Assisting children to eat

Eating is of utmost importance to the health, education and happiness of children with disabilities. Mealtimes allow for social interaction and lead towards independence as well as providing nutrition, which is necessary for survival and growth. For those children with disabilities who also have difficulties with EATing, however, attempting to complete a meal without choking or gagging can be very stressful for both the child and the feeder. SNA’s and teachers are becoming more responsible for ASSISTING CHILDREN TO EAT a growing number of children with disabilities who also NEED ASSISTANT TO EAT.

• Eating - refers to the child being able to actively bring food to his/her mouth independently • ASSISTING A CHILD TO EAT- refers to the child being assisted in the activity of eating • Oral motor control relates to the child’s ability to use his/her lips, cheeks, jaws, tongue, and palate If the child is able to “self-feed” ensure protective clothing is used. If they are eating finger food close supervision is required. Records as shown below should be kept with regards food and fluid intake as some children may be unable to indicate when they are hungry or full.

Understanding feeding skills from different perspectives eating skills are essential for survival; all people must eat to stay alive and healthy. Difficulties in feeding skills may affect all aspects of a child’s life, including growth, learning, communication and interactions with others within the environment. Child and family’s perspective The EATING process is critical for family members. It is devastating for caregivers when they cannot ASSIST their own children TO EAT. It is extremely upsetting, as it will affect the child’s health and growth. In addition to the nutritional aspects, the EATing process is a social process that helps caregivers and family members form relationships and impart culture, traditions and values. Disruptions in the EATING process can upset parent-child, family and mealtime interactions.

Educator’s perspective Sometimes educators do not realise the emotional impact that feeding problems have on families. Therefore educators must respect the different methods that individual families have for coping with these stressful situations. Cultural implications affect all interactions with children and families so the cultural umbrella should always cover all aspects of working with children. Before making any recommendations or developing a feeding plan, educators should determine whether their recommendations respect the family’s beliefs and values.

Therapist’s perspective Two therapists are usually responsible for the development of oral-motor feeding programmes. These are the Occupational Therapist (O.T.) and the Speech and Language Therapist. Together they develop programmes for feeding, taking into consideration many aspects from correct positioning of the child, appropriate utensils to use, to activities to develop oral-motor control. Medical Practitioner’s perspective A comprehensive medical evaluation may be recommended if the child’s feeding remains difficult. The child may have to undergo tests to determine feeding and swallowing difficulties

Role of S.N.A. In a school situation we will be primarily concerned with correct positioning for feeding and eating, ensuring that the child has the appropriate adapted equipment and that the food given complies with special dietary requirements. Correct positioning • Sitting in an upright position • Pelvis and hips symmetrical • Back should be straight and supported by the back of the chair • Shoulders should be level and relaxed • Head in a neutral and mid-line position • Arms forward with hands in mid-line • Legs supported • Feet flat on the ground Unless otherwise stated in a care plan

Adapted Equipment There is a wide variety of adapted equipment available to aid the feeding process. Individual children are assessed by their O.T.s and the equipment is adapted to suit the individual’s needs. Equipment includes: • Cups • Straws • Spoons • Plates and bowls • Non-slip mats • Tables • Chairs Please note it is important that training would be given by qualified supervisors before you would attempt the feeding of a child with a specific disability.

Correct dietary requirements To ensure that a child is never offered food, which may be detrimental to their health, it is necessary for any staff involved in feeding programmes to be aware of children who may have one or more of the following: • Diabetes • Coeliac disease • Nut allergies • Other allergies • Low fat diets • Caffeine free diets • Specific dislikes • Food forbidden through cultural beliefs