Parents talk about feeding: What ECSE professionals and trainers need to know

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Parents talk about feeding What ECSE
professionals and trainers need to know

• Deborah A. Bruns, Ph.D.
• Stacy D. Thompson, Ph.D.
• Division for Early Childhood
• St Louis, MO
• October 8, 2013

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Session overview

• The session will provide an overview of feeding
  development and difficulties from the perspective
  of parents of young children with disabilities.
  Recommendations for ECSE professionals and
  trainers will be shared along with
  feeding-related resources to increase and
  supplement content knowledge and related
  strategies and specialized interventions.

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Background

• Literature indicates that 40-75 of young
  children with disabilities demonstrate feeding
  difficulties (Arvedson Brodsky, 2002
  Bernard-Bonnin, 2006 Bruns Thompson, 2011
  Kuhn, Girolami, Gulotta, 2007 Manikam
  Perman, 2000 Rudolph Link, 2002 Schwarz,
  2003).
• Issues may resolve during infancy or continue
  throughout the early childhood years such as food
  selectivity or refusal, inability to meet
  nutritional needs and limited skills for
  self-feeding (Bruns Thompson, 2010, 2012
  Manno, Fox, Eicher Kerwin, 2005 Thompson,
  Bruns Rains, 2010).

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Background continued

• Although studies have been conducted examining
  specific interventions, overall, there is little
  evidence-based practice in this area. For
  example, there is literature describing
  anatomical issues related to feeding such as
  cleft lip and palate (e.g., Reid, Kilpatrick,
  Reilly, 2007) but little information to support
  ECSE (birth to five) providers.
• To build evidence-based practices, there needs to
  be efforts to further investigate feeding
  difficulties of young children with disabilities
  and the methods to their resolution. A place to
  begin is by gaining a better understanding of the
  parents perspective.

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Background continued

• Parents often identify early feeding difficulties
  and are primary participants in their resolution
  by implementing strategies and specialized
  interventions (Burklow, McGrath, Allred,
  Rudolph, 2002 Johnson, Handen, Mayer-Costa,
  Sacco, 2008 Schreck, Williams, Smith, 2004).
• Members of a childs ECSE team must work with
  parents in order to facilitate positive feeding
  outcomes. It is critical to understand parent
  perspectives on successful strategies and
  specialized interventions to meet feeding needs.
• Parent perspectives can be utilized to inform
  preservice training and professional development
  on feeding development and specific feeding
  difficulties especially in view of limited
  discussion of this topic across ECSE provider
  disciplines (Lefton-Greif, Arvedson, 2008
  McKirdy, Sheppard, Osborne, Payne, 2008).

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Parent panel

• Marissa Baxter / Piper and Sawyer (visual
  impairment)
• Evelyn Barrientos-Perkins / Avery (autism)
• Laura Bishop / Molly (Down syndrome)
• Michelle Wilson / Faren (trisomy 18)
• Jim Jordan / Aidan (trisomy 9 mosaic)

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Recommendations

• Family preferences must be used as the basis for
  team decisions
• Promote child-parent relationship (e.g.,
  reciprocal interactions at mealtimes)
• Encourage parent confidence and competence around
  feeding interactions, oral intake etc.
• Feeding strategies must promote, to the maximum
  extent possible, age-appropriate, functional
  skills as well as independence
• Team members remain up-to-date on feeding
  literature and recommended practices

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Recommendations continued

• Link feeding interventions and collaboration
  with DEC Recommended Practices (2014)
• L3. Leaders develop and implement policies,
  structures, and practices that promote shared
  decision making with practitioners and families.
• L13. Leaders promote efficient and coordinated
  service delivery for children and families by
  creating the conditions for practitioners from
  multiple disciplines and the family to work
  together as a team.

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Recommendations continued

• DEC Recommended Practices (2014)
• A6. Practitioners use a variety of methods,
  including observation and interviews, to gather
  assessment information from multiple sources,
  including the childs family and other
  significant individuals in the childs life.
• A11. Practitioners report assessment results so
  that they are understandable and useful to
  families.
• F4. Practitioners and the family work together to
  create outcomes or goals, develop individualized
  plans, and implement practices that address the
  familys priorities and concerns and the childs
  strengths and needs.

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Recommendations continued

• DEC Recommended Practices (2014)
• F7. Practitioners work with the family to
  identify, access, and use formal and informal
  resources and supports to achieve
  family-identified outcomes or goals.
• INS2. Practitioners, with the family, identify
  skills to target for instruction that help a
  child become adaptive, competent, socially
  connected, and engaged and that promote learning
  in natural and inclusive environments.
• INS13. Practitioners use coaching or consultation
  strategies with primary caregivers or other
  adults to facilitate positive adult-child
  interactions and instruction intentionally
  designed to promote child learning and
  development.

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Recommendations continued

• DEC Recommended Practices (2014)
• TC1. Practitioners representing multiple
  disciplines and families work together as a team
  to plan and implement supports and services to
  meet the unique needs of each child and family.
• TC2. Practitioners and families work together as
  a team to systematically and regularly exchange
  expertise, knowledge, and information to build
  team capacity and jointly solve problems, plan,
  and implement interventions.

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Resources

• Bruns, D. A. Thompson, S. D. (2012). Feeding
  challenges in young children Strategies and
  specialized interventions for success.
  Baltimore, MD Brookes.
• http//products.brookespublishing.com/Feeding-Cha
  llenges-in-Young-Children-P246.aspx
• http//ehs.siu.edu/eat/

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Resources continued

• Ernsperger, L. Stegen-Hanson, T. (2004). Just
  take a bite Easy, effective answers to food
  aversions and eating challenges. Arlington, TX
  Future Horizons.
• Morris, S. E. Klein, M. D. (2000). Pre-feeding
  skills A comprehensive resource for mealtime
  development (Second edition). San Antonio, TX
  Therapy Skills Builders.
• Williams, K. E. (2007). Treating eating problems
  of children with autism spectrum disorders and
  developmental disabilities Interventions for
  professionals and parents. Austin, TX PRO-ED. 

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Resources continued

• Online resources
• Meal Time Notions http//mealtimenotions.com/index
  .htm
• New Visions http//www.new-vis.com/
• Food chaining with Cheri Fraker and Laura Walbert
  http//cheriandlaura.blogspot.com/
• Resource handbook for parents of young children
  with autism who struggle at mealtime
• http//w3.mealtimeconnections.com/documents/handb
  ook_compiled.pdf

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For more information

• Deborah A. Bruns
• dabruns_at_siu.edu
• Stacy D. Thompson
• stacyt_at_siu.edu