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Tuesday, October 23, 2012

31 for 21 Blog Challenge: DAY EIGHTEEN: Textures

Textures can be a problem for children with Down Syndrome.  Some kids with DS have a hypersensitivity to taste, temperature, and textures.

Most kids with Down Syndrome are born with low muscle tone.  Low muscle tone, along with differences in the physical structure of the mouth or tongue, plus other medical complications (such as heart defects, etc) can contribute to the delay of solid food introduction.  Additionally, research indicates that kids with DS take longer to progress through the stages of chewing development.

There is a great chart indicating motor/oral motor milestones for feeding development.  It can be found here:
http://www.fdhkids.com/developmental_milestones/feeding_development.html

Here is a simplified list of feeding developmental milestones:

Before birth, the baby:
Begins to develop the sucking and suckling reflexes around 36 weeks.


At birth to three months, the baby:
Demonstrates many reflexes to protect his/her airway.
Responds to stimulation in and around the mouth.
Turns his/her head toward the nipple when the caregiver strokes the cheeks.
This signals that the baby is ready to eat.
Consumes breast milk or formula using a nipple.
Coordinates his/her breath with two to three sucks of liquid before swallowing and
breathing.

At three to six months, the baby:
Brings both hands up to clasp the bottle but needs assistance holding it.
Consumes rice cereal or pureed fruit and pureed vegetable baby foods.
Eats from a small infant/toddler spoon during feeding.

At six to nine months, the baby:
Holds the bottle independently.
Cleans the spoon with his/her upper lip.Eats pureed meats and a variety of pureed baby foods.

At nine to twelve months, the baby:
Demonstrates lip closure while swallowing liquids and soft solids.
Begins to self-feed by using his/her fingers to grab small foods. The baby may
attempt to eat small, soft dissolvable solids (i.e., soft crackers and small cereals
like Cheerios).
Begins to experiment drinking liquids from a sippy cup.
Begins to consume mashed table foods.
Drinks out of a sippy cup and attempts to hold the handle independently.
Begins to drink through a straw.

At twelve to eighteen months, the toddler:
Coordinates sucking, swallowing, and breathing patterns for longer

sequences.
Begins to eat finely chopped table foods.
Bites through crunchy foods such as cookies and crackers.
Moves the food in his/her mouth from side to side as he/she chews.

At eighteen to twenty-four months, the toddler:
Feeds him/herself using a spoon but may still need assistance.


At twenty-four to thirty-six months, the toddler:
Consumes a variety of liquids and solids through straws and open mouth cups.
Uses a spoon to scoop soft foods while feeding him/herself.

Independently moves toward fine tuning all feeding skills.

At thirty-six months to five years, the child:
Progresses toward chewing and swallowing advanced textures (meats, fried foods, whole fruits, etc.) with close supervision by a caregiver.
Begins (with close supervision) to use a fork to stab food.Drinks from an open mouth cup with no assistance.


What I'm excited about is that Josiah currently falls in the 9-12 month milestone category.  They delay is more on me, than Josiah.  I haven't been as quick to introduce some things as I should have.  Having this list is nice.  I know what to work on next :)


"Perseverance is not a long raceshort races one after another."
- Walter Elliott

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