SLIDE 18 10/5/2018 18
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Case Study: T.
- Participated in frequent (2x/month) feeding therapy from ages 5 years 8 months through 7 years 9 months.
Gradual increase to oral eating with removal of g-tube at 7 years 1 month [Recognize that it typically takes children 2-3 years to move through all stages of oral skill development, and therefore, feeding therapy should be a slow process if skills are truly attained]
- Status updates/changes:
- Participated in Autism clinic at 7 years 5 months and based on his evaluation, was diagnosed with:
- Autism Spectrum Disorder
- Language Disorder (Mixed Receptive and Expressive Language Disorder)
- Monitor for possible Intellectual Disability
- At 7 years 10 months, T had a left temporal lobe resection for seizures
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Case Study: T.
- Individual Treatment Techniques
- Tactile exploration for desensitization; required tool use initially – Sensory bins at home (ex. Shaving cream, dried beans,
play doh, finger paint)
- Sensorimotor Gym activities – ball pit, tunnel
- Oral Motor Warm Ups
- Food Chaining (Initial focus on smooth foods, beverages, and licks of crunchy/flavored foods)
- Drinking some formula by mouth
- Steps of Eating including kissing food goodbye, smelling, licking
- Reward systems, Behavioral approaches, Turn taking
- Dipping foods
- Assist with set up and clean up of meals, meal preparation
- Once accepting a wide variety of smooth/blended foods, progressed towards chewing skills (6 years 4 months)
- Chewing practice with hard foods, crumbing, meltables, fork mashed foods
- Initially, used either munching or tongue mashing or attempted to swallow whole and used liquids to wash down foods &
frequent grimacing
- Moved to lateral bites
- At 6 years 10 months, family with increasing concerns for fine motor skills, and focus of OT shifted to fine motor skill
development however, at 7 years 3 months, family saw decrease in progress of eating skills and returned to focus on feeding during OT
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Case Study: T.
- At 8 years 4 months, T returned to feeding clinic for a full team assessment
- At that time, T was eating by mouth with a shrinking food repertoire, increased sensitivities to smells, very
specific desires for how his food is prepared, appears difficult for him to swallow at times, and overall behavior is a general concern
- Diet included chocolate milk, lemon lime sparkling water, lemonade, soda, peanut butter sandwiches, macaroni
and cheese (without pepper added), tortellini (can be many varieties), pretzel goldfish, grapes, olives, cheese pizza, bean and cheese burritos, hot dogs, hummus, tortillas. Refused vegetables and most meats.
- Many reported sensory concerns including seeking out spinning, jumping, and crashing and loves rough-
- housing. Sensitive to noise. Cannot tolerate many smells. Sometimes intolerant of being messy. Avoidant of
unexpected touch.
- Updated recommendations included: Feeding group, Participating in meal prep/clean up, Children’s cookbooks,
re-introducing the “steps of eating”, present foods outside of their packaging, Apps for toothbrushing, general sensory processing resources, information regarding Feeding Matters (organization)
