http://www.huffingtonpost.com/katja-rowell-md/when-feedin...
As a childhood feeding expert, I have been dismayed recently with the increasing number of parents seeking me out after their children "fail" feeding therapy. With more children diagnosed on the autism spectrum and up to 80 percent of children with special needs struggling with feeding, far more children are entering feeding therapies than even a decade ago.
After reading Carol's words on my Facebook feed, I had an "A-ha" moment. Instead of desensitization through behavioral modification or exposure therapy aimed at increasing the amount and variety consumed, what children like Emma endure, often for months on end, is actually very effective aversion therapy.
Here is a definition from minddisorders.com: "Aversion therapy is a form of behavior therapy in which an aversive (causing a strong feeling of dislike or disgust) stimulus is paired with an undesirable behavior in order to reduce or eliminate that behavior."
For Emma, the "strong feeling of dislike" was the primal terror of abandonment -- and the undesirable behavior repeatedly associated with it? Eating.
For children like Emma, eating becomes automatically associated with heightened stress, fear and arousal, often worsening the initial feeding challenge. The neural pathways are reinforced so that eating = fear. The child eats fewer and fewer foods in smaller quantities, requiring more and more effort (and therapy), until typically 18-24 months later, the child "fails" and is left eating five or so foods, with a relationship to food defined by anxiety and avoidance. As one mother warned, "Bad therapy is worse than no therapy."
And Emma is not alone. Consider a couple of my other cases: the little girl who, within weeks of beginning food "exposure" therapy with a psychologist, would vomit simply pulling into the parking lot, or the boy who cries, gags and vomits every night for two years through the prescribed therapy task of eating two bites of non-preferred foods before being allowed to eat a safe food.
As a doctor, I take my oath to "first do no harm" seriously. And what I am increasingly seeing, as feeding therapy becomes almost a mainstream, first-line strategy for addressing everything from typical picky eating to serious feeding disorders, are children harmed by the very therapies parents turn to for help.
Reviewing the histories of the feeding therapy "failures" I've worked with, in every case there was coercion to varying degrees -- from extreme, where the child was restrained, vomiting and sobbing during therapy, to simply arguing and fighting over therapy tasks like having to eat those "non-preferred" bites, or having to kiss foods. (Some sensitive children even find positive reinforcement, like earning video game time for trying a new food, lessens appetite and worsens selective eating. As one dad explained, "Rewards work for everything but food.") As I talk with colleagues in the eating disorder world, I tell them to get ready. A wave of children who have been part of a grand experiment is coming their way.
All parents need support, but especially those whose children present with feeding challenges. Ellyn Satter's Division of Responsibility in feeding has been around for 40 years, and the research to support this tuned in or "responsive" style of feeding grows by the year. There are amazing speech and occupational therapists helping children overcome oral-motor and sensory processing roadblocks. The key is low stress, no pressure exposures paired with pleasant family mealtimes and structure.
Doctors and therapists must be better educated about the complex nature of feeding challenges. Parents must be empowered to know when a therapy is helping or not and how to support their child's eating where it matters most -- in the home.
Parents tell me that what they were told to do went against their instincts and felt wrong. It is unconscionable that desperate parents are unknowingly bringing their children to experts who do more harm than good. These aversion therapies are failing the children, not the other way around. We can do better.
***i am not a doctor***
I just had a well duh moment followed by TL;DR
Did you have a point?
Diane, she is drumming up business. If you click the link it takes you to this exact article in the huffinton post.
What is the question?
Added: you're not a doctor so what are you. Perhaps a student doing research or wanting us to write your paper? Perhaps a troll yanking our chain?
Why haven't you enclosed your copy of someone else's statement in quotes? Why do you not make this question personal so we know your interest in the article.
Your post is bazaar. Yet it is on a topic of some interest to some of us.
I have had no experience or training in food therapy. Why would I have any way to comment on the article. I read your post first and thought you were the doctor making these comments. Then I read the actual article and see you are quoting what a doctor said.
I'm guessing you're a parent wanting to know the experiences of moms whose children are or have been in therapy. If you're the doctor, then this post comes off sounding lIke a sales pitch which is against mamapedia rules.
So, are you a parent wanting more information or someone wanting to influence parents? I note that this is your first post.
If you aren't the doctor, you must put your quotes within quotation marks. If you're a parent please use your own words to ask questions that are specific to you.
Not sure what you're looking for on this forum. This is your first question so maybe you don't know what this board is for? This is an interesting topic but it reads more like an editorial/opinion piece that should be in a parenting magazine. You don't appear to be directly looking to increase your practice (which is not allowed), but I'm not sure what you goal is here. Just to educate? Okay, but you're supposed to be on this site to ask questions.
ETA: You wrote the following: "As a doctor, I take my oath to "first do no harm" seriously." So I assumed it was you rather than the fact that you copied and lifted the bulk of the article to reprint. We usually don't click on links here, but because it was HuffPo, I did. Marda is right - you have to actually use quotation marks and comments re attribution. So it's impossible to know what you are looking for here. It really helps if you are more clear. People often spend a lot of time answering posted questions, and a lot of it is wasted if you as the questioner are not more specific. For first-time questioners, where we get a lot of trolls and people looking for business without using the advertising section (which are not allowed and which most members will report to the Mamapedia moderators), posts like yours just generate a lot more skepticism. So I'd suggest you edit your question or expand in the SWH section so we know more about what you're hoping to get in the way of responses.
Do you have a question?
You wrote this poorly. What you should have done is talked YOURSELF to this audience, told us that you read this article, offered the link, and then ask your question. You didn't need to copy and paste what the doctor said.
You're supposed to ask a question here. You need to make it so people understand what you are trying to convey. Most of the time, people won't click on an unfamiliar internet link in case you're trying to introduce malware on our computers. The only reason I clicked on it is because it's from Huffpost.
What do I think?
Well, aside from it being odd that you'd cut and paste this entire block of text without making any of your own commentary...
I think that kids don't need feeding therapy. I think that parents need parenting classes.
weirdo post.
:/
khairete
S.
I think most parents do not take their kids to therapy when they have a picky eater. I don't know anyone who does feeding therapy or eating therapy. I know a lot of kids on the spectrum though. What percentage of kids actually do this? My son has sensory issues, and is unique, emotional, and strong willed. And he has always been a very picky eater. At age 2 he would just see a new food and start gagging. As a baby trying new mashed foods he never would eat so many things...he would gag. He gagged at his first bite of birthday cake. When he was young he would run away from the table in true fear when a new food was served. We had to teach him to sit at the table. We had to teach him he has to be polite and never say negative things about the food...especially to the cook! We decided not to make it an issue and I always just serve something I know he will eat. We try to keep thing positive, and he has always been encouraged to try other foods. At age 11 he finds mealtime pleasant and he usually eats most to all his food. He will try a few bites of the food he does not like. He has slowly learned to like some new foods, but he is still picky. I'm not really worried about it bc he's growing well and is a strong kid. I'm not sure why you have posted this except to let us know the therapy has made some kids worse.
If a child has a physical problem eating they need to go to someone who can train them in techniques that will encourage swallowing or if it's worse than that how to do a feeding tube.
There are many challenges with people who simply cannot physically eat.
I have one that would choke about 3 times per week. I cut his food up in very small pieces even though age appropriate size was larger. I'd have to pick him up and turn him upside down. I had to sit with him every time he had food. There wasn't anyone that understood how dangerous it was to leave him unattended.
I have one that is super picky. She has a geographic tongue and it's difficult to fix food she'll eat. Now that she's older I let her do most of the cooking. She might love mac and cheese this week then start to take a huge bite next week and start puking it up and spitting. It might taste like poop or something. She can't explain how awful it tastes. So just because she likes it this week and is eating it does NOT mean she'll eat it next week at all.
I've learned that she needs to be able to say no to me and have her own likes and dislikes.
