More Than Picky: Food Chaining with Cheri Fraker, CCC/SLP

Today I discuss my work with a seven year old child who was tube fed starting at age 4 months. He had years of therapy but did not make progress and even with tube feeds, weight gain was poor. I had to unravel his past, explore his prior diagnostics, win his trust and form a plan. In two years, we reached our goals with PreChaining and Food Chaining therapy, nutritional rehab and a comprehensive feeding team care plan. Want to know how we did it? Listen…

This one is all about how I do my therapy. I talk you through what you would see if you observed my sessions. I describe in detail how to triage feeding disorders, what to say and do as you start your treatment program, how to troubleshoot problems and avoid shut down. I describe what to say when as you start Chaining. I describe how to correctly design a Food Chain. Food education, surprise foods and anchor foods matter. Use the rating scales the right way. I also share with you all the how to’s I have developed in my 37 years as a therapist. Food Chaining techniques work when implemented correctly. Learn how to support and lead a child through sensory exploration in your therapy sessions. Learn how to comfort and encourage them in creative ways that allow them to open up and put fear and aversion down. I talk about how to easily bring new foods to them. I also talk family care and I discuss trauma and fear and the wounds parents carry when their child struggles to eat.

Overcoming picky or problem eating or treating ARFID requires you to taste new foods. That is a tall order. It can be frightening just thinking about it. So how do you learn about a new food and try a bite and feel safe? How do you find new foods that you will actually enjoy? Food Chaining creates chains, the links from the foods you like to eat to new foods that are very similar. We stack the deck in your favor by having you learn to feel good while trying new foods in a new, systematic and safe way. New foods are selected that are very similar in taste, texture and temperature to the foods you eat every day. These modified foods are highly likely to be accepted because they are foods that you are highly likely to like. That is what this is all about, finding new foods you like over and over and over. This two part in one podcast is a detailed guide that is full of advice for the patient, the family and the therapy team. Try Food Chaining, form a plan, and change your eating gently and well. It will change your life.

(Note: Please do not do this if you have food allergies or swallowing problems) Part two helps therapist’s set up an effective home program and additional instruction provided helps the patient try bites of new targeted foods at home. This self help program can supplement your therapy care plan for older kids, teens or adults with ARFID, extreme selective eating or years of picky/problem eating. What can you the patient also do to help yourself? How can you set up experiences at home to improve your sensory tolerance for new food? How can you feel good and safe when you learn about food with your senses? How can you put fear down? Improve your nutritional status? Can you see yourself successfully eating new food? I can! Find out how. Let’s see how far you can go in therapy and at home.

This podcast is for YOU. The patient. The individual dealing with ARFID or extreme food selectivity. Picky has become a huge problem. Fear has climbed to a level that isn’t healthy. Your nutritional status is a concern. Socially, it is hard to eat at a friend’s house or restaurant, and holidays make you feel sick. There are a lot of problems, that is why this is so hard to overcome. Let me make it easier for you. Let me teach you the ONE skill you lack. Once you master that one skill, you too can change your life with Food Chaining.

What do I DO in my therapy sessions? I find “the daily calm” and help the kids relax. I teach them how to learn about a food with their senses. I teach them how to crumb and achieve a test bite and then I teach them the varying motor plans when eating new foods. I teach them about the rating scales and developing advanced eating skills. We look at the few foods they may eat now and then, and we try to eat them more frequently, expanding the core. I help them learn to rate new food experiences in the real world. I respect those ratings. I respect their yes and no responses. We develop the skills in order to double the core diet over and over. It is fun, it is freeing and it works.

Let’s talk about Avoidant Restrictive Food Intake Disorder. There are several types of ARFID and Food Chaining can be a very effective tool for treating children, adolescents or any individual experiencing the challenges of ARFID. A customized Food Chaining program is a great way to change a life and open a child up to being able to enjoy new experiences with food.

The feeding team evaluation and the oh so important first treatment sessions of the plan are discussed. This is the case history of a two-year-old born at 24 weeks. This child is a preemie grad with failure to thrive and aspiration of liquids. How do you start? Who needs to see the child? What does the home program look like? What other referrals do you need? Expand your team PreChaining therapy approach to meet the needs of the child and family. This episode is full of multidisciplinary ideas to add to your treatment program and I share ideas about how to expand the treatment program over time. Thanks for listening and Happy Chaining!

New without No! This podcast teaches the listener how to structure mealtimes, prepare the parents for their part following the home program and how to set the right tone at the table. This episode is full of tips to help you learn how to successfully offer new foods using a Food Chaining program. Sample Food Chains are discussed. I also discuss mastering the simple, elegant art of Food Chaining and expanding the diet with joy.

This episode discusses how to complete your evaluation and set up successful transitions to spoon and cup and stop gagging from occurring. You can let the child treat their own problem! Self directed oral motor is always the best plan! Let’s talk about PreChaining!