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1
List of mealtime rules to establish a positive
mealtime environment
So many feeding difficulties can be improved by
putting in place mealtime rules that set up a positive
mealtime environment for families. Examples include:
n
Having 5 set meals each day – children who graze
on food all day are never hungry enough at meal
time to try new foods.
n
Everyone sits at the table or in a highchair for meals
– children tend to eat less when they are distracted
by the TV or toys while eating.
n
Everyone eats together – children need to be
included in normal mealtime activities (talking
about their day, etc.) and they are more likely to eat
foods that they see their parents and siblings eating.
n
Everyone eats the same foods – this stops parents
feeling they need to prepare different foods for each
child in the family. Some studies suggest that child
ren need to have a food presented to them more
than 15 times before they are likely to try the food.
Ensuring they are offered the same foods as the rest
of the family means they are constantly exposed to
a range of foods.
n
Everyone over 18 months feeds themselves –
children over 18 months should be having all of
their food served as finger foods or pieces small
enough to stab with a fork. Children at this age
should be able to use a spoon independently
(although maybe a little messily).
n
Children are never in trouble for not eating but they
should not be given any other foods if they do not
eat what is offered.
2
Stages of finger foods
by Sarah Starr,
Speech Pathology Services
This is great to give to parents to help them understand
that some finger foods are easier to eat than others. The
handout grades finger foods as:
n
very soft/easy to chew – e.g., well cooked vegetables.
n
soft, requiring some chewing – e.g., pasta.
n
more difficult to chew – e.g., red meat, muesli bars.
3
Triple P (Positive Parenting Program) training
So much of community-based feeding work involves
aspects of behaviour management. Being trained in
M
y
T
op
T
en
R
esources
for
W
orking with
C
hildren with
F
eeding
D
ifficulties
in
the
C
ommunity
S
etting
Kylie Harris
For the past two and a half years I have worked as the senior speech pathologist in the paediatric therapy stream at Logan
Hospital. My caseload includes general speech and language delays in children under school age and the paediatric
feeding caseload. Our feeding caseload includes the special care nursery, maternity and children’s wards and an
outpatient caseload. Most children we see for outpatient feeding are referred to us because they are having difficulties
transitioning through lumpy solids or because they have difficulty with chewy foods such as red meat. The list of
resources I have put together contains those that we use with the outpatient caseload.
Triple P allows the clinician to give accurate and
consistent advice on how to manage undesirable
behaviours. People who are trained also have access to
Triple P Tip Sheets like “Toddlers: independent eating”
and “Preschoolers: mealtime problems”. See the website
www.triplep.netor phone 07 3236 1212 for more
information.
4
Highchair
A highchair is essential for
observing infants and toddlers
eating/being fed in an environ
ment that is similar to home. It
is often during an observation
time that the clinician gains
valuable information regarding
the interaction between carer
and child and the skills of the
carer and child.
54
S
p eech
P
athology
A
ustralia
MULTICULTURALISM AND DYSPHAGIA