What is ILT?
If you are reading this, the chances are that you have a child who is struggling at school. Maybe he or she is finding it difficult to master skills such as reading, writing, maths or spelling. Maybe he or she can do all these things but comes home with reports about unfinished work, or work left at home.
The teacher complains about her being disorganised, untidy or even aggressive towards other children. Or maybe she is described as being unfocused and a daydreamer who never seems to listen. And maybe you agree with the teacher because you see the same behaviour at home.
Labels such as ADHD, Dyslexia, Auditory Processing Problems, Sensory Processing Disorder are mentioned. What’s going on?
Former Grade R teacher: Milnerton Pre-Primary School
I am so glad that we were introduced to ILT! Lisa is an ILT practitioner at our school and all the learners that went to her improved drastically in all areas of development. The learners whose parents were hesitant to follow an ILT program and preferred sending their children to either Physio or Occupational Therapy (because they knew more about it) did not even show half as much improvement. It is AMAZING! One of my boys was clumsy, had a speech problem, could not concentrate for more than a second, etc…and after only two months of following his ILT program with Lisa his speech improved DRASTICALLY, he is able to concentrate, he can do fine motor activities, he is not clumsy anymore…if I did not know that he was following the ILT program, I would have thought it was a miracle. 🙂
“WE’VE TRIED EVERYTHING – NOTHINGS HELPS, NOTHING MAKES THINGS BETTER”
“I JUST DON’T KNOW HOW MANY MORE MEALTIMES LIKE THIS WE CAN TAKE…”
These are real quotes from parents who felt like they had come to the end of the line in terms of finding solutions to their child’s picky eating. The internet can be a fantastic source of support for parents, but there are so many articles out there, often offering conflicting advice. It can be really hard to know what to trust, and sometimes, too much information can just feel plain overwhelming.
Recently I came across Jo Cormack who specialises in childhood eating challenges. She gave me permission to reproduce this article. I would earnestly suggest that you visit her website and take advantage of the help she and her team offer. Details are at the end of this post.
You’ve had your child’s weight and growth checked and it’s all fine. You’ve ruled out physiological causes of their eating issues, like allergies or physical problems with chewing or swallowing. Everyone tells you that they will grow out of it; that it’s only a phase! – Just put the food in front of them and wait for them to eat it, because “they won’t starve”.
But for some children who are extremely wary of unfamiliar foods – the ones who cling to their safe foods like a life raft in a stormy sea, and who really, truly need to know that the food they are offered is firmly within their comfort zone; these children need a bit more help. I call these children cautious eaters.
No amount of gentle (or forceful) persuasion, bribery, creative presentation or talk about the nutritional benefits of food will convince a genuinely cautious eater to eat something that they don’t feel comfortable with. In fact, research shows that trying to encourage children to eat can actually make their picky eating even worse.
Serving cautious eaters foods that they don’t feel okay with in the hope that they will eventually get hungry enough to relent and eat something, can end in several terrifying days where children simply don’t eat. This is deeply distressing both for them and for you. Not to mention dangerous.
It is so tough on parents when they don’t know what their next move should be. We can deal with pretty much anything if we feel that we know what we need to do, and we have the support required to do it. There is nothing worse than that feeling that you know your child needs your help, but you’ve simply run out of ideas.
I understand this anxiety and desperation: The urge to feed and nourish our children is one of the strongest instincts a parent has, and to be honest, most of the parents who reach out to me are already at a very low point with their child’s eating… sometimes things have to get to rock bottom in order to ignite a change.
Help is at hand
I want to share an incredibly valuable strategy that I use in my clinical work when I feel that a child’s picky eating is caused by a genuine fear of unfamiliar and disliked foods. It is all about laying the foundations for helping a child enjoy a varied diet, by teaching them to tolerate unfamiliarity.
Before I get into what this strategy looks like, I want to explain a little bit about how anxiety can be be at the heart of a child’s eating issues, because seeing your child’s eating through this lens can be a complete game-changer.
CHILDREN CAN BECOME ANXIOUS ABOUT FOOD FOR MANY REASONS:
- Perhaps they have sensory processing issues and their experience of eating certain food is so overwhelming to them that it is actually frightening
- Perhaps they have a naturally cautious and anxious temperament; for them, an unfamiliar food (just like an unfamiliar situation or person) can be really challenging
- Perhaps they have got into the habit of using their eating behaviours as a way of feeling in control. The idea of not being in control of their eating may be very scary as it takes a coping mechanism away from them
- Perhaps they are not used to being offered foods that they don’t know and like. If parents consistently stop offering foods at the first signs of rejection, children quickly learn to fear the unfamiliar
This is not an exhaustive list of the reasons why a child may be anxious about disliked and unfamiliar foods. But it has a common theme:cautious eaters feel safe when their food is familiar and unsafe when it is not. If they are expected to eat foods which are not on their safe list, this is extremely anxiety-provoking.
Laying the foundations for change: a 3 step approach to helping your cautious eater
1) Empathy.Before you can truly be there for your cautious eater, you need to try to understand how it feels to be in their little shoes.
It can be a bit of a shift of mindset to understand that your child’s response to food is not ‘bad behaviour’ – that it doesn’t necessarily fall into the categories of boundary testing or (developmentally normal) struggles for autonomy that run-of-the-mill picky eating can often be understood as.
Your child isn’t trying to get attention, they are simply really, really scared of foods which are not on their safe list. Especially for children with an unusually high degree of sensory sensitivity, the experience of eating foods that are challenging in terms of taste, texture, appearance or smell, is just so intense.
Many young children can’t verbalise these fears. They may act out, and express their feelings through aggression or alternatively they may withdraw. The first thing you need to do in order to help them is acknowledge that their anxiety is very real indeed and is not a choice. Research is increasingly linking anxiety in children to eating struggles. However hard it may be to imagine being scared of the wrong brand of crackers – appreciating that your child’s reactions may be anxiety-driven can be very powerful.
2) Make sure that you have a good understanding of your role in relation to feeding your child. You may well already be familiar with Ellyn Satter’s Division of Responsibility (DoR) model. If not, you can learn about it on theEllyn Satter Institute website where you will also find a very useful downloadable pdf about DoR. There are also lots of great articles written by feeding professionals about how DoR can help your family, like this article from Natalia Stasenko or this oneby Sarah Remmer, which includes a fab kitchen printable. If you are more of a book worm than a blog reader, this short, accessible bookby Katja Leccisi, provides a great overview of how to understand your feeding role.
3) Teach your child to expect variation.This is the killer strategy that will make all the difference. You are seeing things from your child’s perspective, you have educated yourself about your role in relation to feeding your child. But you are stuck, because your child will only accept a limited list of foods.
You need to begin to teach your child to accept and expect the unfamiliar, in the context of their safe foods.
Much of my work with picky eaters draws heavily on cognitive behavioural therapeutic theory. Cognitive behavioural therapy (CBT) teaches us that if we avoid something we are scared of, that fear becomes stronger. If we confront our fear and manage to do something that is outside of our comfort zone, the fact that nothing catastrophic happened – it didn’t give rise to a traumatic experience – tells our brain to produce a slightly smaller anxiety response next time that situation comes up.
A key aspect of successful exposure therapy is about making sure that you set people up to succeed and not fail. This makes sense if you thing about it; if you try something scary and find that the outcome is very upsetting because the goal was just not realistically achievable, you reinforce your urge to avoid that situation and your fear increases.
Setting your child up to succeed
You need to introduce variety in a way that will be manageable for your child and which they will not experience as intimidating. You do this by drawing up a list of their safe foods and devising teeny weeny baby changes to the foods on the list. These changes are not meant to be hidden from your child; we’re not talking about sneaky changes that they may not notice as this erodes trust and will defeat the object.
The kind of baby steps I’m thinking of, are ones that your child will both notice and cope with. For example, if your they like plain pasta, take a pasta shape that you know they usually accept and cut it in two (when it’s cooked… cutting dry pasta is no mean feat).
Combination and deconstruction
I use the twin concepts of ‘combination’ and ‘deconstruction’ as a jumping-off point for devising tiny changes to your child’s safe foods. Combination is all about pairing two safe foods in a way that is new for your child, and deconstruction is literally about taking food apart and re-presenting it in a slightly altered form.
For this strategy to work, you need to understand that you have a lot of work to do before your child is even ready to try new or disliked foods, BUT that there is plenty of room for manoeuvre within the context of their safe foods. Some children will naturally be confident eaters, but cautious eaters need to learnfood-confidence. And they need to learn it from within their comfort zone.
How this strategy works in practice
At meals, introduce a tiny change to one of your child’s safe foods. Don’t draw attention to it, just make it available to your child. Don’t praise them for eating it; this may increase pressure and fuel anxiety. Just remain focused on keeping your meals relaxed and upbeat. Perhaps initially try introducing change to their best meal of the day. For example, many picky eaters do best at breakfast – perhaps your child has toast. Cut it into fingers rather than squares. If they like raspberry jam, try sieving it before you put it on their toast so that the texture is very slightly different.
Laying the foundations for change (by helping your picky eater get used to unfamiliarity via constant tiny changes to their safe foods) will set the scene for the longer term task of introducing variety into their diet. It can take weeks – months even – for children to begin to feel comfortable with unfamiliarity. Introduce it at their pace, tune in to them and their responses.
You need to be patient, you need to be persistent and you need to be creative. Above all, you need to be in it for the long haul. But every time your child eats one of their safe foods in a new and different form, you are inching incrementally closer to giving them a positive relationship with food that will last a lifetime.
Jo does add a caveat to this advice. She says that the approach is very effective but only once your family’s mealtime dynamics are right (meaning that meals are family occasions where the conversations includes all members) and when optimum feeding practices are in place. If not, these ground rules need to be attended to first.
For parents wanting to know more about how to parent in relation to picky eating, Jo hasVisit a new membership site which you could link to: https://jocormack.lpages.co/your-feeding-team-sign-up-now/. She has a formidable, experienced team ready to help you.
Visit her website at www.jocormack.comto learn more.
Some people use the terms ‘food allergy’ and ‘food intolerance’ as synonyms but this is incorrect. Some of the signs of food intolerance and allergy are similar but the difference between the two are very important. Eating a food to which you are intolerant can leave you feeling miserable. A true food allergy, however, could be life-threatening. Either way, a child whose body reacts negatively to something in her diet will find it more difficult to focus on schoolwork and do her best. It’s worth considering whether or not she has a food intolerance.
Let’s first consider the differences between the two conditions. If you’re allergic to a food, your immune system will consider the food as an enemy invader and defend the body with antibodies. These antibodies produce symptoms that can cover a range of conditions like hives, eczema, indigestion, nausea, diarrhea, excessive winds and vomiting. More severe symptoms are termed anaphylactic and may include difficulty breathing, dizziness or loss of consciousness. Without immediate treatment – an injection of adrenalin – anaphylactic can be fatal.
A food intolerance, on the other hand, doesn’t involve the immune system. It takes place in the digestive system and is usually due to an inability to properly break down a particular food. This could be due to enzyme deficiencies, sensitivity to food additives (colourants and flavourants) or reactions to naturally occurring chemicals in foods. The symptoms are sometimes vague and can include a combination of gastrointestinal problems such as bloating and wind, diarrhea, nausea and indigestion and aggravation of eczema and asthma. These symptoms often take long to emerge, often several hours or days so it is difficult to pinpoint what foods may be causing the symptoms. The symptoms too may take a couple of days to go away.
Almost any food can cause an intolerance but there are some types that occur more than others. Common culprits are dairy, gluten and foods that can lead to gas buildup, such as cabbage and beans. A specific type of intolerance can develop to the protein in wheat and other grains called gluten. This condition is called Coeliac disease.
The tricky thing about intolerances is that they are dose-dependent. This means that a certain amount of the offending substance has to be consumed before symptoms appear. Small quantities of the food may be handled by the body, unlike people with allergies, who must stay away from even the tiniest trace of the trigger food. Everyone is different, so the amount tolerated will vary from person to person.
If you suspect that your child has a food intolerance, you can try an elimination diet to decipher what food is causing problems. Keeping a food diary is useful because you need to be able to look back to see what might have been eaten a few days before.
What you need to remember is that while a food allergy will probably make itself conspicuous with the more severe symptoms, many food intolerances go unnoticed and ignored. Try to remember that these can negatively affect learning and behaviour – and if your child shows puzzling challenges, keep in mind that food might be the reason. Next week, we’ll list some behaviours that may indicate an intolerance to one or more foods.
Food allergies, sensitivities or intolerances can play havoc with a child’s ability to benefit from teaching. Before we go into this, let’s clarify what causes food (and environmental) allergies and sensitivities.
Genetics seems to be an important factor in the risk of developing allergies. It seems that children with (true) ADHD who have food allergies are also likely to have parents with similar problems.
Nutritional factors are also significant for the development and severity of all forms of allergy. When a child has less than adequate nutrition, his immune system cannot function as it should and is more likely to misfire when faced with various stressful elements in the digestive system. For example, children with deficiencies of omega-3 are more likely to suffer allergies; deficiencies in magnesium and zinc are also know to promote allergic responses. The overall quality of the diet may also play an important role. Too much processed, stale, chemically altered or nutritionally depleted foods may well promote an allergy.
Another factor is toxicological stress. Children who are regularly exposed to pesticides that are toxic to the immune system, heavy metals (lead, mercury, cadmium), plastic residues and solvents may be more prone to allergies.
Developmental markers may also play a role. Breastfeeding may significantly reduce the risk of later developing food allergies. Ideally, babies should be breast fed exclusively until at least six months of age – longer if possible. The reason for this is that a young infant’s gut is naturally leaky and for a good reason. Large molecules, for example the antibodies in the mother’s milk, can cross through the gaps to enter the baby’s bloodstream to protect her from infection while her immune system is still immature. This is a vulnerable time and if other molecules enter the blood, the developing immune system may see them as threatening and becomes non-tolerant of them. This is exactly why mothers are encouraged to not only breastfeed but to carefully and slowly introduce solid foods one food at a time, starting with foods least likely to generate an allergic response. This ‘educates’ the baby’s immune system and helps the body develop a tolerance towards each food as it is introduced.
Intestinal parasites are worth a mention as well as they may also cause upsets in the digestive system and underlie the emergence of allergies. For this reason, regular treatment is advised for the whole family and not just for the fur children!
Non-food allergies such as hay fever can raise the severity of food allergies. If these types of allergies are particularly active in some months of the year, such as Spring, pre-existing food allergies may become more predominate at the same time.
When the immune system is not involved in a child’s reaction to foods, we refer to them as having a food intolerance. Knowing the difference is important because it will impact on the success of treatment. The most frequent reason behind food intolerance is inadequate digestion of particular nutrients. Lactose, or milk sugar, is probably the most common example of an intolerance due to digestive difficulties.
Take a long, serious look at your child. Sometimes allergies and food intolerances show up in his or her physical appearance. Some children can show a characteristic ‘spaced out’ or even an almost ‘demonic’ look when they suddenly become impossible. These looks can sometimes be accompanied by sounds such as throat clearing or clucking. This last noise is typical of a dairy or milk sensitivity. Some slur their words or begin to speak very rapidly. A few children whine or repeat the same phrase over and over. In addition, they may develop a hoarse voice or red ears or cheeks after exposure to a certain food or chemical.
Other signs include dark rings under the eyes, which can be grey, black, blue and even reddish. Nose rubbing, skin-scratching, wriggly lets, small horizontal wrinkles under the eyes and facial twitches and tics are very common in some children.
Abnormally rosy cheeks are particularly characteristic of allergic children between the ages of two and four years (and of adult women who have multiple food or chemical allergies).
Some children show hives, which look like mosquito bites or more generalized rashes.
And lastly, a bloated or abnormally large abdomen may also be a sign of problems – not always of a food allergy or intolerance but possibly of a yeast infection or parasites in the gut.
Next week we’ll continue this theme and describe the behaviours that so often accompany food intolerances – and are mistakenly thought to be ADHD, oppositional or even defiant behaviour caused by mental disorders.
In last week’s post, I wrote that a baby’s brain is very undeveloped at birth, owing to the relatively small size of a newborn’s head. In fact, the newly born child has all the brain cells (neurons) he will ever need but they aren’t able to communicate with each other very efficiently.
One of the most important developmental stages in these early days is for the infant to do what is necessary for these neurons to connect to each other. Eventually, he’ll end up with neural networks that are needed for learning and living. These networks provide us with the ability to learn language, interpret sound and vision, control emotions, think and remember. The quality of the brain cells themselves and the way they connect to each other will determine whether that individual grows up with an average or a really smart brain.
Some of this will depend on the child’s genes but a great deal will depend on the environment you provide and in which the child will develop. It’s not true that clever parents will automatically have clever children. Academic success and intelligence are hugely reliant on a growing environment that is characterized by lots of love, little stress, mental stimulation and a good diet.
Mental stimulation is not provided by mindless facts. Many children can learn to count, recite the alphabet, give correct answers to learned questions and so on, but these don’t indicate a good brain. Essentially, as Dr David Perlmutter points out in his book (see reference below), the goal of parent’s interactions with their young children should not be whatthe children learn but howthey learn it. Stay away from activities that dull their brains, deaden their senses and put them at risk for later learning difficulties.
It’s better for a developing brain to learn what letters and numbers represent rather than being able to spell or count. In order for this to happen, they need to learn their shapes and understand that letters and numbers are symbols that carry meaning according to their shapes.
It’s also important that the connections being made by the neurons are firmly cemented in place. For this to happen, children need repetition of incoming mental stimulation. Most seek this out automatically by insisting that parents reinforce learning. Most of us know how a child will demand the same story over and over again, or be happy to watch the same film again and again. This is a good example of how children learn and how they strengthen the connections in their neural networks.
Here’s one example of a brain-building activity given by Dr Perlmutter that will help the child to learn the meaning of numbers:
For a child beginning at around age 12 months: Find a puzzle containing pieces shaped from numbers 1 to 10. Fitting the numbers into their correct places allows the child to experience the ‘feel’ qualities of numbers, which helps to ingrain the picture of the number into their brains. You can enhance her experience by showing her what a particular number represents. For example, when she puts the number 2 into the correct place on the puzzle board, hand her two small balls and say “Two.” Every time she puts back another puzzle piece, add balls to her collection until the puzzle is completed. This paves the way for early recognition of the symbolic nature of numbers. This is far more beneficial than simply teaching the child to memorise counting from one to ten.
Acknowledgement is given to Dr David Perlmutter who wrote the informative book Raise a smarter child by kindergarten: Build a better brain and increase IQ up to 30 points.Available from Amazon books.