Gonna have to make it on our own

Thursday was our last day at the feeding program! Yay! The whole thing was easier than I thought it would be, and actually kinda fun. They still want her to go back twice a week for speech therapy visits. This will mostly be working on introducing new, chunkier textures. Most of the hard work with Sophie was done in the first 2 weeks of the program, and the last 3 week have been just teaching Stephanie and I how to handle her. We had one week where we sat in the room while they fed her and got to be cheerleaders, and the last 2 weeks we did the feeding with the therapists observing us. And the last 2 days they stood outside the room, as part of the "final exam" we called it.

So essentially the whole premise is positive reinforcement and conditioning. We present Sophie with a reward (toy, book, video) and then offer her a bite of food with a totally monotone voice. If she doesn't take it, we remove the reward and tell her again to take her bite/drink. If she cries, fusses, throws the food, smears it in her hair, gags herself, spits up, etc, we totally ignore her. When she takes her bite, we go nuts praising her and saying things like "Good eating! Good taking your bite!" and give her the reward. Then we offer the next bite or drink with the monotone voice again. It sounds really simple and such a basic concept, but it's tough to execute. The idea is to only give the reward AFTER she does what you want. You're not supposed to be sing-song when you ask for a bite because that's a reward in itself, she gets something out of making you beg. If she spit up and you wiped it up, that can be a reward because she made you do something. If she cries and you console her, that's a reward, etc. If you were to get mad at something, that reaction can be a reward.

But it does work. Eventually she figured out that the only thing that was going to get her anywhere was eating or drinking. Of course, kids love trying to test. So when we switched from the therapists doing the meals to us, she regressed. Same thing when we tried doing some meals at home last weekend. Pretty much anytime you change anything--person, time, place, reward, food--you might have to start over again.

For example, Thursday was the last day of the day program. Friday morning was our first feed on our own. I made some blenderized pancakes (she's working on smooth, yogurt-like textures right now) and juice. I held the spoon out, Sophie looked at it, wrinkled her nose, and started screaming. She cried, screamed, pulled her hair, pushed away the spoon, and flat-out refused to take one bite or drink for the entire 20 minute session until the buzzer went off to end it.

Second try, two hours later, she looked at me, looked at the spoon, looked at the toy, opened up and took a bite, and did fine for the whole meal. Since then, she's been doing great. There've been a few gags and spitups, and sometimes most of the drink comes right out of her mouth, but she's been trying.

more to come about our new roles as dietitians...