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 f...

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...

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 dec...

(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. W...

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...

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 tr...

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 a...

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 an...

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!

Part 3 discusses advancing your Food Chaining program to more solid foods for the child who has no core diet. The 6 steps and principles of the Pre and Food Chaining programs are explained in detail.

This is a short episode and it is part 2 of our last episode about a three year old with only one food, applesauce pouches. This one is a discussion of how to start sessions and your home program and I discuss what foods to try.

This episode is about how to assess and treat a three year old child with only one food in the diet: applesauce pouches. How would a PreChaining/Food Chaining driven pediatric feeding team evaluate and treat this child and literally teach the child how to eat? Want to know what you should do in sessions? Find out! This podcast actually tells you what to DO.

This season will be all about cases. The Specifics on what to DO during a feeding evaluation and setting up child specific treatment plans. Diagnostic therapy helps a child be known. Then you can design the right plan, set the right tone and develop eyes that SEE.

In this episode, I talk about the evaluation process, team care, building trust and developing eyes that SEE. I discuss what the parent needs to do at home and what the team should do. So how do you put the problem down to get things on track?

You want to try Food Chaining. But how do you get started? How do you set up a snack time in a therapy session? What do you do in the beginning? I have seen a lot of things online that are described as Food Chaining, but they are not using the program as we designed it. What fruits and vegetables can I try? How do I coach a child to learn the skill of trying a new food? This IS Food Chaining! The...

Your evaluation forms matter! You will need a very detailed medical and nutritional history and the Individualized Eating Profile. The IEP consists of data from the growth chart, analysis of the three to five day food record, oral sensory motor age and patterns noted in the Food Chaining Intake Form. This information will help you fully know your patient and plan their customized and effective Cha...

What are you doing to learn about Y-O-U. Who are you? You are the product. You are the resource that people are turning to and you need to understand how you learn, teach, counsel, guide and work with families or on interact on a team with other personalities. Do you communicate well with physicians? Expand your vision. The True Colors Assessment will be discussed. Are you green, orange, blue or g...

This episode addresses the issue of Nipple Confusion. Is it real? Or is it a preference? Or an oral motor problem showing itself in two distinct methods of feeding? Baby can’t or won’t take a bottle and mom has to return to work? This episode gives you ideas of how to help. Baby has taken a bottle but is now refusing breast? What do you DO? These are very treatable disorders. How can you build two...

NEC is a horrible and poorly understood disease. “The Why’s “ behind it are hard for any medical professional to understand. We are still studying NEC and we need a lot more research. What is it? What happens? How can a therapist support a child and family? What does treatment look like? In NICU and at home? Learning about NEC made me a much better therapist and I have just scratched the surface o...

As Mary Massery would say, “if you cannot breathe, you cannot function” and she was right. Today’s episode explains the respiratory conditions of prematurity and how they impact the lungs and breathing. Breathing is a foundation skill and is the priority of our early treatment. I also talk about some of the early feeding issues associated with RDS, BPD and MAS.

How did Food Chaining start? What are the 6 steps of Food Chaining? How do you use the Food Chaining Intake form? Why are the rating scales so important? How do you start a diagnostic therapy program? I answer all of these questions. There are also many examples of Food Chains with many tips provided to get a child specific, customized Food Chaining therapy program going forward without stressing...

Conditions of prematurity have lasting effects. If you work in pediatrics, with any child, anywhere, you are treating some preemies. Prematurity continues. What is IVH, an Intraventricular hemorrhage? Why does it happen? Prognosis? I give you information to understand what that means and the impact on the developing baby. I also talk about team based PreChaining therapy for children with PVL and h...

What should you ask, how do you ask it, how do you interpret the information you receive, how do you communicate compassionately with the family, how do you give them bad news, what ARE the 911 issues, how do I recognize the red flags, when and how do you ask the doctor to address urgent feeding issues? Develop diagnostic therapy programs and gather information. Addressing medical and nutritional...

How can you as the CCC/SLP help the nursing mom, support the child and the family, work with the team and learn from the lactation consultant? Do you understand the benefits of feeding colostrum and breast milk and how that impacts development of the microbiome? What is the microbiome and why is it so important? How can you support the health of the microbiome? Do you understand the basics of brea...