When I first met Kyler, he had been entirely dependent on his feeding tube for nearly four years. As an infant, he didn’t eat very well and often times, he wouldn’t stay awake long enough to consume enough to grow. The feeding tube was supposed to be a temporary solution after an episode of dehydration, but it became Kyler’s sole means of nutrition after unsuccessful attempts to teach him how to eat. His parents worked diligently with a variety of therapists in an attempt to teach him how to eat. They tried exposing Kyler to small bites of food, intensifying flavors, and using vibrating brushes to stimulate his mouth. Extended family members helped too. Nothing worked.
Eventually, Kyler was enrolled in the Healthy Beginnings feeding program, which utilizes the principles of ABA. We began by assessing what kind of toys he liked, which foods and how much he would eat, as well as learning about the attempts that had been made to teach Kyler to eat prior to meeting us. We took a few steps backward. For instance, his therapist at school was working on Kyler feeding himself with a spoon. It was important to teach Kyler first to take, chew, and swallow the bite before providing the added demand of self-feeding. We also assessed which textures were appropriate for Kyler. He could chew regular food, but what we found was that he couldn’t chew it quickly or efficiently enough. And if Kyler was going to get off of his feeding tube, we had to lower the texture of his foods so that he could eat a greater volume in a shorter amount of time. While we worked on increasing the variety of foods that Kyler would eat, we also taught him how to drink from a cup so that he could receive his formula orally, rather than through the feeding tube. As a part of this process, we consulted with Kyler’s nutritionist for food and volume recommendations, as well as several occupational therapists that had worked with him previously.
Kyler’s parents received training from the Healthy Beginnings team as to how to feed him food and drinks at home. All four of his grandparents learned too! With time, practice, and persistence, Kyler gained weight and no longer needed his feeding tube anymore. Kyler has since graduated out of the Healthy Beginnings program and continues to be fed utilizing a specific mealtime protocol. However, this protocol has allowed for more foods to be added to his diet and will hopefully lead to him taking bites by himself.
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Written by Ben Sarcia, MA, BCBA, LBA
