Print Eating together is an act of love: Mealtimes and inclusion (part one) an article by Ena Heimdahl, MA The following is the beginning part of an article on the website of Dysphagia Café (Connecting the Dysphagia Clinician with a Global Community) - One of the magical moments of everyday life is eating together. This moment can turn into a nightmare for many children with PMLD (profound multiple learning disabilities) and their caregivers. Problematic mealtime behaviors are a common concern in children diagnosed with feeding and/or swallowing problems, collectively known as ‘dysphagia’. This article primarily focuses on concerns in neurologically impaired children (NI) with dysphagia. The challenges that dysphagia creates often make mealtime stressful and unpleasant. Many problems that children experience in the areas of feeding, growth, and food acceptance have been attributed to a combination of the medical or physical condition of the child, inappropriate food selection, and/or inappropriate dynamics during feeding (Satter, 1990). Inappropriate caregiver-child interactions have been found to precipitate problems that include attention for negative behaviors, responses to attempts at forced feeding, and reduction of feeding choices due to food selectivity preferences in children. Premature children describe their own swallowing difficulties with strong words, “Ena, do you understand? My throat stops here!” and I remember very well the little girl putting her hand on her throat (Heimdahl, E. et al., 2015). Feeding disorders are common in infants and toddlers, with approximately 25% to 40% of these children having trouble with feeding. The incidence of severe feeding problems has been reported to be even greater—as high as 80%—in children with severe to profound mental disabilities. Furthermore, the number of children affected by feeding disorders is growing because medical advances have reduced the mortality rate of children born prematurely, a group especially at risk for dysphagia. It is important to understand that eating is a very complex act. In most cases, no single factor accounts for a child’s feeding difficulties. Rather, several factors interact to produce them. Awareness of this complexity combined with interdisciplinary team management will produce the best outcomes for children and their families. There are many different types of feeding disorders, and they can take on various forms. We have grouped the difficulties into four categories that will be useful in better understanding and comprehension of these problems. The categories indicate possible intervention pathways utilizing adaptations, accommodations and compensations. We named the categories to try to give the child a voice. They are as follows… Continue reading here: http://dysphagiacafe.com/2016/03/30/eating-together-is-an-act-of-love-mealtimes-and-inclusion-part-one/