FEEDING SKILLS AS AN ACTIVITY OF DAILY LIVING

-Triveni Goswami Vernal
Registered Special Educator (A64010)

Feeding oneself independently is an important Activity of Daily Living. The ability to self-feed helps the child, try out various textures of food and explore different sensory experiences related to food (sight/smell/taste/touch) etc. Feeding comprises of several individual components that need to be worked upon independently, such that a strong foundation is laid, to be built upon later. The pre-requisites for Self-feeding include,

1) Biting and chewing small pieces/morsels of food
2) Swallowing
3) Oro-motor skills: Licking, Sucking Liquids and Blowing out air
4) Eye-hand coordination
5) Postural Control
6) Fine Motor and Gross Motor skills

BITING AND CHEWING: To develop the skill of feeding oneself, the child will have to learn to explore various textures of food (crunchy, soft, gooey, hard), varying temperatures (be able to handle cold/hot foods), and various tastes (spicy, sweet, sour, bitter, salty). The child should be able to use his teeth to bite and chew the food into smaller pieces, so that it breaks down, making it easy for swallowing.
SWALLOWING: The child should be able to swallow the food, only after it has been broken down to smaller pieces and have been chewed upon. Many children on the Autism Spectrum have a condition called Dysphagia (difficulties associated with Swallowing). If the problem persists, a trained practitioner in the field of Occupational Therapy or even Speech and Language Pathologist, should be consulted.
ORO-MOTOR SKILLS: The child should be able to use his tongue to lick, suck liquids with a straw and blow out air. All these skills may not occur naturally in a child and they may have to be taught these skills by a trained practitioner.
EYE-HAND COORDINATION: Feeding skills require good eye-hand coordination. In order to pick the food and place it in the mouth, the child will have to first, focus and pay attention to the food to be eaten, perceive the texture/shape etc of the particular food and then decide to pick it up with either his fingers or use a spoon or fork for it.
POSTURAL CONTROL: It is of utmost importance that the body posture of the person is upright, while eating, such that there is no possibility of choking and other obstructions while swallowing. There must be stability in the positions of the head and the torso.
FINE MOTOR AND GROSS MOTOR SKILLS: Both fine motor skills and gross motor skills need to be developed, for self-feeding to occur. Gross motor skills for feeding include the purposeful movement of the arms to the mouth, ability to control one’s posture while eating, being seated while eating, using one arm while eating, while using the other, to provide support etc., while Fine motor skills for feeding include the pincer grip (to pick up pieces of food/fork/spoon etc), opening and closing containers, lifting the spoon/fork/fingers to the mouth, lifting a glass of water to the mouth to sip on etc.
According to the article, “Guidelines for the Development of Self-Feeding Skills” by Kimberly Mielke (http://www.handyhandouts.com/viewHandout.aspx?hh_number=156), “A child who is practicing and learning self-feeding skills is also improving:
• Strength in his/her back, arms, and hands.
• Using both arms and hands together.
• Coordination in his/her arms and hands.
• Eye-hand coordination.”





VISUAL AIDS RELATED TO FOOD AND FEEDING
FOOD TASTE

VISTING A RESTAURANT

EATING LUNCH

REQUESTING FOR FOOD

Thus, we see that the skill of Self-Feeding as an activity of daily living, is built upon multiple smaller components that need to be worked upon individually, till a degree of independence is achieved in them. Only then, can one work on developing self-feeding skills. Many children on the Autism Spectrum need help with many of these building blocks (fine motor skills, gross motor skills, swallowing, oro-motor skills, eye hand coordination, postural control etc) and even when they master these, they may still require the help of visual supports to remember, plan, initiate and execute the steps of the particular skill.

RESOURCES:
https://www.niepid.nic.in/Meal%20times%20skills.pdf
https://www.swft.nhs.uk/application/files/2314/5995/2570/feeding_skills.pdf
https://chicagooccupationaltherapy.com/articles/feeding-and-oral-motor-development-milestones/
http://www.handyhandouts.com/viewHandout.aspx?hh_number=156
https://www.growinghandsonkids.com/visual-perceptual-skills-needed-independent-feeding.html
https://www.theottoolbox.com/oral-motor-problems-and-feeding/
https://behaviorplace.com/tips/mealtime-independence
https://davida.davivienda.com/viewer/boardmaker-free-printables.html
https://www.twinkl.co.in/resource/nonverbal-communication-meal-time-cards-t-s-1650633478
https://www.twinkl.co.in/resource/t-s-143-choice-cards-and-board-options-pack

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Author Triveni Goswami Vernal

Triveni Goswami Vernal is an Autism advocate, registered Special Educator (CRR A64010) and an Independent Researcher. Her areas of interest include Autism, Disability Rights, Gender, Art and Northeast studies. She is a mum to an 11 year old on the Autism Spectrum

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Creative representation for this blog is done by our extremely talented CreativeSaathi associate Kabir Vernal