Friday, July 10, 2009

Book Review: Just Take A Bite

Just Take A BiteJust Take A Bite, written by Lori Ernsperger, Ph.D. and Tania Stegen-Hanson, OTR/L, contains thorough explanations of how certain environmental, behavioral, motor-based, and sensory-based issues may contribute to eating problems in babies and children with developmental delays and resistant eaters. Short case studies spotlighting kids aged 2 months up to 7 years old are interspersed throughout the book to illustrate certain concepts and ideas. I think it has similar information found in "The Down Syndrome Nutrition Handbook" by Joan Guthrie Medlen. The difference is that Just Take A Bite is very solution-oriented and offers practical suggestions, not a quick-fix. Is there such a thing as a quick-fix to eating challenges?

Matthew's Occupational Therapist (OT) highly recommended it to me and even lent me her copy for a couple of weeks. The book helped me expand my understanding of the feeding challenge landscape in terms of how my resistant eater/food neophobe experiences it. The guidelines and tips for creating and implementing strategies provided in the book are very empowering tools. Some of the suggested activities are intended for older kids, requiring more active participation than Matthew is currently capable of such as guessing a food item by touch in a mystery box. Here are a few goals that I have set for Matthew with suggested activities (many of which are taken straight out of the book, but they definitely make sense for us to try):

Oral-motor Goal: To improve chewing skills
- create a mouth box.
- at the end of every meal, use foods that increase extended chewing skills.
- practice chewing foods in a teething feeder.
- sometimes place food off to the side of Matthew's tongue instead of in the center.

Sensory Development Goal 1: To increase acceptance of new foods
- encourage food play activities.
- place the new food item on or near Matthew's tray at dinner time.
- encourage Matthew to touch the new food even if he doesn't eat it.

Sensory Development Goal 2: To minimize opportunities for food jags- make small changes to preferred food items.
- introduce a new brand of the preferred food item.
- offer at least 1 new food item alongside preferred food items.

While setting these goals may seem like an unnecessary process and a matter of common sense, writing them down certainly helps me stay organized and focused. I also do not have a deadline for achieving these goals and may have to alter the strategies, taking cues from Matthew's progress. The idea is to be flexible as needed.

I do wish the book had an index to make it easier to look up topics by key words. Also, the scope of the book is limited:
"The book is not intended to address severe feeding issues and physical difficulties associated with tube feeding. Some children with severe physical and medical limitations require significantly more than the treatment plan suggested here and are clearly beyond the scope of this book. For further information on this topic, refer to Suzanne Evans Morris and Marsha Dunn Klein Pre-feeding Skills: A Comprehensive Resource for Mealtime Development, 2nd ed (2000)."
Overall, I think this is a great book that helped me devise simple goals and strategies (with our OT's additional input) for addressing Matthew's feeding challenges. It may not be a quick fix but I feel like I'm headed in the right direction.

Related posts:
Toy Review Tuesday: Mouth Box
Transitioning from Baby Food to Solid Food


Ann said...

Thanks for that book review. We just finished with two months of intensive therapy and find several of your goals are in line with our development goals. One you mentioned, small changes, or fading, is a constant for us. As we try to move forward with eating, he is less resistant if we use fading. Also offering the preferred food along with the non preferred foods really helps.
I know Artie's issues stem from choking and aspiration so we need to strengthen muscles. Another therapy we use is 'chewing therapy'. Simple tubing from a nebulize cut to two inches in length with 1/2 inch end split to resemble a spoon of sorts. Right now we are using it to chew a specific number of times on each side. We hope to fade into food on the tube and then finally placing food with the tube. Whew! I know it works. Just doing it and keeping track of progress helps.
Again, thanks for the review! And please do add me to your blog roll. I appreciate that!

Unknown said...

Wow. I had no idea this kind of information was available. Thankfully, Carly had/has no issues with eating. I sometimes feel like I know far too little even after 7 years with Carly. We were left out of many informative things after Carly was born. First, we dealt with the shock of having a child born with Ds. Then, as we thought things were going great. The heart issue came about. Then...things calmed down. You'd a thought someone in the medical field would have clued us into these much needed therapies and such. That's one reason I started my blog. I'm finding so much out that I never knew. It makes me kind of sad that I didn't know then what I know now. Thanks for all the information you have readily available.

Tara said...

Totally off topic, but the kid on the cover is the spittin' image of my 2yo son. I actually gasped and looked closer to make sure it wasn't him! LOL! I have to say that I'm almost dreading starting solids because of all the potential food issues. It almost makes pumping seem easy! :)

Monica said...

Thanks for sharing!!!

RK said...

Very interesting...and I keep this kind of info in the back of my mind for someday, down the road, though I don't know when. :) But someday...we'll get to chewing someday!

Signe said...

thanks for visiting my blog and sharing your's with me. It's wonderful and I appreciate all of the useful information you are sharing. Our kids are very close in age, too. Lauren will be 2 this month, on the 22nd. It's really been a great ride. I look forward to more posts from you.

Signe said...

oh, forgot to add: your son is beautiful!

To Love Endlessly said...

There is so much that I learn through other parents vs. the medical community or EI. Thanks for the info.

Jill said...

What a great cover photo! HaHa! You are always so informative, Ria. I love your honesty and expressions...especially the way you share what you've tried, what works-what doesn't and why you think so. I've learned a lot reading your posts! Your tireless efforts encourage me as I sometimes get worn out trying to find new and ways to help Nate grow and learn. Keep up the fresh ideas (no pressure lol) Your blog is important to many many moms out there and your sharing your life is so much appreciated.