Join Angela, Axel, Abel and Asher as they welcome their new sibling home.

Saturday, March 15, 2014

On feeding

Oh my word. I thought Asher's tongue would drive me crazy when we adopted him. He sucked on it constantly, which built it up to twice the size it should have been, and he could do nothing else because he was constantly sucking his tongue. It took a few weeks of constantly giving him a different kind of oral input so he didn't feel the need to suck his tongue anymore, along with corrections when the habit overtook him. Not only was his tongue a really bad habit, but it caused major difficulties for him to eat anything other than pureed foods. He had no idea what to do with his tongue, and it took us two years of intensive feeding therapy to get him chewing well enough that I didn't have to send pureed foods in his school lunch! Today Asher chews most of his meals, with certain things like Pizza being foods we still puree. Oh, and he will gladly show you where the food grinder is in case you don't know.

Along comes Audrey. Many of you commented on how she looks so much different in this picture.

The only difference between that picture and others you've seen is her tongue. Audrey's tongue thrust is extremely strong, and she has been resistant to me touching her face or really doing any kind of physical cues to her face at all. She completely shuts down, moves to a corner and will have nothing to do with with me. And, since she can hold quite a grudge,  I decided not to push this issue anymore until we got  home.

But feeding…feeing is a big problem! I wondered how in the world I would feed her on the plane when the mess she makes covers a four foot radius! I did learn why she was so tiny when the foster family got her. In the institution her diet consisted mainly of pureed foods, but her tongue thrust is too strong for her to manage pureed foods, so most of it got pushed out of her mouth. In an attempt to find out just where her feeding and oral motor skills were at, this was one of our attempts at pureed foods. Please note the towel covering the chair. After this session I started feeding her in the hotel shower so we didn't get food on every possible surface.

Feeding was difficult, and frustrating. In the foster home she learned to eat solid foods, but the technique left something to be desired. It was a bit like watching a wild animal eat. Now she needed to learn to take single bites, chew and swallow before stuffing more into her mouth. This is a common problem for post institutional children, and it can be very frustrating to deal with. With all of our kids I have started by my feeding them every bite of food. Not only does this teach them a different rate of speed to eat, but it's also good bonding. It helps the child learn that every bite of food comes from mom or dad.

I've noticed a few things. Audrey can't eat pureed foods because she doesn't know where the food is in her mouth. Her tongue is looking for it, which causes the increased tongue thrust. Here is a video of her eating bananas one week ago (March 9th) you'll notice her tongue come snaking out of her mouth as she's trying to move the bananas around. That tongue is the reason for all the mess. You'll also notice she doesn't close her lips on the fork, instead using her tongue and kind of scraping with her teeth to get the banana off the fork.

I've also discovered she does really well with crunchy foods, like cheerios. They give her a lot of input so she can feel where they're at in her mouth, and there is very little tongue thrust when she eats them. In an effort to give her increased input with other foods, while at the same time using up all the pureed foods I brought along, I've been adding cheerios or other crunchy things to her foods.

Today for lunch we had…well…it was supposed to be like goulash, but whatever. Soft noodles are something she has trouble with so I added some dry corn flakes to the stuff just go give some hard bits for her to feel. The results are wonderful! Is she using her lips perfectly? No, but wow! Look, her tongue doesn't come snaking out and she isn't loosing 1/2 the food from just letting it fall out!

The other thing we've been working on is keeping her tongue in her mouth during other parts of the day. Like all day. In the foster home she always wore an infant drool bib because the drool was constant.  Guess what! She is doing it! Her tongue is in her mouth at least 90% of the time! And guess what else! When her tongue is not hanging to her chin she's not drooling all over the place. She also likes to lick her hands and arms, but that is just not allowed anymore. "You are a beautiful little girl, and beautiful little girls don't lick themselves." No, she can't understand a word I was saying to her, but I hope she understood my tone of voice.

Now we're at a point we hit with Asher. Her tongue is in her mouth all day, and her mouth not hanging open, so now she thinks its impossible to make any of her singing or happy noises. Keeping her jaw from hanging open, and her tongue in, is not comfortable yet, and actually takes a lot of work, so she can't even consider that she can still make noise. I'm missing her happy noises, which she has a lot of since she is a very happy little girl. I know they will be back very soon as she discovers this is not so horrible after all.

1 comment:

  1. I love that each picture we see of your sweet Audrey she looks happier than the last. The one of her outside enjoying the sunshine, she looks delighted with herself and with the attention and love from you and Axel. I can't wait to see her blossom even more when she gets home and gets to be experience forever family life and love.
    Thanks for taking us with you on this trip through your blog. My kids(7yr old triplets) loving seeing what yours are up too. We have an Asher as well. They especially loved the sign language and used it with their cousin who has DS, but love to use it on me at home when they want something. They are proud that six months later they still remember it.
    Hugs from New Zealand