I rarely bring my speech/language pathology training into the blog, but I’m just so proud about what I’ve done for Mira in this last week (and how it’s impacted meal time) that I felt it was too exciting not to share. Here’s a little bit of the back story: As many do, our toddler is having a hard time with food. She used to eat pretty much anything and everything that we put in front of her (or at least would try it), and then about a month ago all that changed. We would get ‘no, no, no’ or ‘all done’ and the dish/bowl would be pushed off her tray onto our table (at least not the floor, amiright?). This is a super frustrating phase, and it’s especially frustrating when you love cooking. As you know from the blog and from my stories both Dave and I really enjoy cooking, and seeing Mira take a bite of something, make a gagging face, and say ‘all done’ can be soul crushing.
I decided that rather than lament and get frustrated with every meal I would try something that would give her autonomy within a structure of our choosing. I decided to make some ‘Individual Graphic Symbols.’ I always refer to these as ‘PECS,’ but I know that technically that’s not accurate as PECS is a specific communication system, and what I’m doing is much less structured. When you are using ‘Individual Graphic Symbols’ for an individual with a communication disorder you are using a low tech augmentative and alternative communication (AAC) system to help the person express themselves. They may not have the spoken word to communicate what they want, but they have the pictures (and sometimes that awareness comes first). For us we wanted to give Mira access to images of a variety of foods that she likes to eat, giving her the independence to choose what she wants. At the same time, we needed to keep these choices within a small set that we are willing to make and/or have on hand at a given time.
When I was working in early intervention many parents expressed concern that using an AAC system (e.g., baby sign, PECS, Individual symbols) would negatively impact their child’s use of speech and I am here to say that that is NOT the case. Research has shown us again and again that using these supplemental systems only helps facilitate language development.
Mira can say many of these words already and if she doesn’t know them on her own she will readily imitate; however, she is unable to recall most of these foods independently when sat down at a table and asked what she wants to eat (as I wouldn’t expect many 18 month olds to be able to do). So having these images helps her recall things she’s already seen and helps her associate the food with the word.
Here’s what you need to make a an individual graphic system: a mini binder (or large, depending on how far you want to go with your food choices), laminator (I have this one), laminating sheets, velcro fasteners, couple pieces of white paper, printer (I have this one), and a word processing system.
Assembly: First you will need to make a list of the items that you want pictures of (I find that this list is ever expanding). Then you will search for images of the items you’ve listed and copy and paste those images onto your word processing system. Once the image is on the word processing system resize it to be about 1.5-2.” Continue until you’ve filled the entire sheet, and then print. Cut each picture out and arrange them on your laminating sheet (making sure there is space between each picture so the laminate will completely seal around the image). Send the laminating sheet through the laminator and let it cool. Now it’s time to make the pages of the binder (where the images will be fastened to), cut an 8″ x 11″ paper in half and send them both through the laminator. Apply the velcro hook to the page and the loop to the images. Organize your images however you choose (I tried to separate meal type, snacks, and fruits/veggies).
The ultimate goal of giving her autonomy when it comes to food choices has definitely been accomplished. I can feel the tension releasing at meal time, we are worrying less that she will never eat vegetables and she is enjoying making her selection.
As with all things related to raising a child, this phase will pass and we will be onto some new challenge, but I hope that I can always find a middle ground between bringing what I’ve read, learned or heard to the table for Mira and accepting who she is as a human.
Be well.
The Art of Running in the Rain 