02 June 2011

Observing Feeding Therapy

During Bennett's feedings on Tuesday night and Wednesday morning, I was asked to sit behind a one-way mirror to observe Bennett's Feeding Therapy.

As you can see, Bennett sits in a small chair with a tray.  He has access to a TV/DVD player and a favorite DVD.  Elmo is his favorite.   Next to Bennett sits the "Feeder" who has his food on the table and a notebook nearby.  The feeder has a predetermined menu and system she must follow.  For this feed, it was 2 bites of blended macaroni and cheese followed by 1 bite of yogurt followed by 1 5 milliliters of chocolate milk.  Bennett must eat what is given to him each time.  If he does not, the Feeder turns off the TV and takes away his toy until he chooses to eat or until the 25 minute timer goes off, whichever comes first.

At snack time on Wednesday morning, I was allowed to join Bennett in the room to observe the feed.  My job during this feed was to be only the "rewarder."  Therefore, I only rewarded Bennett's behavior.  I ignored negative behavior and refusals.  I never asked him to do anything...that job is that of the Feeder.

As evidenced by this picture, Elmo was the DVD of choice.  A pack of DVDs sits in a black case nearby.  Bennett's favorite toy, Douglas is "sleeping" while he eats.

My big boy before he begins eating.  He has two Thomas trains as his toy.  He can change this toy as often as needed to keep him motivated.  Toys are usually switched out at least once during a 25 minute period.

The timer is very important to this process.  The "Feeder" needs to be able to feed Bennett adequately within 25 minutes.  Otherwise, he and the "Feeder" become fatigued.

This is a picture of the opposite side of the room than Bennett.  The one-way mirror I observed through at first is seen on the left hand of this picture.

This is Little Bennett's view of the window.  However, he never knew I was even there.  In fact, once I began going into the room, Oliver had a chance to observe us both through the window.

Bennett sits next to a large cabinet of toys.

Toys, Toys, Toys....all motivations for children to eat.  Kids will eat for toys.

Baby dolls, tractors, balls and barbies.  When children get bored of eating, the "Feeder" pulls out a new toy.  Almost always, the child will respond to the reward of playing with a toy.  It's a simple Pavlov's dog experience.

I will begin feeding myself (being the "Feeder") starting the afternoon of Thursday.  I think I'm ready!!


  1. Oh my goodness I so need to do this with Nathan. I wonder if he is too old to train? I'm going to be reading these posts and taking notes. So Tv and toys are ok? I thought they were distractions.

  2. This is very interesting!! Good luck as the "Feeder". You will do great. :)

  3. Very interesting. I didn't realize that we were doing a "good thing" by letting madeline eats her snack and dinners. It has always motivated her too. Bennett looks like he is getting thicker?! It must feel great to see Bennett doing well!

  4. Breck, you are such an inspiration! You are so positive in light of tough times. I'm still around, just kinda in a funk but I'll be out of it soon :) Love the pics of Bennett, he's getting to be so big now.
    Let's talk soon Momma!

  5. I found your blog through Feeding Tube Awareness support group on Facebook and just had to send you some virtual hugs. My three year old twins have been through this exact kind of positive reinforcement feeding therapy also, and it is a life and sanity saver! The feeding team that taught me how to get my resistant eaters to be even willing to look at food without meltdowns and puking, let alone eat it happily, are miracle workers. We use toys and books and television, whatever it takes. But it is a very slow process. There have been many days where no incentive works, when they get sick it's like taking 10 steps back. The beauty of this feeding method is that you can always bring them back to enjoying the experience of eating, even if it's with a lot of distraction. One of my twins has been G tube free since March, and his brother just finished the feeding program at Mt. Washington Pediatric Hospital for the second time to help him learn to swallow better with great success. I think that he will be G tube free hopefully by Thanksgiving. I tell you all that to say that it will be difficult, it will be slow, there may be days that you think this is just not working, but I promise if you stick to the feeding protocols rigidly, and praise, praise, praise, your son will eat. It's a beautiful thing, seeing your child happily eating. People take it for granted. Keep up the good work, you're doing awesome!

  6. It sounds like you found a great therapist. It took us a while with our daughter.

    I found this website to be really helpful. It made me feel less alone in dealing with feeding issues and helped me find our great therapist.

    I hope therapy and eating are continuing to go well for you!



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