About 2 months ago our clinical coordinator at the preschool where I work asked whether I would be willing to supervise a graduate speech-language pathology student over the course of her summer semester. She explained to me the student would need 80-100 direct clinical hours and I would be supervising every one of them. I'll be honest and admit that my silent, initial reaction was to say "no". My caseload has recently increased, along with paperwork and outside demands. I have supervised students twice before and loved it; however, I have not done so in my current position, so this was unchartered territory for me. Nevertheless, after some friendly coaxing and encouragement I agreed and began to map out how I would greet this new challenge.
We are now almost 2 weeks into her semester and I have quickly remembered the mutual benefit of such a relationship and why I truly love the delicate art of teaching. Having a student on board is both a breath of fresh air, as well as an additional resource that I both need and welcome during this busy time of year. In fact, the proverbial light bulb has gone off in my head and I am now wondering why we haven't done this sooner?
For those of you considering opening your office doors to SLP students, here are some advantages to doing so straight from the ASHA website:
"Supervising student clinicians also benefits the supervising SLP in a number of ways, including:
- Keeping up with current information in the field
- Sharpening clinical skills by teaching others
- Stronger relationships with university programs
- A sense of "giving back" to the profession
In speech-language pathology, as in any field, it is as important to keep good employees as it is to find new ones. While there may be some impact on the SLP's productivity and the facility's bottom line for speech services when the SLP supervises a graduate student clinician, it is unlikely the impact will cost as much as recruiting and hiring new staff. Estimates on the cost of personnel turnover run as high as 1/3 of a new hire's annual salary to replace an employee (U.S. Department of Labor, retrieved June 18, 2007). Happy employees tend to stay with an employer. Giving SLPs the opportunity to grow professionally and personally by supervising a student clinician is one way of improving morale and ultimately retaining that SLP."
Of course, many factors can play a role in the success of such an endeavor, but there are existing supports for both the supervisor and the student.
Join me next week as I further explore this opportunity and what YOU need to know!
We are halfway through the month of May and Memorial Day is less than 2 weeks away! It's time to take out your grill, dust it off and fire it up! Starting this week and continuing through the next couple weeks I will be sharing grilling recipes that are perfect for picky eaters and the entire family.
Most picky eaters don't enjoy very complex foods such as a burger with a bun, cheese, lettuce and tomato. If this is true for your child, you may want to try the following:
Grill/cook the burger thoroughly so that it is not soft or mushy in any way. Leave off the cheese and simply cut the burger into bit sized pieces and present like a regular burger or hot dog. Cut to an appropriate size so it is easy for little fingers to pick up.
*This recipe is made to be prepared on either a grill or on the stove top, cooked in a greased skillet.
Recipe: Homemade Veggie Burgers
You will need:
½ cup Shredded Zucchini
½ cup Shredded Carrots
¼ cup Diced sweet yellow onion
1 and ½ cups of Flour
½ cup of Bread crumbs
1 egg beaten
ADD: a slice of cheese to the top when cooking if preferred (especially for those non-picky eaters!) or add a tablespoon of parmesan cheese to mixture and cook right into the burger.
- 1. Shred and dice the vegetables: the carrots, zucchini and onion. Have your child help with this part of the process.
- 2. Heat the olive oil in a skillet over low heat, and cook the onion and garlic for about 5 minutes to help the flavors emerge.
- 3. Mix in the carrots and zucchini. Continue to cook and stir for 2 minutes. Remove pan from heat.
- 4. Add in the bread crumbs, 1 cup of flour and the beaten egg. Mix everything together.
- 5. Add the additional seasonings: salt, pepper and parsley (add parmesan now if preferred as well)
- 6. Refrigerate mixture for 1 hour to allow it to hard and congeal together.
- 7. Preheat your grill or prepare stove.
- 8. Place the remaining flour on a large plate. Form the vegetable mixture into eight 3 inch round patties. Drop each patty into the flour, lightly coating both sides.
- 9. Oil the grill grate or skillet on the stove and cook patties 5 minutes on each side, or until heated through and nicely browned.
- 10. *Add cheese if desired to a cooked side and cook on low while it melts.
Enjoy the burgers and beautiful springtime weather with your family!
Last week, I shared the life-changing information I learned at a seminar entitled "7 Mindfulness Habits of the Highly Effective Brain" given by Jonathan Jordan, MSW LCSW, a well-traveled social worker and master life coach. My post talked about the definitions of "mindfulness" and lists the actual 7 habits that Mr. Jordan recommends in order to achieve this level of existence.
Here are the Habits listed again with some additional information to help you attain each one:
Habit #1 Have a Nutritious Diet
"Eat colorful fruits and vegetables, Omega 3 fatty acids and natural Vitamins E, C, B and folic acid. Avoid refined carbohydrates and saturated fats".
Habit #2 Focus Sequentially
- "We can do simple tasks like walking and talking at the same time, but when it comes to true multitasking, your brain just can't do it". Instead, "focus on one task at a time, complete it, then focus on the next task and repeat the process"
Habit #3 Be Physically Active
- Studies show that 20-30 minutes of moderate exercise, like walking, 3x a week is all you need to confer a wealth of benefits to your brain"
Habit #4 Participate Socially
- Staying socially active throughout life can help to maintain normal brain function and put off the onset of dementia"
Habit # 5 Sleep Well
- "Sleep deprived people do not have the speed of creative abilities to cope with making quick but logical decisions, nor do they have the ability to implement them well"
Habit #6 Challenge Yourself Mentally
- "When you learn new things or even think new thoughts your brain restructures itself. The more you exercise your brain, the better it performs. Brain imaging scans actually show proof of this: your brain physically changes once you begin learning and doing new things.
Habit #7 Have a Positive Attitude
- "Attitude Changes Everything, Including Your Brain". So, "surround yourself with positive people who help you reinforce this attitude".
And finally, WHY is being mindful helpful and WHAT can it do for you?? The following characteristics are just some of the Mindful Research Outcomes shared during the training. The list is a collection of the improvements people have consistently demonstrated and reported due to their practice of being "mindful":
To learn more about Jonathan Jordan, MSW LCSW and his teachings, visit him at
"We can't stop the Waves, But we Can Learn to Surf" ~ Jon Kabat Zinn
I have been looking for new way to cook Brussels sprouts for my family. After researching some different recipes, I decided to mix a few together and create my own! The bacon and mushrooms add a nice meatiness to the sprouts, while the cheese and butter help to unite all the flavors together.
Hope you enjoy!
Cheesy Bacon and Mushroom Brussels Sprouts
You will need:
1 and ½ lbs of fresh Brussels Sprouts
½ lb of low-sodium Bacon
2 tablespoons of butter
2 tablespoons of extra virgin olive oil
1 cup of small portabella mushrooms cut into small pieces
1 cup of shredded Asiago cheese
A pinch of Pepper
2 cups of low-sodium chicken Stock
1. Wash and cut all the Brussels sprouts into four quarters. Let them dry thoroughly on a paper towel and then place them to the side.
2. Cook the bacon by placing it in a large, deep skillet. Cook over medium-high heat and flip the pieces consistently so they cook and brown evenly. Cook until crispy, but not burnt
3. Remove the bacon with a slotted spoon and lay on a paper towel to soak up the grease. Pour almost all of the grease out of the skillet leaving just a coating to help add flavor and to prevent burning for the rest of the dish.
4. Add in an tablespoon of butter and olive oil and have them melt together in the pan.
5. Stir in the cut mushrooms and cook for about 5 minutes on medium heat.
6. Stir in the Brussels sprouts and mix thoroughly so that they are completely coated
7. Add the chicken stock by pouring in both cups.
8. Bring the stock to a boil over high heat. Reduce heat to medium-low, and simmer until the Brussels sprouts soak up the broth and are tender, yet still slightly firm, about 10 minutes.
9. Break the bacon into tiny bits and add to the halved Brussels sprouts in the pan and stir.
10. Add in the pepper and shredded cheese. Mix until cheese is melted.
11. Serve as a delicious and flavorful side dish!
This past Thursday I went to a wonderful training entitled "7 Mindfulness Habits of the Highly Effective Brain. "The presenter was a man named Jonathan Jordan, MSW LCSW, a well-traveled (he's been to 146 countries) social worker and master life coach who was hired to give this same presentation to our own United States Senate. Although I was able to earn 6 ASHA hours by attending (which was a huge benefit!), it was the title that really grabbed my attention.
I've had an exceptionally busy spring this year. My work caseload has increased over the last few months, including additional paperwork requirements. I am also now a mother to TWO growing and busy little girls and we have had many exciting events within our family and with close friends--anniversaries, weddings, moves and milestone birthdays. Some days I feel the demands are endless--always something that needs to be done. I thrive on my ability to make and obey "to do" lists, as well as "multi-task", being able to cook dinner, while laying out clothes for the next day while answering phone calls and returning texts and emails.
When I sat in the training last week, the room was full of RN's, OT's, SLP's, PTs, social workers and teachers. In reference to the audience, Mr. Jordan stated (and I am paraphrasing) that he finds in his line of work that "professional caregivers" often have the hardest time receiving care. However, we are exactly the people that need it most. It isn't possible to give and give and give and never or rarely replenish. Eventually the well will run dry. So, in order to prevent that from happening, Mr. Jordan talked about the importance of MINDFULNESS in every day life. In case you are not certain of what true mindfulness is, here are a few definitions offered verbatim from Jonathan's seminar:
- Being aware of and accepting your thoughts, feelings and circumstances
- without judgment, reaction or distraction (and without expectation)
- awareness of awareness
- conscious of being conscious
- the ability to step outside of yourself and observe your moment-to-moment experience
Although some of this may seem vague and impractical, listening to the seminar, learning about the research and hearing the scientific evidence was enlightening for me. There is too much information to squeeze into one post; however I will leave you today with the list of 7 Mindfulness Habits that Jonathan recommends and next week continue the discussion, sharing why this is more than just a self-help checklist.
Habit #1 Have a Nutritious Diet
Habit #2 Focus Sequentially
Habit #3 Be Physically Active
Habit #4 Participate Socially
Habit # 5 Sleep Well
Habit #6 Challenge Yourself Mentally
Habit #7 Have a Positive Attitude
Join me next week for a follow-up discussion. The information has been so
professionally and personally beneficial for me that I know you will find wisdom and truth in it as well!
Now that the chilly weather is finally beginning to break and the sweet smell of spring is in the air, it is the perfect time to visit your local farmer's market and see what is in season. From time to time on this blog I explore the juicy world of fresh fruits and vegetables and in the process, educate myself and others about how to: 1. BUY SEASONAL PRODUCE and 2. COOK SEASONAL PRODUCE.
The website, CUESA.org offers extensive lists of both vegetables and fruits that are in season during the month of May. Shopping and cooking in season is a wonderful way to save money and eat fresh! Using some of the suggested veggies on the seasonal lists above, here is a wonderful side dish that your little ones could easily help you make and will enjoy eating, especially if they love cheese!
Recipe: Cheesy Cauliflower and Peas
You will need:
1 small can of Condensed Cream of Mushroom Soup
1/2 cup milk
1 (20 ounce) bag frozen cauliflower florets, thawed
1 cup finely grated Swiss cheese
1/4 cup cooked crumbled bacon
1 cup of peas (if frozen, let them thaw a bit)
(The bacon needs to be cooked prior to adding it to this recipe. Baking it in the oven at 400 degrees on a long pan with tin foil underneath the bacon to catch the grease is my preferred way to do this. Cut the bacon in half and lay out the strips side-by-side on the pan. Using this method undoubtedly helps the bacon to cook evenly and gives it a nice crispy crunch.)
1. Preheat oven to 350 degrees
2. Lightly grease a 2 quart casserole pan with cooking spray or butter.
3. Pour the soup and milk in a bowl and stir.
4. Add in the garlic, cauliflower, peas and half of the Swiss cheese and mix everything together.
5. Pour into the greased casserole pan.
6. Sprinkle the top with the bacon and the remaining cheese.
7. Bake at 350 degrees for 50 minutes or until the cauliflower is tender and mixture is hot and bubbly.
Today is the last day of April and tomorrow begins May, or what SLP's across the globe lovingly refer to as "Better Speech and Hearing Month"! This year the slogan for BSHM is "Helping People Communicate". In order to properly kick off the month, today's post offers a list of ideas and resources for speech therapists to utilize during OUR special time of year!
- To begin, here is the link to ASHA's Better Speech and Hearing webpage, \which offers several wonderful resources to help therapists promote and embrace the message of the month. This link includes a BSHM poster as well as an exciting catalog full of bags, mugs, t-shirts and more to outwardly endorse BSHM! Display the poster in your speech office or in the school halfway. Spread the word to staff, parents and the students that it is Better Speech and Hearing Month!
If you would like to really increase speech and language awareness in your workplace and make some needed changes or improvements, here are some additional ideas:
- Have a Fundraiser! Is the speech department at your school in need of some new supplies? Are there tools that you need that would help to make therapy more effective and useful for the children? BSHM is the perfect opportunity to have a bake sale for the speech department and raise some money that can go directly to the needs of the children who receive speech and language services.
- Be a Resource for Staff and Parents! This month is the perfect opportunity to provide a training for teachers who may have students with speech and language needs. Show them how to utilize augmentative communication more in their classroom or how to improve their responses to children with language delays. Reconnect with the parents of your students by sending home a few informative handouts about how to stimulate better communication at home. The possibilities are endless!
- Get Your Students Involved! Have your speech and language students draw a picture about speech class and hang them around the school! Have a speech and language party so all the children in speech class can meet each other and know that they have a common bond! Or have your students bring a friend to their next therapy session so they can tell them about all they learn when they come to see you!
Whatever you do, have fun this month and capture the opportunity to be creative and think beyond your usual job description!
Please share how YOU choose to honor Better Speech and Hearing Month this May!
My older daughter who just recently passed her 3 ½ birthday remains quite the picky eater despite many attempts on my part to help her taste and enjoy different foods. One of the foods she continually refuses is yogurt. I first introduced yogurt when she was a baby. I would sit her up in her comfy cushioned high chair, face to face and spoon feed her various flavors of yogurt specially made for babies. It was smooth and creamy. No chunks or added texture, just silky baby yogurt. In those early years she would sometimes open willingly and eat the yogurt served to her, but it was never her favorite. Every few months or so I reintroduce yogurt in various forms hoping to disguise it enough that maybe she will try it on her own and actually like it! Sometimes I even tell a little white lie....and call it something it is not, such as a Popsicle or ice cream!
Here are some different ways to present yogurt just in case your picky eater won't touch the stuff!
- Freeze it! This really has been the most successful form in our house. I pour the yogurt into a freezable container, freeze it and then present it as a frozen popsicle-like snack! You can also buy the long tubes of yogurt and freeze them. They really transform into a frozen popsicle yogurt stick!
- Drink it! You can drink yogurt two ways: 1) Buy drinkable yogurt smoothies and present it to your child with props, such as a fun spoon or straw. 2) Add a few tablespoons of water or apple juice to regular yogurt and mix until fully blended and becomes a more liquid-like consistency and therefore easier to drink
- Dip it! Dip fresh-cut fruit, crisp vegetables, cookies, toasty waffles, bagels, etc. into your yogurt and enjoy!
- Crown it! Give your yogurt a finishing touch by adding some sprinkles, mini-chocolate chips, crushed cookies, mini-marshmallows, bits of fruit and whatever else you have handy. Adding on that extra bit of sweetness or crunch may be just the incentive your little one needs!
Last week I shared that I would be back on the road joining our Early Intervention homecare team once again for a few visits a week. I am still working in the preschool for the majority of my week; however I have added several Birth to 3 homecare families to my caseload as well. I also shared that since I left homecare roughly 3 years ago, some changes have occurred in our county. One of these new practices is utilizing speech consultations as part of the child's therapeutic plan. This has become a more routine procedure recently.
When I shared this information last week a reader from the state of Indiana offered this comment after reading my post:
"We have not made these changes where I work, but I would be interested in hearing more about your speech consultations. Why is speech consultation the chosen level of service? Are these kids close to aging out of services? What are their diagnoses? Do you come back another time to see how it's going?
I find this intriguing and would be interesting in presenting it to my boss, but would need more information. Thanks in advance for any help.
I would like to take today's post as the opportunity to respond to the reader's inquiry and explain what a speech and language consultation looks like in our county. This is not a technical definition from the county, it is my interpretation as it has been explained to me:
A speech consultation is recommended when the existing IFSP team (parents and therapists) have concerns regarding the child's speech and language skills and are in need of an SLP's expertise to see if in fact the child is delayed and what can be done to assist them. The child can be any age and diagnosis does not seem to play a part in the decision. (The children I saw this past week are currently considered "developmentally delayed" and no further diagnosis is being considered at this time. In addition, they are making consistent and steady speech and language progress in their current environment.) At the consultation, the SLP will meet the child and their family and ask key questions about the child's current speech and language skills, medical and developmental history, as well as parent and team concerns. The consultation should be completed at the child's home with their family/caregiver(s), as opposed to a childcare center, and with one of other therapists or educators who are currently working with the child. The reason for this recommended scenario is to hopefully achieve the greatest benefit from the consultation: The parents are present so they can ask questions and learn new information about their child's speech development and a therapist or educator is present to help implement the recommended strategies after the consult is complete. Strategies can be recommended verbally and are also documented on the consultation form. The SLP can share outside resources for the parents and therapists/educators to utilize as well, such as helpful websites, books, etc. The team is instructed to utilize the suggested strategies for several weeks and if concerns remain at the time of the next quarterly review then speech therapy may be recommended and added to the child's case at that time.
I would love to hear from readers about this part of EI homecare.
Do you do speech consults in your county? Do they work the same way as what was described above? Are they effective? Please share your thoughts!
Next week is "E" week at our school, meaning we will be talking and learning about all things "E"! So today at our teacher planning meeting we brainstormed on all the Exciting E-based Events we could plan for the upcoming days. Some of our ideas included: Egg-shell painting, making scrambled-Eggs, Exercise activities outside in the spring air and Eating the alphabet! Last spring in May I wrote several posts about Lois Ehlert's book "Eating the Alphabet: Fruits and Vegetables from A to Z". It is a fabulous book especially great for picky eaters who tend to eat the same repertoire of foods every day. For more information about Ehlert's book and suggestions on how to implement the book at home or in therapy, visit my posts from May 2012.
In addition to "Eating the Alphabet," we discussed taking the idea one step further to "Cooking the Alphabet", starting with the letter A of course and moving through all 26 letters to Z. This is a great way to get both your students and your own children committed eating healthy and trying new foods. Here are some ideas on how to engage your students and children in the process of "Cooking the Alphabet":
- Have them help you CHOOSE what to COOK! Brainstorm on all the foods you can think of that start with each letter. For example, for the letter A, such foods you could list would be: Apples, Apricots, Avocados, Artichokes, Arugula, Almonds and Asparagus, just to name a few. Make a list of foods they have eaten and another list of those they have never tasted. Then, choose one of the new foods that everyone would like to try.
- Taste the Raw Food - If avocados are the choice, slice one open and explore! Look at, touch and taste the inner layers. What color is it? How does it feel and smell? Taste the food raw and in its most natural form so the child can be exposed to simple basic clean foods that aren't processed or altered in any way.
- Choose or Create a Recipe Using Your New Food - Look through food and recipe magazines, colorful cookbooks and online for a recipe that highlights the new food you are sampling! Choose your favorite recipe and get cooking! Try making guacamole from scratch or an avocado salad. Gather together all your ingredients and enjoy the process of making something delicious with your little one and/or students!
- Repeat the Process Next Week with a Letter B Food and so on!
Due to changes at the workplace, which are mainly fiscally driven, my current work position is expanding and I will no longer treat children solely in the preschool. Now, some of my days will be split as I will be back on the road in homecare therapy for a few hours a week. It's been more than 3 years now since I left homecare and the birth to three program; and although it will be a big change from the preschool scene, I am excited about reconnecting with my Early Intervention roots. Earlier today I took some time to call the families I will visit later this week to introduce myself and set a therapy time. It felt good, like putting on a favorite and familiar pair of pajamas, comfortable.
I am also really excited about working once again with some of my old co-workers and friends who have remained in homecare for the past 3 years. I put time aside today to reach out and connect with them and learn about some of the little ones I will meet in a few short days. I am also learning about the changes that have occurred and have been implemented since my time in homecare. For those of you reading this who are homecare therapists, are these also considered "best practice" where you work?
- New Forms - I need to familiarize myself with the forms they are using now, but one aspect that I know has changed is that the information being reported now needs to be much more data driven. We are having the same changes in preschool. I can share more information about this once I begin using the current forms.
- Speech Consults - Two of the children I will see this week are actually one time consultations which have been recommended and approved by the child's IFSP team. My job is to meet the child and offer helpful hands-on suggestions to the parents and team members for use with the child to hopefully improve their speech. This practice was just beginning in our county 3 years ago when I left, but seems to have become more routine since then.
- No Goodie Bags - When I first began in homecare which will be 7 years ago in July, my co-workers and I would enter homes with a bag of our own toys and tools, prepared to engage the children in language-based play hoping to elicit speech production and demonstrate for parents how to do this effectively. Now therapists are being told to leave their Santa-bag-of-goodies behind and utilize what the family has in the home so that you are treating within the child's natural environment. I am a little nervous about this one, but confident I will learn to adapt!
My new schedule begins this week ... wish me luck!
If you are working in homecare now, is your county implementing the same practices listed above?
Today I am posting a recipe that a friend recently shared with me. It is easy, healthy and delicious! The main ingredient is broccoli, "the most nutritious of all its cabbage family members" according to the Whole Living website.
According to the Food.com "Home of the Home Cook" website, the word "broccoli" comes from the Italian word 'Brocco' meaning arm branch and is a relative of cabbage, Brussels sprouts, and cauliflower. It is said to contain as much calcium, gram for gram, as milk.
Broccoli is in season during the months of October to April (perfect for now!). When choosing fresh broccoli, "look for a strong color, tight buds and healthy leaves on the stalk. The stems should be a lighter green than the buds and easy to pierce with a fingernail. Avoid stalks with yellowed or open bud clusters and stems that are hard and dry". Broccoli can remain "Unwashed in the refrigerator for up to 4 days in a plastic bag".
And don't forget, "The stalks are edible and contain many nutrients!"
Recipe: Crispy Broccoli Bits
You will need:
4 Cups of Fresh Broccoli florets
2 tablespoons of bread crumbs
1 tablespoon (or more!) of Parmesan Cheese
1. Steam the fresh broccoli for approximately 8-10 minutes, or until the broccoli has softened a bit but is still crunchy.
2. Lay out the broccoli to dry on a paper towel for about 10 minutes and pat it dry.
3. Once the broccoli is just slightly damp, place in a mixing bowl. Pour in bread crumbs and stir until broccoli is evenly coated.
4. Sprinkle salt, pepper and garlic powder on top and stir again.
5. Melt butter in a pan and add olive oil. Pour in your broccoli mixture and cook on medium to high heat for about 10 minutes, stirring frequently.
6. Sprinkle with parmesan cheese for the last two minutes or so and stir so that the broccoli is evenly coated. Turn up the heat at the end to brown the tips and bring out the flavors of the butter, garlic and cheese.
7. Serve as a side dish and enjoy!
This is a delicious dish that even picky eaters who normally do not like broccoli will enjoy!
This week I am exploring feeding issues found with children diagnosed with cerebral palsy. The information surrounding this topic is very vast and extensive. My goal for this post is to provide useful information and resources for both therapists and parents.
Let's begin with WHO is capable of addressing feeding issues with young children. Although speech language pathologists are sometimes the main therapist addressing feeding, there are other professionals who can add expert advice and assistance. As stated in The Cerebral Palsy Handbook, by Marion Stanton, "To get advice on this one aspect of a child's life you may have to go to as many as five different professionals. The physiotherapist will concentrate on the best positioning of your child. The dietician can advise on the best kinds of food to give her. The speech and language therapist can advise on the best ways to achieve a good chewing pattern and mouth closure. The occupational therapist can advise appropriate feeding equipment and seating. Finally, you may need to discuss any digestive problems with the (nutritional) consultant".
With several of the children I have treated who had been diagnosed with CP, I worked closely with both an OT through Early Intervention services and a dietitian through the child's private insurance. We collaborated about what the children needed, such as the recommended amount of calories, the textures they should be ingesting and how to strengthen their bite, chew and swallow, etc. Having this interdisciplinary collaborative approach is truly ideal, although with budget cuts and a lack of resources and professional availability, it may not always be possible. However, it is important information to know and to ask about when in team meetings and in a doctor's office planning out your child's therapeutic plan.
In addition, when you are developing the plan it is essential for parents and professionals to know how children with Cerebral Palsy benefit from nutrition and dietary therapy as well as possible areas of concern. The MY CHILD website reminds us that because "the majority of individuals with cerebral palsy report feeding or digestive difficulties, a dietary counseling program can be highly beneficial...Depending on the severity level of the individual's cerebral palsy, his or her digestive challenges and the ability to properly chew, swallow, and self-feed, effective dietary therapy can be devised to meet the individual's unique needs. Some of the more common dietary concerns for those with cerebral palsy include:
Ways to prepare food- dietary practitioners can adjust textures and consistency of food by pureeing, chopping and grinding foods for a more palatable experience. Foods can be softened by adding broth, gravy, milk, or juices to accommodate constipation issues. Liquids can be thickened for ease in swallowing.
Ways to feed- optimally, practitioners look for ways a person can self-feed, a skill that greatly enhances quality of life. This may include training an individual to use adaptive equipment. However, when caregivers are needed to assist in feeding, practitioners can teach effective ways of doing so. This can involve appropriate space between servings to allow for natural swallow, or feeding smaller portions more often throughout the day. In some cases, individuals with cerebral palsy must rely on a feeding tube for partial or total nutrition intake.
When to feed- adjusting timing of meal times may involve smaller, more frequent meals throughout the day. Sufficient time is required between bites or drinks to allow for natural swallowing. Sometimes meals are scheduled around medication needs to avoid stomach upset, curve appetites, and address drowsiness.
What to feed- if an individual with cerebral palsy has trouble with asphyxiation, reflux, or pneumonia, it is important to avoid foods that are more likely to exasperate these conditions, like nuts, seeds, and hard or stringy foods. Diets can be adjusted to provide more energy, balance metabolism, compensate for deficiencies, and enhance digestion. Vitamin, mineral and food supplements may assist those with malabsorption or who tire when eating. High fiber diets curb constipation. Prune and apricot juices may provide natural laxative qualities. Some foods enhance absorption of vitamins and calcium.
Providing proper mouth care- drooling, aspiration, and long-term anti-seizure medication use can contribute to an increased risk of dental decay, cavities, gum disease, and bacterial infections. Dietary practitioners can substitute sugars and carbonation with fresh fruits and vegetables. They also consult dental specialists to encourage proper dental hygiene, which may include regularly brushing, drinking fluorinated water, and scheduling dental check-ups.
*I hope that today's post has given parents and professionals some points to think about,
as well as some resources to consider when preparing a child's therapeutic feeding plan.
For me, the yummiest part of any muffin whether made at home or fresh from your local bakery is usually the top of the muffin. The upper half of any good muffin is often sprinkled with some extra flavor, adorned with toppings such as crystalized or powdered sugar, cinnamon, mini-chocolate chips. Really the possibilities are endless and each option adds that extra pop of flavor to every bite! So, when I found a muffin-top pan (yes they do exist) and muffin-top baking cups that fit the pan perfectly in one of our neighborhood stores, it was a must-have purchase! Now, both my older daughter and my husband agree, the muffin-top muffins are their favorite way to enjoy my homemade muffins.
Here is a slightly sweet, but healthy recipe to try at home with your little ones. An easy texture for picky eaters to enjoy! These muffins are delicious as muffin tops OR as traditional muffins. Either way, your little ones will love them.
Easy Brown Sugar Muffins
For the topping, you will need:
1/4 cup instant oatmeal
1/4 cup packed brown sugar
1/2 tablespoon ground cinnamon
1 tablespoon melted butter
For the muffins, you will need:
1 1/2 cups instant oatmeal
1 1/4 cups all-purpose flour
1 teaspoon baking powder
3/4 teaspoon baking soda
1/2 teaspoon cinnamon
1/2 cup packed brown sugar
1 egg white
1 cup applesauce
1/2 cup milk
(add mini chocolate chips or raisins if you want some added flavor or texture)
1. Preheat oven to 400 degrees. Grease muffin pan or line cups with paper muffin liners.
2. To make the muffins: Mix together the oatmeal, the flour, baking powder, baking soda, and cinnamon and set aside.
3. In a separate bowl, mix together brown sugar, egg white, applesauce and milk until smooth. Slowly add flour mixture. Pour the batter into the muffin cups.
4. To make the topping: Slowly melt butter over low heat on the stove in a small pan. Stir in the oatmeal, brown sugar and cinnamon. Mix ingredients together and sprinkle over the muffins.
5. Bake for about 20 minutes, until the edges are golden and the topping is slightly crispy. Let cool and enjoy!
*Here is a picture of a muffin top pan with a muffin top cup in place. From the picture you can see how shallow the cups are; therefore creating a shorter muffin and the muffin top effect. Muffin top cups are made more stiff and sturdy, as well as wider and more flat than traditional muffin cups to help them keep their shape.
As I began my search for helpful information regarding cerebral palsy and how it affects feeding and oral motor function, much of what I found included various cases that have been conducted on this very topic. Oral motor therapy has become quite controversial in our field of speech therapy over the past 10-15 years; therefore some of the literature that I found seemed somewhat confusing and maybe even contradictory.
One fact I think any speech therapist who has worked with a child with CP can attest to is that in most cases, feeding and oral motor function is affected by this condition. How we treat these issues and ultimately help the children and families dealing with CP is where the debate begins. I thought a good place to start would be with providing readers with some statistical facts about the correlation between CP and feeding issues/oral motor dysfunction.
The following information was provided on the MY CHILD website which I found under their "Nutritional and Dietary Plan Counseling" link:
"The majority of individuals with cerebral palsy, 93%, will experience feeding difficulties. Since cerebral palsy results in impairment of muscle groups, facial muscles can be affected. The facial muscles are one of the strongest muscle groups in the body. Impairment hampers a child's ability to chew, suck, or swallow, thereby creating a high risk for undernourishment, failure to thrive, malnutrition, growth delay, and digestive difficulties. The following conditions are common in those with cerebral palsy:
- 86% experience oral-motor dysfunction
- 77% are diagnosed with gastroesophageal reflux
- 74% report chronic constipation
- 60% present with swallowing disorders
- 32% report abdominal pain
Other conditions include vomiting, chronic pulmonary aspiration, diarrhea, choking, drooling, flatulence, and pneumonia. The individual may take longer and experience discomfort when eating. He or she may also become sluggish from undernourishment, and dental problems may arise from excess drooling, longer meal times, or from stomach acids when aspiration occurs".
The site continues on to list over 45 resulting conditions ranging from abdominal pain, aspiration, bladder and bowel dysfunction, chewing, dental and choking concerns, delayed growth and development, failure to thrive and obesity, excessive drooling, and sucking and swallowing dysfunction as well as many others. Based upon this extensive list, it is clear that most individuals with cerebral palsy would have a need for some form of oral motor/feeding therapy when necessary.
Join me next week for a continued look at Oral Motor and Feeding Therapy for
Children diagnosed with Cerebral Palsy