We introduce a new series on Activities of Daily Living, where Emma McKinney shares tips and looks at assistive devices
Some children with disabilities experience difficulty performing everyday activities, known as self-care or activities of daily living (ADLs). These include dressing, bathing, toileting, mobility, transfers, grooming and personal hygiene. The amount of assistance a child may need depends on many factors, including the child’s health status, medical diagnosis, range of motion, strength and functional abilities.
In this first part in the series, we take a look at self-feeding. Self-feeding allows a child to explore a variety of sensory experiences. Children should be given the opportunity to physically explore food by feeling and playing with different textures (lumpy, smooth, crumbly, dry, wet, gooey foods), smells (strong, sweet), sounds (crunch, slurp etc), and tastes. While playing with food may be messy, children learn new skills. They are far more likely to try new foods, be comfortable with different food textures, and strengthen and develop their fingers and hand coordination. Children should be encouraged to use their fingers to pick up and explore food (such as macaroni, cheese cubes, peas etc, which develop fine motor functioning). It doesn’t matter if they smear, drop or squish food, as this is a process that takes time and the focus is on sensory integration. Later, when they are comfortable and if they are able, they can begin to use a fork, spoon and knife. Again, let them play and explore; let them watch you or an older sibling feeding.
Self-feeding also helps strengthen their posture, back, arms and hands as they sit upright, and requires the coordination of using both hands to move the food and bring it to the mouth, which also involves hand-eye coordination.
Available modifications and assistive devices include:
- Larger cutlery
- Built-up handles to improve a child’s grasp on an object like a spoon or fork (you can use tape, foam, cardboard tubing, cloth etc)
- Bent and curved angled cutlery, which limits wrist-turning when a child brings food towards the mouth
- Utensil holders such as straps and Velcro that help to attach the utensil to the child’s wrist or hand
- Weighted utensils, which help with stability
- Adapted cups with anti-spill rims, easy grip handles, built-in straws etc
- Velcro or taped wrist bands to attach and secure cutlery to a child’s wrist
- Suction cups or non-slip material to stop a bowl or plate from moving,
- Bowls or plates with high rims
- Elevating the child’s bowl or plate by using a platform or books, so that the distance to the mouth is shorter
Encourage children to play games that will strengthen the parts of their body required for feeding, such as scooping and pouring water or sand, threading big beads, pinching, cutting and slicing play dough, or play-feeding dolls.
Dr Emma McKinney is a “children with disabilities” specialist, a post doctoral fellow at Stellenbosch University and owns a company called Disability Included. email: emma@disabilityincluded.co.za
