Occupational therapy case study.
Reason for referral:
This child was based in Leeds referred to the team due to difficulties with their feeding and fine motor skills.
For their child to eat a range of foods without gagging at mealtimes, all of the time.
Holistic needs assessment
Outcome from assessment:
Difficulties linked with postural stability, bilateral integration, body awareness, and tactile defensiveness
Before starting feeding therapy we worked on the skills needed to eat, such as postural stability, in-hand manipulation, ability to use both hands together, and tactile defensiveness.
Following 4 weekly sessions we moved onto feeding therapy. This involved me creating a food hierarchy which would be used each week for 12 weekly sessions. Before and during each session we completed calming regulating exercises such as wall press-ups, being squashed between pillows and blowing bubbles. These have a calming effect on the central nervous system. When completing therapy we need a child to be calm and relaxed, this is because when their anxiety goes up we know that they won’t want to complete therapy or try anything. Once the child was calm l slowly moved up the steps to eating. Over the sessions it’s great to move up 1-2 steps and solely the child will start higher and higher and move up the steps. We used lots of fun activities to engage the child the food, such as painting with food, making cars with the food, creating animals.
The family also had work to do at home around exposing their child to food in different way. Such as, reading children's books about food, asking the child to help with food preparation, going food shopping together and picking out the fruit and vegetables and helping to plan meals.
Following 3.5 months of intervention the child:
· Had feedback from school that his handwriting had improved,
· was able to complete previous gross motor activities he had had difficulties with
· was able to tolerate a wider range of food choices,
· had reduced his gagging when eating foods,
· was able to have food mixed with other food he doesn’t like in a pre-packaged box.