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Occupational Therapy

Article By Lindsay Meador, COTA

Increasing independence and success with self feeding during mealtime is very important, and it is one of the milestones that your child should reach as they grow and develop. It is crucial to start working with them early on to instill the correct strategies and to provide your child with the building blocks to master this skill. Components that must be considered include your child’s posture and positioning, body awareness, fine motor skills, and their bilateral and hand eye coordination. Choice of furniture at mealtime also plays a significant role in whether your child will be able to attain correct posture and positioning as mentioned above. Please check out our blog to learn more about a variety of tips and strategies that you can implement to help your child be more independent with self feeding during mealtime!

Posture and Positioning

One of the first things parents or caregivers should look at is positioning and posture of the child when coming to the table for a meal. Children with poor postural control and/or weak core strength may have trouble sitting in the correct way to improve accuracy and ease with self feeding. A child who struggles with postural control may be seated to far back in the chair (causing spillage of food when bringing to their mouth) or they may be seated with their stomach against the table as they have trouble with maintaining an erect posture (requiring both tactile and verbal cues from the parent). Building up a child’s core strength to be able to maintain correct posture is essential, but it is not the only component to consider. It is also important to consider the angles your child displays with their body when eating. Think 90/90/90. Children should be seated with their hips, knees, and ankles all bent at 90 degree angles. To give more of a visual, picture these joints each having an angle like the corner of a perfectly formed square. Sometimes you may have to squat, bend, or look at your child sideways to determine if your child is achieving the 90/90/90. Their feet should also be supported either by the ground or by part of the chair. Their feet should be firmly planted and rested on a solid surface while eating, and feet should never dangle.

Furniture Choices at Mealtime

Another component that is important to consider when bringing a child to the table for a meal is furniture choice. The size of the furniture needs to correspond appropriately with the child’s body size. Just as a teenager or grown adult would not sit in a small child’s chair, a small child should not be sitting in an adult size chair as this will not give the child adequate support and will hinder adequate positioning. Consider an alternate method such as a small child’s table and chair or a booster seat. This will allow their arms to be able to reach the table and give their feet a place to rest. Be consistent in where your child sits and how they sit when eating a meal. It is important for the child to know the correct way to sit when eating. Establishing a routine is VERY important!

 

There are many kinds of booster seats out there, and it is up to the parent to decide what works best for their child. When considering what booster to buy, be sure the booster provides adequate support for the back and feet. For a child that tends to wiggle or squirm, try a seat cushion or have them stand up while eating. If allowing your child to eat at a “kiddie” table, try pulling the table up to the regular dining table, so that the child still feels like they can be apart of the meal and interact. If at a family or holiday party (such as Thanksgiving or Christmas) try setting aside a “kiddie” table for all the siblings and cousins.

Body Awareness and Hand-Eye Coordination at Mealtime

Children with poor body awareness are simply not as aware about what their body is doing or what may be touching their body throughout the day including during a meal. They do not feel things as keenly as we do. They may be sitting in a very awkward or uncomfortable position at mealtime unaware that their posture isn’t correct. These children often tend to end up very messy during a meal exhibiting food on their fingers, faces, and clothes because they don’t know when it’s happening. They also most likely will not be aware its there after the fact, as they don’t feel it or there is no awareness of of discomfort.

Tips to improve body awareness in your child include but are not limited to:

1. Proprioceptive input (heavy work activities)

2. Games that involve ID of different body parts

3. Mirror games

4. Practicing spatial awareness – obstacle courses at various heights/directions

5. Following verbal commands that include specific body parts and specific directions

Hand-eye coordination at meal time is also an important component as this involves getting the food to mouth, reaching for a drink, or securing a piece of food on utensils such as a spoon or fork. Children who have poor body awareness combined with poor hand-eye coordination may accidentally get food on their cheeks or chin as they are trying to bring to mouth. They may overshoot, undershoot, or not align their utensil correctly resulting in spillage or a mess. Once the mess is there, they may not be able to feel it due to poor body awareness.

 

For kiddos who have trouble with hand-eye coordination and motor planning, EZPZ is a great brand that offers a variety of plates, bowls, and mats that suction to the table, booster seat, or high chair holding their position during mealtime. Having dishes that stay in place and remain secure also make it easier for little ones that are still learning to eat with utensils. Another option that is offered are cups that feature non slip grip, weighted bases, and tactile bumps to provide topple resistance support

Fine Motor Skills and Grasping

The way your child holds their utensils at mealtime, whether that be a spoon, fork, or knife, is very important and directly relates to overall hand control during mealtime. This also directly correlates to how children may hold their writing utensils. Many children attempt to compensate how they hold utensils due to delayed fine motor development or strength. Children may display “thumb wrap” grasp when writing and “shovel grasp” when eating. This is seen when children tend to wrap their thumb around the rest of their fingers. Inappropriate grasp may result in inadequate development of the small muscles of the hand. It is very important for parents to be aware of their child’s grasp and to correct it when needed. It’s essential in the development of hand strength and hand skills that they will need not only in the present but future as well. For more ideas of how to develop hand strength and hand control in your little ones, please refer to our previous blog posts.  🙂

Bilateral Coordination

Bi means “two” or in this case “both” sides of the body. Bilateral coordination is the ability to use both sides of the body together in a coordinated manner. An example of this would be one hand holding a fork in efforts to secure a piece of food while the other hand steadies the plate. Often times, children tend to not give much attention to their non dominant hand. It can often be seen hanging at their side or placed in their lap while performing functional tasks such as self feeding, writing, or coloring. Instead their non dominant hand should be steadying the plate or the paper to improve accuracy and execution of task. By the age of 4 or 5, your child should be independent in using two hands to complete a task without having to be cued.

 

If your child is not displaying appropriate bilateral coordination, it is good to give them verbal cues or reminders to do so. Think of the dominant hand as the one that performs the actual task, while the non dominant hand acts as a stabilizer assisting the dominant. A verbal cue may include a phrase such as “use your helping hand” to hold the paper or plate. Another thing to consider, once again, is your child’s position. Be sure that they are positioned correctly to be able to utilize and have unrestricted access to both hands. This will allow for a much more precise and neater job/execution of task, and hopefully a much cleaner child at the end of a meal!

Tips to improve bilateral coordination include but are not limited to:

1. Bopping a balloon or bubbles

2. Tearing, crumpling, ripping paper

3. Cutting tasks with scissors

4. Connecting and separating interlocking toys

5. Playing catch

6. Manipulating play dough or Theraputty

7. Mr. Potato Head

8. Lacing activities

9. Stringing blocks or beads with string or pipe cleaner

10. Coloring, drawing, writing

Try our Free Online Screening Tool

If you are not in therapy and you are wondering if your child may be falling behind with sensory processing, fine motor skills, speech and language or developmental milestones, please try our online screening tool. You will be given a survey of age-appropriate milestones for speech, language, gross motor skills, fine motor skills and sensory processing for children ages 1-6.

https://texarkanatherapycenter.developmentchecklist.com

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