How Art Can Help You Achieve Feeding Goals

It sounds ridiculous, but sometimes in order to work on sensory feeding you need to start by avoiding food altogether. What?! How could that be? I know, like I said, it sounds ridiculous, but hear me out. Before you even tackle desensitization, and cooking activities, you need a solid foundation to build on. You need to build positive associations with food and food based activities. "But how can you do that without working with food?"Let me walk you through the steps so that a) you see the method behind the madness, and b) you can begin to implement these strategies with confidence in knowing even if you're not working with food yet, your headed in the right direction.

Why art? Simple, because:

1) Art can be messy. Tactile defensiveness is often observed in neurodivergent children, for example those diagnosed on the autism spectrum. If your child HATES getting their hands dirty, and they HATE getting food on their hands, one thing you know you have to work on is desensitizing them to something getting on their hand. Whether it's glue and glitter, or frosting and cookie crumbles.

The first step is to tolerate a substance on your hand. How do you that? One of the first things I work on in this situation is wiping. So, I keep a damp textured towel or paper towel nearby. Why not a wipe? You can keep a wet wipe nearby as well, but a textured towel provides the added tactile input I need to help desensitize that child to something foreign on their skin. It gives added sensory feedback, so that as you use it over time, they become less resistant to the subtle sensory input the receptors on their hands are taking in. They are getting desensitized. This is likely going to take time. Initially, you will have meltdowns, which often includes crying, throwing, screaming. How do you deal with this? Know your child, and be prepared. "What the heck does that mean?", you ask? Just that. If you know your child has tendency to throw things when they are upset, keep everything out of reach. If you know before they start screaming, they first exhibit some specific behavior, like quivering their chin, be prepared. Keep the damp textured towel near you and as soon as you see some residue on their hand, know that you have to be prepared with the towel to wipe it as soon as you see that chin start to move. Why didn't I say "as soon as that residue gets on their hands?", well because you are working on increasing their ability to tolerate that residue. So, with each try, you're going to take just a little bit longer before wiping. One important component of this whole strategy that I must note, is that you maintain your calm. I know , it sounds hippie dippie, but watch any seasoned teacher, pediatric therapist, para-professional and then observe a newbie in any of those fields. There will be an observable difference in the way they maintain the children's attention, control over the classroom, and how effectively they redirect them. Many will say its confidence that comes with experience, and sure that's true, but how is that confidence projected. Through their energy. A seasoned professional isn't frantic in the face of chaos. Their years of experience has afforded them a set of actionable steps they know they can take to handle challenges. So, basically they have a reserve of plans and so panicking is not necessary. If you don't have any idea what to do, then people panic. How do you know they are panicking? You sense it. You can see their eyes jetting from one place to another, you can see them start to sweat, you can hear the tension in their voice, and their rate of speech. Children, even infants, can sense these things too. They may not say it , but they can sense stress and uncertainty and they in turn mirror those feelings. Understanding this can help inform how you react to their meltdowns. Staying calm allows you to redirect their behaviors, by modeling the desired behavior. You want them to learn to tolerate the discomfort of a substance on their hands. You can of course acknowledge how they are feeling, but it is important to redirect them, and teach them that the discomfort is fleeting, since you can easily resolve this situation by picking up the towel and wiping it away. This will take many attempts, but gradually you will see them begin to mirror the same confidence and problem solving that you have modeled. You will also start to see that eventually they won't react to it as dramatically as during initial attempts.

"...findings suggest that mothers’ stressful experiences are contagious to their infants and that members of close pairs, like mothers and infants, can reciprocally influence each other’s dynamic physiological reactivity. ( Waters, 2014)"

2) Scripting. Scripting is a form of communication that some neurodivergent children, especially those diagnosed on the autism spectrum, rely on to express themselves and communicate. For example, when excited, you may hear them say "YOU DID IT!" Except they are not directing their excitement towards you and your accomplishment, they are expressing their joy for themselves. They have just been exposed to that script by way of cartoons, video games, even you. Since these children may have difficulty understanding another's state of mind (Fletcher-Watson, 2014), they don't understand that when you say "YOU DID IT!", you are happy for them. The are associating that phrase with the sentiment they are feeling in that very moment. You may also observe this when they are sad and use a phrase like " Try Again", or even "Game Over" because they have seen these phrases when they were disappointed and have come to associate those phrases with those specific feelings. Which is why pediatric center/ school based, and home based SLPs will work heavily on providing appropriate scripts.

What does scripting have to do with art and feeding? You an easily incorporate the same phrases and actions into both activities. If you start with art, you are tackling their tactile discomforts and using scripted cues and phrases to develop comfort and familiarity with those cues and phrases. When you move them from art to actually interacting with food, they will be more likely to participate in, and follow directions that you have modeled and worked on for weeks during arts & crafts activities. For example, using the scenario above of a child who is tactile defensive and doesn't tolerate touching or picking up food , and who also has sensory feeding aversions. We start with art to work on desensitizing, and following simple directives with art using tools, then taking away the tools and working with our hands. Next, working with our hands and food. An example of an activity sequence would look like this:

Glueing crumbled tissue paper on a paper plate b y dipping the tissue paper in glue. First, we use a tweezer to pick up the tissue, while modeling the action of the tweezer with my own hands and using a phrase like " pinch and pick up" or even simpler " pinch pinch pinch". With the tweezer they are directed to dip the tissue paper in a blob of glue I create on the side of the plate, using a scripted phrase like " dip in glue", or "dip dip dip". During the activity I will also find excuses to deliberately have them move a piece of tissue paper that is already covered in glue so that we can work on manipulating items with their hands and wiping. I will also ask them to pat the pieces down to make sure they are securely attached to the paper plate for the same reason. After a few sessions, time to conveniently misplace the tweezers. Depending on the child, I may or may not model using my hands to pinch and pick up the tissue paper and then to dip in glue and pat down on the paper plate or I may opt to use hand over hand, or partial physical cues. That really depends on what the child is ready for. Once I get to the point of them tolerating picking up paper covered in glue with their hands and following directions, I will try to transition to a food based activity which would have 2 foods that are already accepted, for example, if they accept pretzels and yogurt, I will have them dip the pretzels in yogurt and "write on the plate in yogurt.

Eventually the flavors of the accepted food will start to change to increase the variety of foods they accept. Flavored pretzels, pretzels of different shapes, and hardness, flavored yogurt-sweet and savory, etc. Then from pretzels to crackers, which for the sake of this example is a non-preferred food. However, I would pair that with a yogurt dip I know they really enjoy and we would treat the cracker like a spoon. All the while, I will either, myself or have the parent, model taking a bite of the cracker. You can also use the excuse of being hungry yourself to have them pick up, dip and then feed you. You get to model how delicious the food is and give them plenty of opportunities to manipulate and interact with food without the pressure of having to try something they aren't ready for yet.

Take these idea and adjust/adapt them to suit the needs of your child. The most important take aways would be to monitor your reactions and energy, plan out the scripts you want to use between the art activity and the food based activity, and model the desired behaviors.

TL;DR

Art activities are messy, but they will help you work on desensitizing, practicing cues that you can transition into food based activities. You can also work on scripts, action based and verbal, that they can use across both activities.

As always, information is provided for educational purposes, if you have feeding, swallowing, or speech& language concerns please have your child or loved one evaluated and consult with your therapeutic team prior to implementing any new strategies.

References

Fletcher-Watson, S., McConnell, F., Manola, E., & McConachie, H. (2014). Interventions based on the theory of mind cognitive model for autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews, 3(3), 1–74. https://doi.org/10.1002/14651858.cd008785.pub2

Gerber,S.(2021)Emerging programs for autism spectrum disorder : improving communication, behavior, and family dynamics.N.L Papaneophytou & U.N. Das(Eds.)Academic Press

https://doi.org/10.1016/B978-0-323-85031-5.00025-6.

Smirni, D., Smirni, P., Carotenuto, M., Parisi, L., Quatrosi, G., & Roccella, M. (2019). Noli Me Tangere: Social Touch, Tactile Defensiveness, and Communication in Neurodevelopmental Disorders. Brain Sciences, 9(12), 368. https://doi.org/10.3390/brainsci9120368

Waters, S. F., West, T. V., & Mendes, W. B. (2014). Stress Contagion: Physiological Covariation Between Mothers and Infants. Psychological Science, 25(4), 934–942. https://doi.org/10.1177/0956797613518352