset or stressed, the item was then taken away from her and her attention diverted. Though she was showing strong aversion to coloured sprinkles. We believe that is because she could not control where the sprinkles went - so thus they were everywhere. A complete table clean was required after a couple of minutes.
A food chopper was also introduced. This plays into the part of teaching Emma the physics of food. The food chopper was said that it was big teeth chomping down on food, making smaller pieces - just like teeth do.
So on the scale of the 32 steps to eating - Emma managed to get to step 10. This means that she was able to touch certain foods with her whole hand.
It sounds like a slow process, but they are taking her back right to the start again and start teaching her the eating behaviour. She gets along fantastically with her therapist and the rapport between them is going to help Emma go a long way.
Saying this, Emma has done similar work with her therapist back in Australia, but without all the psychological work and background to it. It is all falling into place and we can see how this will be immensely beneficial for Emma.
So another full on and exciting day for us here at Food Camp in Denver. Time to relax and prepare ourselves for tomorrow. :-)