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Showing posts with label general guidelines. Show all posts
Showing posts with label general guidelines. Show all posts

Wednesday, June 20, 2012

Feeding your child – Tips and Techniques for Parents - Video




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A video for a New Parent


By Sarah Rosenfeld- Johnson,
A Speech Language Pathologist with more than 35 years of experianxce,a  Feeding Specialist, an Educator, a founder of Innovative Therapists International/TalkTools http://www.talktools.com/
Watch a video and share your opinion in a "Post a Comment" section at the end of the page. Thank you – Urszula

Friday, April 27, 2012

Picky Eater and New Food




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If you have one I would  encourage you to get familiar with the abstract. 
Pleases let me know if you have found it useful by leaving your opinion in a "Post a Comment" section at the end of the page. Thank you - Urszula


We should provide a toddler with three well-balanced meals each day.

Why? Simply because he or she is growing, needs lots of energy to play and to explore the world. Good nutrition is important to his/her overall health. It can also prevent many medical problems, including becoming overweight, developing weak bones, and developing diabetes.

What if my child has only one or two full meals each day? If your toddler has had a good breakfast and lunch, then it is okay that he doesn't want to eat much at dinner. The only time that you should worry is if your child isn't gaining weight or isn't very active.


You shouldn't worry about a toddler that:

·         Doesn’t seem like he/she eats a lot. Remember that as long as he/she is gaining weight and is active and healthy, then he/she is likely getting enough calories.
·         Only eats a few kinds of food each day, such as peanut butter and jelly sandwiches or chicken nuggets and french fries.
·         Won’t try any new foods. You still should keep trying to introduce new foods offered it 10 or more times.
·         Doesn’t eat a balanced diet each day. Most kids don't. As long as his/her diet seems balanced over a week or two, he/she is likely getting enough variety. If he/she really isn't, talk to your Pediatrician about a vitamin supplement.
·         Doesn’t finish everything on his/her plate. The idea that children should sit at the table until they 'clean' their plate is out of fashion. Instead, children should be taught to recognize when they are full and then stop eating. If your toddler isn't finishing what you offer, learn to offer smaller portions.
·         Doesn’t eat what you prepare for him/her. Try to avoid making elaborate meals for your toddler or offering foods with a lot of spices or sauces. Instead, keep things simple. While you shouldn't have to prepare a separate meal for your toddler every day, don't be surprised if he/she doesn't want to eat 'adult' foods.
·         Is overweight. Okay. Instead of restricting calories provide a healthy diet and encourage regular physical activity. Be sure to watch your serving and portion sizes (offer toddler size portions) and don't offer too much milk, juice, or high calorie snacks.

Feeding youngsters can be challenging. They are often picky eaters, are hesitant to try new foods, and in general, don't seem to eat very much.

You can keep trying to introduce new foods by putting a very small amount (like 1/2-1 tablespoon) on his/her plate and don't force him/her to try or finish it. Many kids won't try a new food until they have been offered it 10 or more times.


The best nutrition advice to keep your child healthy 
includes encouraging him/her to:

·         Eat a variety of foods.
·         Balance the food you eat with physical activity.
·         Choose a diet with plenty of grain products, vegetables and fruits.
·         Choose a diet low in fat, saturated fat, and cholesterol.
·         Choose a diet moderate in sugars and salt.
·         Choose a diet that provides enough calcium and iron to meet their growing body's requirements.

The best way to promote good nutrition is starting from yourself by setting a good example for your child. Healthy eating habits and regular exercise should be a regular part of your family's life. It is much easier if everyone in the house follows these guidelines, than if your child has to do it alone.


Additional tips for caregivers:

  • Use lean meats and skim or low fat dairy products.
  • Use unsaturated vegetable oils and margarines.
  • Read the nutrition label on foods to check for the amount and type of fat it includes.
  • Limit foods that contain a large amount of saturated fats.
  • Limit foods high in sugar and avoid adding extra sugar to your foods.


To prevent child from being too full you must remember:

  • Do not let your child to drink more than 16-24 ounces of milk each day.
  • Do not let your child to drink more than 4-6 ounces of juice each day.
  • Do not let your child to fill up on sweets and snacks.
  • Do not force your child to eat when he/she is not hungry.
  • Do not give your child servings that are too big. The average toddler serving is about 1/4 of an adult serving size. Don't go by the serving size listed on nutrition labels, as these are mainly for older children and adults.


To prevent feeding problems we also need to remember:

  • Not to use food as a bribe or reward for desired behaviors.
  • Avoid punishing your child for not eating well.
  • Limit mealtime conversation to positive and pleasant topics.
  • Avoid discussing or commenting on your child's poor eating habits while at the table.
  • Limit snacks to two nutritious snacks each day.
  • Not to prepare more than one meal for your child. If the child doesn't want to eat what was prepared for the rest of the family, then he/she should not be forced to, but you should also not give him/her something else to eat. He/she will not starve after missing a single meal, and providing alternatives to the prepared meal will just cause more problems after.


Food Pyramid

There is not a toddler food pyramid. The Kids' Food Pyramid is for children aged 2-6 years, but you can still use it to guide what your younger toddler eats, including 6 servings of grains, 3 servings of vegetables, 2 servings of fruits, 2 servings from the milk/dairy group, 2 servings from the meat and protein group, and a limited amount of fats and sweets. Just remember that the serving sizes will be smaller for younger toddlers and are equal to about 1/4 an adult's serving size.
The Basics of a Toddler's Diet is about 1300 calories each day. Bigger kids will need a little more and smaller kids a little less. A good hint is - 40 calories each day for each inch of his /her height.
Although you shouldn't usually count calories, knowing how many calories your toddler needs can help when planning his/her diet and can also help reassure you that your child is getting enough to eat.
A common problem is observed in a kid who don't eat much, but drinks 4 cups of milk and 3 cups of juice each day. That can add up to 1350 calories, which is probably more than he/she needs for all day. It is not surprising then that this child wouldn't be hungry for other foods.

If the parent follows the American Academy of Pediatrics (AAP) recommendations as to how much milk and juice he/she drinks, that will take care of:
·         300-455 calories (about 19 calories per ounce) from whole cow's milk (or a similar amount from breastmilk if you are breastfeeding your toddler 2-3 times a day) if he/she is drinking 16-24 ounces a day. Remember to not give low fat milk until your child is 2-3 years old and don't overdo it on milk. If he/she gets up to 48 ounces of milk a day, then he/she is getting over 900 calories a day just from milk, which is almost 70% of the number of calories he/she needs all day.
·         60-90 calories (about 15 calories per ounce) from juice. Don't overdo it on juice either. If your child is drinking 2-3 10 ounce sippie cups of juice that is giving him 300-450 extra calories.
·         So you now have only another 550-950 calories to get in him/her, divided between three meals and two snacks. That is very little if you look bellow at the number of calories in foods kids usually eat.


Product
Calories
american cheese (one slice)
apple (1/2 small apple)
banana (1/2)
beef, ground ( ounces)
bologna (1 slice)
bread (1/2 - 1 slice)
breakfast cereal (1/4-1/2 cup)
chicken nuggets (3 - 6 pieces)
eggs (1/2 - 1 egg)
french fries (7 - 15 steak fries)
french fries (8 - 17 Funky Fries)
fruit cocktail, canned (1/4 ounce)
Grahm Crackers (1 - 2 sheets)
grape jelly (1 tablespoon)
hot dog (1/2 - 1 hotdog)
ice cream (1/2 cup)
Macaroni & Cheese (2 1/2 ounces)
mozzarella cheese (1 ounce)
pancakes (1)
peanut butter (1 tbspoon)
pizza, cheese (1/2 - 1 slice)
Pop Tart (1/2 - 1 pastry)
popsicle (1)
pudding (1/2 cup)
vegetables (1 tbsp per year of age)
yogurt (1/3 cup)
45 calories
40 calories
50 calories
85 calories
90 calories
20-40 calories
40-80 calories
105-210 calories
35-70 calories
60 - 120 calories
150-300 calories
50 calories
60-120 calories
50 calories
60-120 calories
135 calories
260 calories
80 calories
60 calories
95 calories
140-290 calories
1-200 calories
70 calories
110 calories
25 calories
50 calories


Sample Diet

Breakfast
·         1/2 cup (4 ounces) of cereal, + 1/4 cup of milk + 4 oz of orange juice = 230 calories.
·         Or a slice of bread with 1 tablespoon of peanut butter and jelly + 4 oz of orange juice = 250 calories.
Lunch
·         1/2 sandwich (one slice of bread - 40 calories) + 1 slice of luncheon meat, e.g. bologna (90 calories) and cheese (45 calories) = 175 calories.
·         Or a tuna fish sandwich (add 1/2 tablespoon of mayo to the tuna to get 50 extra calories).
·         Or a sliced and quartered hot dog + water, juice or milk.
Dinner
·         1-2 ounces of chicken (75-100 calories) or beef (120-165 calories) + 2-3 tablespoons of vegetables (50-75 calories) + some bread (40 calories) + 1/2 cup of milk (76 calories) = 361-456 calories.
Snacks
·         Your child will likely need a couple of small snacks mid-morning and in the early afternoon. These might include 1/2 cup of milk (76 calories) or juice (60 calories) + 2-3 tablespoons of fruit (50-75 calories), or a slice of cheese (45 calories). Alternatives might include some jelly, pudding, or yogurt.

            This sample diet will give your child well over 1000 calories. In reality, he/she may not eat 3 full meals each day though. Many toddlers just eat one good meal a day and it is usually still fine. If he/she eats a good breakfast (250 calories), a small lunch and dinner (100 calories each), has a couple of snacks (150 calories each), 16 ounces of milk (300 calories), and 6 ounces of juice (90 calories), then he/she is still getting almost 1200 calories.

            The Food Guide Pyramid was designed by the US Dept. of Agriculture to promote healthy nutrition in children age of 2 - 6 years. It is just a general guide. The focal emphasis is on the five major food groups, all of which are required for good health. The second emphasizes is that fat, oily and sweet food should be used with a big caution.

            After the age of two or three years, you can begin to use 2%, low fat, or skim milk instead of whole milk. Your child's diet should resemble that of the rest of the families, with 3 meals and 2 nutritious snacks each day. You should limit milk and dairy products to about 16-24 oz each day and juice to about 4-6 oz each day and offer a variety of foods to encourage good eating habits later.

            Feeding practices - avoid giving large amounts of sweet desserts, soft drinks, fruit-flavored drinks, sugarcoated cereals, chips or candy, as they have little nutritional value. Also avoid giving foods that your child can choke on, such as raw carrots, peanuts, whole grapes, tough meats, popcorn, chewing gum or hard candy.

What counts as one serving?

To ensure good nutrition in your child and that they grow up healthy, they will need to eat a large variety of food. The amount of food is much less important. Remember that your child's appetite may decrease and become pickier over the next few years as his growth rate slows. As long as they are gaining weight and have a normal activity level, then you have little to worry about. You can still offer them a variety of foods, but can decrease the serving sizes if they don't eat a lot.


I. Grain group
6 servings a day, e.g.:
1 slice of bread,
1/2 cup of cooked rice or pasta,
1/2 cup of cooked cereal, and
1 ounce of ready to eat cereal

II. Vegetable group
3 servings a day, e.g.:
1/2 cup of chopped or raw vegetables, or
1 cup of raw leafy vegetables

III. Fruit group
2 servings a day, e.g.:
1 piece of fruit or melon wedge,
3/4 cup of 100% fruit juice,
1/2 cup of canned fruit, or
1/4 cup of dried fruit.

IV. Milk group
2 servings a day, e.g.:
1 cup of milk or yogurt or
2 ounces of cheese

V. Meat group
2 servings a day, e.g.
2 to 3 ounces of cooked lean meat, poultry or fish,
1/2 cup of cooked dry beans.
You can substitute
2 tablespoons of peanut butter or 1 egg for 1 ounce of meat.


Fats, Oils and Sweets

No more than 30% of your diet should come from fats. For a 1600 calorie diet, that would equal 53g of fat each day, with most preschool children requiring even less. The type of fat that you eat is also important. Saturated fats in foods such as meats, dairy products, coconut, palm and palm kernal oil, raise cholesterol more than unsaturated fats, which are found in olive, peanut, and canola oils, or polyunsaturated fats in safflower, sunflower, corn, soybean and cottonseed oils. Limit saturated fats to no more than 10% of daily calories.
Sugars supply is a large amount of calories, with little nutritional value. They include white sugar, brown sugar, corn syrup, honey and molasses and foods like candy, soft drinks, jams, and jellies.

References:

Monday, April 23, 2012

How to help a child to manage Auditory Processing Disorder




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There are many suggestions how to help a child to deal with 
Auditory Processing Disorder (APD), also known as 
Central Auditory Processing Disorder (CAPD).
Read an abstract and let me know if you found it useful by sharing your opinion in a "Post a Comment" section at the end of the page. Thank you - Urszula


Basically a caregiver or teacher should:
1.      Treat a child with APD as you would treat a child with a hearing loss.
2.      Help a child to avoid breakdowns in auditory processing by 
setting the environment to be friendly for him/her.
Suggestions for the parents and teachers how they can set the environment and help the child:
  • Seat a child away from visual, auditory, and motor distractions, such as fans, heaters, windows, doors, and pencil sharpeners.
  • Make sure light is on a speaker’s face, not child’s.
  • Allow a child to move to a quiet area when doing silent reading and independent work.
  • Wait for the room to become quiet before giving instructions or directions.
  • Enforce appropriate speaker-listener manners for all children when together – one person talks at a time; others listen quietly.
  • Gain child’s attention before giving new work or directions.
  • Speak clearly, with a moderate rate, and stand in one place, facing child.
  • Give child a longer time to respond, beyond what you might consider normal, when asking questions.
  • Simplify/explain new vocabulary; encourage child to ask questions for clarification.
  • Give concrete, interesting examples, demonstrations, and written or pictorial information when presenting new concepts orally.
  • Break complicated directions into fewer parts and give child time to complete the first step before going on to the next part.
  • Prior to a discussion, write down two or three main points for child to listen for; then check for memory and understanding of those points.
  • Use child’s strengths to convey information (e.g., if your child is a good reader, give reminders in writing; use closed captioning during TV or video programs.)
Go on
to see more books of interest to parents of children with
Central Auditory Processing Disorder (CAPD)

Instructions for a child to follow to avoid auditory processing breakdowns:
  • Keep your eyes on the speaker, and try to get eye contact.
  • Use good listening behavior - quiet body and closed mouth.
  • Ask to have directions repeated or clarified when you feel confused or unsure of what to do.
  • Repeat information quietly to yourself, after directions or information are presented orally.
  • Ask someone to explain what words mean, or use a dictionary or electronic thesaurus, when you aren’t sure.
  • Visualize – make a picture in your mind, to help you remember important points.
  • Wait until your parent or teacher finishes giving directions and answers questions before starting a task.
  • Write down your assignments at school to help you remember what you’re supposed to do when you get home.

A parent/care giver can also reach for other type of intervention, such as:

1.      Speech therapy provided by a therapist experienced in Auditory Processing Deficits.
2.      Environmental aids, such as Auditory Trainers or Assistive Listening Devices, either individual or group, which can be used at home or in classrooms.

3.      Phonemic Training and other reading methods.

Friday, April 6, 2012

Dysphagia and Swallowing Therapy and Treatment, Diet and Liquid Consistency




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First read an abstract and then let me know if you have found it useful by leaving your opinion in a "Post a Comment" section at the end of the page. 
Thank you - Urszula


I. Swallowing therapy/treatment
Conventional therapy for dysphagia typically employs
  1. Compensatory strategy techniques
·         diet changes
·         head positioning
·         modifying bolus size
  1. Specific techniques aimed at improving the coordination and strength of the swallowing muscles
·         thermal stimulation
·         biofeedback
·         mendelssohn maneuver
·         supraglottic swallow

VitalStim Therapy is the use of electrical stimulation for activation of muscles. Research shows that the combination of electrical stimulation and traditional treatment techniques is very effective at restoring swallowing function.


II. The standardized diet, consistencies and general guidelines
The American Dietetic Association (ADA), the United States' largest organization of food and nutrition professionals, in January 2012 officially changed its name to the Academy of Nutrition and Dietetics, developed guidelines for the National Dysphagia diet published in  “The National Dysphagia Diet: Standardization for Optimal Care”

The standardized diet consistencies and general guidelines are:
Level I - Dysphagia Pureed
A. Guidelines:
This diet consists of pureed, homogenous, and cohesive foods.
Food should be:
  • "Pudding-like"
  • No coarse textures, raw fruits or vegetables
  • No oatmeal or unprocessed wheat bran stirred into cereals
  • Any foods that require bolus formation, controlled manipulation, or mastication are excluded.
NOTE: Smooth chocolate candy (plain) is allowed if thin liquids allowed.
B. Purpose
This diet is designed for people who have moderate to severe dysphagia, with poor oral phase abilities and reduced ability to protect their airway. Close or complete supervision and alternate feeding methods may be required.

Level II - Dysphagia Mechanically Altered
A. Guidelines:
Consists of foods that are:
  • Moist, soft-textured, and easily formed into a bolus
  • Meats are ground or are minced no larger than onequarter-inch pieces; they are still moist, with some cohesion
  • All foods from NDD Level 1 are acceptable at this level.
  • Avoid rice, bacon, hard cooked eggs, potato chips/French fries, and fibrous cooked vegetables
B. Purpose
This diet is a transition from the pureed textures to more solid textures. Some chewing ability is required. The textures on this level are appropriate for individuals with mild to moderate oral and/or pharyngeal dysphagia. Patients should be assessed for tolerance to mixed textures. It is expected that some mixed textures are tolerated on this diet.

Level III - Dysphagia Advanced
A. Guidelines consist of:
  • Food of nearly regular textures with the exception of very had, sticky, or crunchy foods.
  • Avoid French bread, fresh apples, pears or grapes, and cooked corn.
  • Foods still need to be moist and should be in “bite-size” pieces at the oral phase of the swallow.
B. Purpose
This diet is a transition to a regular diet. Adequate dentition and mastication are required. The textures of this diet are appropriate for individuals with mild oral and/or pharyngeal phase dysphagia. Patients should be assessed for tolerance of mixed textures. It is expected that mixed textures are tolerated on this diet.


Liquid Consistency Controversy
Liquid consistencies:
  • thin     
  • nectar     
  • honey
  • spoon or pudding thick
With dysphagia patients we use:
  1. Pre-thickened liquids or food
  2. Instant food & beverage thickeners:
Please watch a video to learn more how to use a thickener.
http://www.dmes.com/p-13369-simplythick-how-to-mix-video.aspx


·         Thick-It manufactured by Milani
http://www.woodburyproducts.com/thickit_powder.htm?gclid=CNrY3_jeoK8CFUbe4Aod7lTamA  
·         Thick & Easy manufactured by Hormel
http://www.healthykin.com/p-358-hormel-thick-easy-instant-food-beverage-thickener.aspx

I also suggest to look into:

Thursday, April 5, 2012

Glosne czytanie dziecku.




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Bylabym bardzo wdzieczna za wszelkie opinie/refleksje i umieszczenie ich na koncu artykulu w "Post a Comment" sekcji. 
Serdecznie dziekuje. - Urszula

(…)Codzienne czytanie dziecku dla przyjemnosci jest czynnoscia prawdziwie magiczna zaspokaja bowiem wszystkie potrzeby emocjonalne dziecka, znakomicie wspiera jego rozwoj psychiczny, intelektualny i spoleczny, jest jedna z najskuteczniejszych strategii wychowawczych, a przy tym przynosi dziecku ogromna radosc i pozostawia cudowne wspomnienia. (…) Czynnosc ta jest łatwa, nie wymaga od nas, doroslych, szczegolnego przygotowania, jest przyjemna i inspirujaca takze dla czytajacego, nic nie kosztuje, gdy korzystamy z biblioteki czy wymieniamy ksiazki z innymi rodzicami (....). Powyzsze cytaty pochodza z ksiazki Ireny Kozminskiej i Elzbiety Olszewskiej "Wychowanie przez czytanie" wydanej przez Swiat Ksiazki.

Napisano tony publikacji i przeprowadzono mase badan naukowych na temat zalet glosnego czytania, wiec aby sie nie powtarzac odniose teorie do konkretnego przypadku jakim jest moja czteroletnia corka Basia.


Od kiedy siegne pamiecia zawsze czytalam jej na glos. Poczawszy od okresu prenatalnego, czyli ciazy. Wowczas to siegalam glownie do radosnej, bogatej w melodyke poezji. Od kiedy przyszla na swiat staralam sie siegac do ksiazek odpowiadajacych jej poziomowi rozwojowemu; ksiazek bogatych w bodzce wzrokowe, dotykowe, a czasami i zapachowe, kolorowe obrazki, na ktore mogla patrzec i znajdowac odniesienie do slow. Oczywiscie na tym etapie moja rola polegala na powtorzeniu slowa, upewnieniu sie, ze zwraca uwage i wskazaniu palcem na konkretny obiect.

Czytalam zamiennie, raz po polsku, innym razem po angielsku, odpowiednio do tematu, zainteresowania i oczywiscie dostepu do slowa pisanego. Ksiazka byla zawsze w zasiegu reki.

Czytanie stalo sie rutyna: przed snem, w metrze, w samochodzie, podczas krotkiej przerwy na spacerze, w ksiegarni, czy oczywiscie w bibloitece, podczas wyszukiwania nowch ciekawych ksiazek czy serii. Dlugosc czytania uzalezniona byla od uwagi jaka mogla poswiecic i czasu jakim dysponowalysmy, 5, 10, 20 minut, czy nawet godzine.


Dzis, kedy wyraza zainteresowanie szczegolnymi pozycjami, a ktore dostepne sa tylko po angielsku czytamy je w orginale. Znajduje w tym duzo zalet. Basia rownolegle uczy sie slownictwa angielskiego i polskiego. Czesto tlumacze angielskie slowa na jezyk polski dzieki czemu w kontekscie akcji jest jej o wiele latwiej wyobrazic sobie, skojarzyc i zapamietac slowo, ktorego na codzien nie uzylibysmy w domu. Przy okazji angielskich powiedzen podaje jej odpowiedniki polskie.


Podczas czytania dochodzi do naturalnej interakcji pomiedzy czytajacym a sluchaczem. Zadajemy pytania, tlumaczymy znaczenie slow, przewidujemy co sie wydarzy, fikcyjne sytuacje odnosimy do rzeczywistosci. Zauwazam silne powiazanie wieczornego czytania ze snami. Czesto kiedy Basia przebudzi sie w nocy zadaje pytanie dotyczace ksiazki, badz dzieli sie refleksja jaka zajmuje jej mysl.


Ksiazki sluza mi czesto jako material do szukania odpowiedzi na interesujace ja zagadnienia, badz jako odniesienie do przedstawienia niejednokrotnie trudnych do wytlumaczenia mechanizmow dzialania socjalnych zachowan. Dzieki scenom opisanym w ksiazce czesto jest jej latwiej zrozumiec i zaakceptowac pewne normy spoleczne. Zarazila kolezanki ostatnio czytanymi seriami “Rainbow magic” Daisy Meadows i “Ivy + Bean” Annie Barrows i Sophie Blackall. Teraz ich bohaterowie czesto uczestinicza w wolnych zabawach.


Dzis, czteroletnia Basia, jest bardzo otwarta, pewna siebie, spostrzegawcza i kreatywna. Z latwoscia wyraza swoje potrzeby, dzieli opiniami i uwagami. Rownolegle uzywa dwoch jezykow. Zmienia kodu nastepuje automatycznie i bardzo naturalnie. Polski jest naszym sekretnym jezykiem, ktorego uzywamy aby powiedzic rzeczy smieszne badz zadziwiajace, bez obawy, ze urazimy czyjes uczucia.