This afternoon, Santino took out his thermos and cereal packets and followed instructions to hand me all but the one bag he had placed on the table to eat as a snack later in the day. I gave him a two-step directive but paused until he completed the first step to move onto the second. Santino was offered a choice of utensils with which to eat his pureed food. He chose a spoon and ate independently. He was also offered water but initially refused the bottle. I have been allowing Santino to use the water fountain outdoors, and he is now able to do so entirely independently. He requested two of his cereal packets after we returned indoors. We also worked on food desensitization using candy corn, which Santino took from me, smelled, and placed to his lips. I have been pleased with the steady performance, improved motor control, and readiness to examine novel foods that Santino has been demonstrating during meals at lunchtime.
This afternoon, Santino got his lunch out of his book-bag and took out his thermos, following directives. He needed help opening it and requested a fork when offered a choice of utensils. Santino ate independently and requested an alphabet activity while eating. We are working towards building acceptance to new foods through gradual exposure, and Santino is no longer averse to being in close proximity to new or unfamiliar foods and will even touch or put them to his lips when prompted and encouraged, using the I-Pad as motivation and reinforcement. At times, Santino will eat pudding, although it is not his preferred choice. He continues to request his favorite cereal, Fruit Loops, after eating his main meal. Santino benefits from consistency in his structure and daily schedule, and understands expectations regarding his food and lunchtime behavior.
Santino helped arrange the items from his lunch on the table, per my request. When asked if he wanted to eat using a spoon or fork, he asked for a fork for the first time. His lunch was pureed potatoes and he finished it in its entirety without any difficulty using the fork. After his main meal, Santino requested his snack of Fruit Loops cereal. I saw that there was an opened and uneaten vanilla pudding on another table which I understand he had requested in his prior class but that he did not eat. We will continue to broaden his food repertoire as well as the people with whom he will eat.
Santino sustained social greet with me upon initial sight and we had a nice exchange of engaged and prolonged eye contact. Today, Santino had alphabet pasta for lunch - much like Spaghetti-O's. I expected more resistance to eating it, but Santino consumed about one fourth of the portion. However, it should be noted here that this was largely dependent on my verbal prompts to "take a bite." With his other smoother pureed foods, Santino readily eats the entire contents of his thermos independently. However, I am very satisfied that he ate some of his lunch, as it was of a much different consistency than his usual fare, and I am seeing better acceptance of alternative food options this year with less resistance to trying new foods. I am also continuing to reinforce this progress with a lot of verbal praise, along with specifying the reason why I am acknowledging and rewarding his performance.
Santino ate his lunch well today even though it was slightly different than the usual fare. It seemed to be pureed potatoes, but without sauce, and he ate independently and finished the portion allocated in its entirety. Santino demonstrates a good ability to hold and move utensils within one hand and displays good eye-hand coordination while eating. I hope to continue to work towards improving the distal grouping of his hand functioning so that it facilitates his participation in other activities of daily living. Santino also requested and drank spring water from a 16.9 oz. bottle as well as water from the water fountain outdoors in the playground area. He also requested and ate a pack of Fruit Loops cereal - his favorite snack.
Communication skills regarding feeding and food etiquette/trying a new food
Lesson Outline
Santino was helped to take his lunch out of his lunch bag and set up needed utensils. He asked to eat, requesting in a compete sentence, when prompted minimally, and today he acknowledged my name and added Miss Dorothy to his request. Santino requested a spoon during feeding after being shown different utensil options, and he correctly identified napkin when shown to him. He is a neat eater and will use a napkin if some food accidentally spills on himself or the table or chair. Santino enjoyed the smooth consistency of his pureed potatoes and ate independently. He was offered water and a cereal snack following his main meal. The big news today is that I offered Santino a cut cotton candy grape and modeled how I wanted him to first 'kiss' it, which means to put it to his lips, and to then put it in his mouth and eat it! Santino did so, given the modeling and prompting techniques described. He rolled it in his mouth at first, but also chewed and swallowed it. Success! I tried with the other half but he just squished it; however, I lauded him with praise and high fives for listening to and following directives and trying a new food item. I am extremely satisfied with the progress Santino demonstrated in his feeding skills today.
