Fussy eating is common in children, particularly between the ages of 18 months and five years. Fussy eating can vary from the child who has a few specific likes and dislikes to the one who will only eat a limited range of familiar foods and refuses to try anything new.

It is important to remember that a healthy child with not starve themselves. Most fussy eaters manage to get enough nutrients to remain strong and develop normally until they grow out of it. Healthy children eat when they are hungry, and usually not before.

Tips to encouraging healthy eating:

• Keep meal and snack times regular – Smaller meals and snacks are easier for children to manage than three big meals.
• Choose healthy snacks. Offer fruit, milk, yoghurt, sandwiches, cracker biscuits and cereals.
• Avoid letting children fill up on drinks which may dull their appetite. Water is the way to go!! Limit cordials and soft drinks.
• Providing a variety of food from within the 5 main food groups will provide children with all necessary nutrients. If they don’t like pumpkin, try carrots. If they don’t like milk, try yoghurt or cheese.

Strategies for managing food aversions or fussy eating:

• Introduce new foods in a fun way to build up taste and textural tolerance.
  • Disguise food- Try shaping foods into something your child loves
  • Prepare food together – make it fun!!
  • Trial and Error – It can take ten or more tastes of a new food before a child will learn to accept a new flavour, so don’t give up if something is refused after one taste.

• Try preparing foods with textures your child likes. If they don’t like chewing meat, try softer meats e.g mince, or meat substitutes i.e baked beans.
• Offer a choice between two foods – This gives your child a sense of self control
• Let your child choose some food at the supermarket
• Praise your child when they try a new food!

Strategies to avoid:

• Forcing your child eat a new food by using negative language or punishing your child will create negative associations with eating the food.
• Ignoring the fussy eating i.e making separate meals for your child.

Written by Carmel Walsh – Speech Pathologist for De Silva Kids Clinic

Learning Through Reinforcement: Operant Conditioning

What is Reinforcement?

• Reinforcement is the consequence or feedback given to a child following their behaviour or response.
• It is given following a correct or desirable response

Types of Reinforcement

• POSITIVE REINFORCEMENT: The addition of something pleasant. Examples: toys, food, social praise, sensory feedback
• NEGATIVE REINFORCEMENT: The removal of something unpleasant. Examples: finishing work, going on a break, turning off a loud sound
• Both Positive and Negative Reinforcement INCREASE the likelihood of a behaviour occurring again in the future and creates desire and motivation to learn

Punishment

• The removal of something pleasant (e.g., taking away a toy, turning off the TV, etc.) or the addition of something unpleasant (e.g., more work, clean up, etc.)
• Punishment is NOT reinforcement
• In theory, punishment is designed to DECREASE the likelihood of a behaviour occurring again in the future.
• NOTE: The effects of punishment are often short term

Reinforcement should be:

• Contingent on the child’s behaviour/response. Example: If a child says “ball” they should receive the ball as reinforcement, not something unrelated such as tickles or a high 5

• Immediately following a child’s behaviour/response. Do not allow a delay
• Consistent. All those working with the child should be reinforcing the child the same way, and for the same behaviours. Reinforcement needs to be extremely frequent when teaching a new skill
• Graded. Reinforcement should be dependent on the QUALITY of a child’s response. Higher reinforcement should be reserved for highly desirable responses/behaviour. Remember to reinforce attempts also to maintain the child’s motivation.

Reading is a great way to support your child’s language development. Reading will help improve both their receptive and expressive language skills. Studies have reported that reading to your child as early as eight months old can have significant impact on early language development.

Tips for reading with your child:

• It is ok to read the story again and again. Repetition will help your child learn language.
• Choose books with rhymes or songs. Clap along to the rhythm and help your child clap along.
• Talk about the objects and actions in the picture (e.g. “Look the boy is diving into the deep water!”)
• You can expand language (e.g. if your child says “tree”, you can respond by saying “yes that is a big, green tree”)
• Model language by commenting more and questioning less, so that it does not feel like a test.
• Relate the story’s events to the child’s interests, hobbies and daily activities (e.g. “That boy is riding a blue bike like yours”).
• Discuss the story with your child. (“Why do you think the monkey stole the key?”)
• Help your child become aware of letter sounds. (While pointing to a picture of a snake, ask: “What sound does a snake make?”) As your child develops, ask more complex questions. (While pointing to a picture of a ball, ask: “What sound does ‘ball’ start with?”)
• Play sound games with your child. List words that rhyme (“ball,” “tall”) or start with the same sound (“mummy,” “mix”).

Written by Senali Alahakone – Speech Pathologist at De Silva Kids Clinic

Sleep is such a common problem area highlighted by parents and families. There are many reasons why children may be having difficulties with their sleep cycles. Below are some areas that may impact sleep and wake cycles for your child.

Weighted Products

• Try a big teddy bear or some plush toys in bed, added some weight to the toys stuffing (sand or rice bags).
• A weighted blanket or body pillow in their own bed.
• Weight works for us, heavy doona or cushion to cuddle.
• Deep pressure input such as weighted blankets, tucking in sheets firmly, sleeping in a sleeping bag or hugging a body pillow can sometimes be helpful.
• Some might be comforted by the closed space between mum and dad. Try long pillows on both sides in their own bed. Sometimes it also helps if the pillows smell like the parents so getting the parents to sleep with the pillows one night then having the pillows in the child’s bed the next. Also such things as weighted blankets and tight tucking in can help.

Proprioceptive Input

• Lots of vestibular – hammock spinning, scooter board etc during the day for a few weeks might be worth a try.
• Proprioceptive work – pulling/rowing works to calm prior to sleep along with
  the ‘routine’ that the family are doing.

Break the Cycle

• Break their sleep cycle by waking them at 7 am and not letting them sleep until 10 or 11. It will be a few horrible days but it may break the cycle.

Sounds

• Does Dad snore?  Are they comforted by the rhythm or sound of Dad’s breathing or snoring?
• Try some white noise recordings eg. surf crashing, womb sounds or fan.

Social Stories and Rewards

• Try a bit of a reward system for them to provide some extra incentive to stay in their room. Providing them with a “what-to-do story” or social story outlining calming options they could do if they wake in the night might help. Calming options if they wake may include those that you, the family or your child have already identified; however, some ideas may include things like: listening to relaxing music, hugging a favourite toy or pillow firmly, rolling themselves firmly in their blanket etc.
• Social stories and sticker charts have also helped lots of children be motivated to stay in bed.

Light

• Play around with lighting to check if this is an environmental factor affecting sleep. If inside light is becoming distracting leave an outside light on and note the difference in sleep behaviours.
• Try a ‘Groclock’ – this is a light which changes from a blue night face to a bright sun face to give children a visual cue as to when it is the correct time to get out of bed. You can set the times and durations to your needs and your family schedule.

Written by Alannah Sofianos, Occupational Therapist for De Silva Kids Clinic.

Imagine that you are having a conversation with someone but you have not really processed or “heard” what they said? What would you do? Maybe you ask them to repeat themselves, which would help you to process the information. This can happen to all of use sometimes, BUT this is happening constantly for some children. Try to imagine paying attention and learning all day with this difficulty!!

Your child may have adequate hearing (where their ears are sending the sound to their brain) but poor auditory processing (their brain doesn’t match up the sounds properly). This is called Auditory Processing Disorder (APD or CAPD).

But, what is the difference between HEARING and AUDITORY PROCESSING? A common misconception is that APD is a hearing problem. Hearing is when the sounds collected by your ear is sent to the brain. Auditory processing is “what we do with what hear” – so when your brain notices and uses the sound.

Some of the signs of APD to look out for in a child are:

• Forgets what is said in a few minutes
• Easily distracted by background noise
• Does not listen carefully to instructions and often requires directions to be repeated
• Says “what”, “huh?” or “pardon” at least 5 times a day
• Learns better one-on-one

Some suggestions, in the areas of attention, seating, instructions and time, can help children with (C)APD be successful.

Attention

• Speak at eye level: speak at your child’s eye level, get close to your child, and face them to provide clear information
• Use cueing: cue your child to become aware of times when they are not paying attention. Use words, such as “listen”, “are you ready”, and “remember this one”

Seating

• Quiet study/work area: Provide your child with a quiet area for better learning environment.
• Avoid noisy sources: Seat your child away from distracting noise sources. For example, TV, loud music, kitchen appliances when they are trying to listen to the speaker. Seating your child away from windows and doorways will also reduce distraction.

Use daily routines: Use daily schedules to help your child stay focused and organised. Sample Bedtime Routine:

8:00PM – Bath time

8:20PM – 3-part routine: dry off, brush teeth and pee

8:30PM – get into PJs and clean up toys (set a night-time – not a play-time- scenario)

8:40PM – Story time
8:55PM – Bed time. Night time routine: talk about the day, compliment your child on things he did well, say your ritual goodnight “I love you. Goodnight. Don’t let the bedbugs bite.

Instructions

• Speak in clear voice: speak at a comfortable loud level, and rate (fast or slow) that your child can follow easily.
• Use natural gestures: use gestures to enhance the message. For example, pointing or holding up objects. Avoid making excessive and unnecessary movement while delivering messages as this may distract your child.
• Give written and verbal instructions: provide written and verbal instructions to help your child in following directions and completing tasks.

Time:

• Avoid fatigue: give your child short activities instead of one long activity. Provide breaks, such as doing 5 star jumps, so your child can move around if needed.
• Response time: give your child more time to come up with answers to verbal questions.

It is important to remember that children react to changes in their environment differently. Different strategies will work for different needs of each child. It is important that you know your child’s individual profile of strengths and weaknesses.

Most importantly, choose a few strategies and … practice, practice, practice!

Written by Didem Karademir, Speech Pathologist.