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A Pediatric Perspective

Tuesday Tidbit (tadbit tardy) - Finger Feeding help

Published November 3, 2009 11:14 PM by Wendy Hof

One of the challenges of working with toddlers and their independent self-feeding skills is that you are sometimes challenged to work with a toddler who doesn't have the skills to be independent but is at that age where they are striving to do it all themselves anyway.  They want to do everything themselves and are not always welcoming when it comes to hand over hand assistance or, for that matter, any kind of assistance.  I've found you need to be a little tricky so that they think they are doing it all by themselves when in actuality you are guiding them in the direction you want them to go, with a little assistance to get there.

One of the ways I have found to help a child with their finger feeding skills to to place only one or two small pieces of safe food (puffs, gold fish, etc) on their tray.  Let them first try and pick up these pieces by themselves so you can assess where their skill level is.  Do they need help closing their pincer grasp so they can actually hold the food in it or are they not even to the point of being able to make a pincer grasp and are still at the racking into their hand stage?

A good strategy to help both if they are still raking or if they are just not closing their fingers into a pincer grasp is to pick up one of the pieces of food and hold it between your thumb and finger in front of them.  Their first step is usually to tilt their head forward as they believe you are going to feed them with what is in your hand.  Slowly pull away far enough so they can't reach the food with the tilt of their head.  Hold up the food in your fingers so they can see it.  It is good to make sure that whatever you are offering is something that will motivate them.  Remember - motivation is always the key in having a successful therapy session. 

With the food in between your fingers on one hand, use your other hand to nudge the elbow of the arm you are working on eliciting the grasp from.  More often than not they will reach out to get the food from your fingers.  You should try and hold on to the food relatively well so they may have to work a little to get the food from you.  Once they start to isolate their thumb and pointer/middle fingers and reach with a somewhat accurate pincer grasp - be sure to release the food into their fingers/hand so they feel successful.  If the need is there, gently help them release the food into their mouths once they have independently moved their hand up to their mouth. I found a good way to do this is to slip a finger gently into their fisted hand and push the piece of food through their fist/grip and right into their mouth.

If you do this several times at each meal they will begin to gain strength and dexterity in their hands and become successful with their pincer grasp.  They should become comfortable enough to be able it each out and take the food from you.  Challenge them a little.  Hold the piece of food right in front of them to gain their attention and then the next time move it up and to one side or another.  This is good to make them reach across mid-line and to reach up.  Remember whatever you may be offering them needs to be something they really want.  Be sure to encourage them regardless of if they start with a more raking movement because with repetition they should be able to gain more exprience with their attempts at pinching the food and getting it to their mouths.  The more successful they become the more they will start to reach for the food in the proper way using their thumb and pointer finger consistently and spontaneously.

The key starategies are a) finding a food that is safe and motivating to them and b) helping them without being right in their face and taking over.  Let them think they are doing most of the work themselves so they can successfully start to feel independent.

Thanks for stopping by - hope to see you back here again.



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