Encouraging Play, Fine Motor, Speech

Thanks. At local stores, I am not finding versions that have only laces and no velcro straps. If there are velcro straps DD gets obsessed with them. I got Converse shoes and for now she is unable to figure out the laces.

 

DD's OT was here at lunch on Friday to see how chewing/eating is going. DD was on her best behavior. No spitting on my face or throwing food. She was having khichdi so not much chewing but chewed cherries and cucumber in the raita okay. Taking bites of food is still something to work on. I give her apple sticks and boiled beans to bite with front teeth. We have a little game of taking little bites off from each end. She now tries to take a bite and then offers me

 

This past month I have been trying to get my DD to clean up her toys every day before bedtime. First I played a cleanup song on the phone and walked with her to every scattered toy and helped(made) her put it in the toy bin. Now she does it without the song when I say let's cleanup. I still have to prompt her to get xyz toy and put it in the bin but I don't walk her to and fro to anymore. This also helps me know that she knows the names of most of her toys. She sometimes gets too interested in a toy and starts to play and then I step in to put it away.

 

My daughter ate really well until she was 1.5 years old. After that she started spitting (spoon fed food) and throwing (finger foods). Once she starts to spit, she continues on to blow raspberries until she is tired. She lost a lot of weight and it was a big concern.

Fortunately, she is not a picky eater and has no medical or oral motor problems with chewing and swallowing.

We knew her biggest issue was sitting still... she likes to move and hates being belted up in the high chair, so would yell and yodel like a tied-up mini Tarzan. (My secret nickname for her is Mowgli, can that be a girl's nick name??) We tried having her on her ride-on toy and offering her a spoonful for each ride around the living room. That worked for a week, then she started spitting all over the living room carpet.

Another issue is food texture. If she got something lumpy or a little unexpected in her mouth (even a bit of a curry leaf), it went right on my face, followed by furious screaming until her face turned beet red. I gave her blended food to avoid lumps, but how long can I feed her that... Every time I reintroduced some texture, it was the same story.

To make the high chair tolerable, the advice we got:

1. Eat along with her so that it is special family time - Didn't work, she wasn't aware enough to realize that it was 'special family time'. Maybe in future.

2. Have her sit in high chair not just for eating but for other play time so that she gets used to it and there is no association between high chair and food - I tried this for some time. But even in play, she needs her breaks to run a lap before coming back to me, so it wasn't very practical.

3. Pair the high chair with something she loves – this worked best for us. She was just starting to like books when they were paired with songs. So we would sit with a bunch of books, one person singing the book and another feeding. After a few weeks, she was so enchanted by the books that she would peek into the next page, but we only turned the page if she opened her mouth for a bite. In the beginning, it used to take us 60 min+ to feed her and we often used to skip our own lunch. Now it is a lot better and takes less than 30 min.

For texture issues - I stopped cooking specially for her. It took a while, but with help of various chew toys, she understood the meaning of the word 'chew'. So I give her something she could kind of swallow (like dal+quinoa) and then in the next bite offer something to chew (like veggies) saying 'chew'. Now I am very slowly combining different textures in the same bite and she is tolerating it okay so far.

For the spitting - She spits because of the texture and then gets a kick out of our reactions. (We know she does not spit because she has had enough) So any time she spits, we ignore her and turn our head away completely. It got a lot worse before it got better (extinction burst), but we no longer react and she is not doing it as much now. It comes back once in a while… when her nanny laughs or reacts when she spits or blows raspberries. I used to have her nanny give her breakfast/lunch, but I am now doing it myself to avoid this.

It's the same for throwing finger food or rubbing food on her head. We stopped reacting and it has decreased considerably.

So right now, for meal times, we are book-dependent. Trying to fade away this dependency but she really needs entertainment to sit still. We are trying more bites per page. A few times we have tried turning on TV, but she gets completely engrossed and turns into a zombie and there is no interaction to prompt her for the next bite.

Sometimes, if alone, I try just singing songs because turning pages and spoon feeding at the same time is a bit difficult. She does okay most of the times.

Maybe when she is able to feed herself, we can have that dinner together as a family. Right now, we don't even have a dining table, we had to get rid of it because she kept crashing into it. So it's a little awkward to eat together.

Another problem is that I have no clue when she is done eating. I have been using the sign 'all done' (twisting hands back and forth a few times) for more than a year and she understands the word and the sign but never did it herself. It's a big help for her to understand that word because it is very handy in the hospital where her anxiety skyrockets. Recently, someone mentioned it might be easier for her (motor planning wise) to start with hands high together and moving away from midline. So I have been signing 'all done' this new way for the past month, and she actually started doing it this week with a verbal 'duh' for 'done'. But she does it only when I prompt her, not to indicate being done. I am going to prompt her each time we are done with any activity and hopefully she will catch on.

Something a therapist mentioned, that has helped keep things in perspective:
(from Division of Responsibility in Feeding - Ellyn Satter Institute)
The parent is responsible for what, when, where to feed.
The child is responsible for how much and whether to eat.

 

This link has details about setting up a music routine at home: Setting Up a Music Routine at Home

I have a little routine based on it.

Greeting song is always the same (only the beginning):


Movement song: there are so many, I change it up.
Head, shoulders, knees, toes/Ring around the rosey, etc

Singable book: I have laminated picture cards of all her singable book covers and she chooses the book to sing.

Instrument song:
With drum: Ants go marching or Hand Hand Fingers Thumb
With Xylophone: Row row row your boat or Mary has a little lamb (those are the only ones I know)

Target skill:
Any alphabet song or number song.

Closing song:
The article says use the same song but I use any song that has 'Bye' in it.

We used to do it daily but now we do it every 3-4 days. I have playlists on my phone with variations of these songs. Sometimes I just play a playlist without book/instrument/movement/book cards and DD still likes it. Especially in the car.

 

7/24: Action songs, playing in the play tunnel, lots of books, story time @ library

 

Books, songs with actions, identifying animals, then went to park.
Trying some pretend play with her baby doll. As of now, she will hug, kiss, pat, pat gently the doll. Calls the doll 'bebe'