Expanding Student Diets and Exploring Sensory Differences

In honor of the work the Friends and Family of Trisomy 4P did this month to
bring awareness to the disability, I wanted to share the latest milestone
of Miss Natalie, my favorite friend with Trisomy 4P.

Recently, she has expanded her diet and learned to eat finger foods!  This
may not seem like a huge achievement, but for children who have sensory
issues and the need for sameness, it is a phenomenal feat.

When I first met Natalie, her diet consisted of yogurt, pudding,
applesauce, oatmeal, and foods that were pureed to a similar consistency.
In the beginning, this was out of medical necessity.  NOTE: If you are
working with a student who has food sensitivities and/or a  limited diet,
BE SURE TO WORK CLOSELY WITH THE STUDENT'S FAMILY AND PHYSICIAN to insure that the student is ready and able to explore new foods.

After Natalie's doctors gave her the green light to expand her diet it
wasn't a quick process.  Her parents started by pureeing food a little less
smooth and adding small amounts of texture (for example, a little cupcakecrumbled into her yogurt or pudding). 

Natalie eating a yogurt and cupcake mixture at
school for her birthday with her big brother. 

This expanded her diet.  But through observation we found that Natalie was
only eating new things that were presented on a spoon.  From a very young
age that was the only way she ate, and a challenging one at that, we worked
and worked to get her to eat with a spoon independently and now we were
expecting her to change it up and she was not having it!

Natalie has always struggled with change and new experiences, for example
when she first started school she would scream or cry in the presence of
new toys and activities.  She resisted touching and interacting with most
toys, books, and puzzles.  We worked toward progress in this area by
strategically using 'put in' tasks with new materials.  'Put in' tasks were
her favorite activity and something she was very successful at so by using
an area of strength and interest we were able to expand her repertoire of
toys and learning materials, which is a whole other post. But what I want
to point out here is that we used an area of strength and interest to
further her skills in small increments.

In regard to foods, and working toward eating finger foods, we used the
same concept.  I purchased toddler yogurt drops and cereal puffs.   In the
beginning, the only expectation we had for Natalie was that she put the
toddler finger foods into a container.  This was the only skill that
existed for several months (patience is often our best friend)!

Then last summer, Natalie's amazing parents started noticing Natalie
putting dirt in her month while playing outside.  This was huge as she had
never put anything in her month via her own fingertips!

Although this picture is a little blury, I wanted to share it as this was a
make or break step in Natalie's progress.  First off, if her parents hadn't
noticed this new skill of putting dirt in her mouth, and took it as a sign
that she was ready for the next step, she wouldn't be where she is today.
Secondly, if they hadn't been so supportive of this new skill she may have
stopped progressing.  I am sure they weren't super excited she was eating
dirt but if their reaction in that moment was very alarming and concerned,
"NATALIE STOP EATING DIRT, THAT IS TERRIBLE!!"  She may have held back and
stopped putting things in her mouth. Instead, her mom did the most
ingenious thing, she brainstormed what foods looked like dirt, and created
a crumbled Oreo mixture with the consistency of dirt.

From then on the pace began to pick up, but not without a few more bumps in
the road.  Natalie became used to eating things out of a cake pan, and
would only do so from that sized pan, so her parents went to work again.
They began using smaller and smaller pans, and then moved to a bowl and
even to eating food off the table in efforts to eat out of a bag, her
hands, and off a plate like children traditional do.

Without knowing Natalie, you still may not recognize the huge achievement
this is for her, but take a moment to think about the variety of foods, and
eating opportunities we experience every day.  Natalie's old eating habits
were very limiting to her and her family.  The family had to be very
mindful when going on family trips or even when traveling out of town for
her doctor's appointments. By strategically changing Natalie's eating
habits, through hard work and perseverance, her family has opened her world
up to new opportunities.

With that I would like to bring us back to honor the families and children
affected by Trisomy 4P and other Trisomy conditions.  March is Trisomy
Awareness month but I also like to think of it as Trisomy Acceptance
month.  Whether affected by Trisomy or any other disability, every student
is a person first, who has so much to offer.  I certainly recognize this as
I reflected back on my journey with Natalie and her family.  She is a
beautiful young girl with an abundance of love and determination.  I have
learned so much from her and her family's belief in her and advocacy for
her!  For that I am truly grateful.

I wish her and her family the very best throughout the many milestones they
will achieve in the future!

Do you want to learn more about Natalie and her 4P friends? You can also
click here to read more about her home and school programming and another desensitizing technique for snack time!

Our ECSE Classroom's Schedule: Part Four - Snack Time (10:00 am or 10:20am - 10:20 or 10:40am)

Welcome back!  It is 10:00 (or 10:20 depending on if we get outside time or not) in the routine of school day.  Are you hungry yet?  I hope so...it’s snack time! 

Here are our snack prep area and snack tables. 

Click here to view a video example of how snack preparation works in our classroom. 

Yep, all our students help with snack jobs.  Impressive, huh?!   

Originally, we added snack prep jobs to solve behavior management issues.  Before snack jobs came about, it took an entire staff person away from large group to set the tables for snack.  The absent adult made it difficult for some kids to sit and perform at large group without prompts and supports from staff. And then...we revamped and added in snack jobs as suggested by our amazing OT, Miss Debbie!

So here is a closer look at how they all work.  First, during large group one staff person cleans off the tables and lays out the placemats. 

This one is used for when we have special guests like parents or observers. Other ones have staff and student photographs on them.

  

The mats are $1.97 placemats I picked up at Walmart and cut in half and then traced a cup and tray outline on them with a permanent marker so that the kids could practice one-to-one correspondence as they set the table and know exactly were to place the trays and cups. The trays and cups are also purchased from Walmart.  The trays are $0.98 and the cups are 2 for $0.88.  You can find them in the kitchen section. 
 

 

We decided on using trays rather than just napkins or plates as they are a precursor to the larger lunch trays that students use in the cafeteria when they move on to kindergarten.

Note: The staff person that sprays the tables and sets the placemats out does so after the student she supports at large group earns three tokens for good behavior (sitting up tall, listening to the teacher and doing your work) and gets to go play educational games on the iPad for 5 minutes using a sand timer from Watching Time Pass. 

(The tokens are earned and then stored on a DVD cover.)

Following the time on the iPad, the staff person is done prepping the tables and they both go back to group as a layered grouping feature best meets the needs of the student and uses staff time efficiently.  Here is the back of the DVD token system.  It is the student's picture schedule.  It says "Time for circle time!".  Other picture icons are stored on a Velcro strip inside the DVD case. It's so compact...a motivating system and schedule all-in-one!

Note that each placemat is color-coded with colored tape from Discount School Supply to match colored tape on the back of each chair. 

This helps get the mats out quick and strategically so that students that need extra adult help are sitting by adults and kids who have a hard time sitting by certain peers are sitting by those that will be good role models.  Color coding the snack mats also gives us an opportunity for layered grouping.  One of our kiddos in the afternoon class, who has a hard time sitting for all of large group, dismisses a little early to match the mats to the color on each chair.  A great way to give him the movement he needs without disrupting his peers!

As the students get dismissed for snack, they are prompted to line up on a black square to wash their hands. 

These black construction paper squares have been contact papered to the tile to support kids in not crowding each other at the sink.  We use other black shapes for lining up to go outside and lining up to go in the hallway.  Just another way to imbed learning about shapes throughout our school day!

As each student steps up to wash their hands, they have the opportunity to look for their assigned snack job on the magnetic board mounted behind the sink.  

Notice some students look for their photo while others look for their name or even last name.  Then, after washing their hands and finding their job, they walk to the right of the sink to get the supplies needed to complete their job. 

One student gets the trays from the top drawer, one gets the plastic basket of cups off the top of the drawer system, and another gets the plastic basket of napkins.  Then, two other students get out the food for the orange and purple tables from the orange and purple drawers. (The drawers are just clear tubs that have been lined with purple and orange construction paper.) One student gets the water pitchers out of our mini-fridge just to the right of the sink. One or two students place the artificial flowers on the table to match a di-cut flower that is packing taped to each table.  I say one or two students as this is one of our easiest jobs so if we have some pretty young or lower-level students, we will simply have their job be matching one vase of flowers to di-cut flower packing taped to the table. 

Notice the artificial flowers are in an old aluminum can so that we don’t risk a glass or ceramic vase getting broken. 

Whew...snack prep is done.   Time for snack.

Not a lot to say about actual snack time other than we try to support our kids in using language at snack so we have little snack language boards to support requesting and conversation. 

We also have a thank you board posted for students to read for information and thank the friend or staff person that brought snack for the day. 

Some of our students would prefer to breeze right through snack time so they can go outside.  To support appropriate eating and snack conversation, we often set out a 10 or 5 minute sand timer from watching time pass so the kids can manage their time wisely. 

When the sand is all gone, each child is in charge of going to the table to dump and put away their snack items. 

This is a great precursor to lunch time in the cafeteria as the students get promoted and move on to kindergarten.  

With that, I promote you to outside play!!  Join me next time for the inside scoop on outside time!    

Best wishes, 
Lindy