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Texture Fading with Four Year Old

Jennifer Dahms, M.S., CCC-SLP

April 16, 2012

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Question

I have a four‑year‑old who will only eat pureed foods.  There are no medical issues or oral issues.  He refuses to allow anything with texture to touch his mouth.  Ideas?

Answer

I would probably use the technique of texture fading.  For example, if you have a bowl of  stage two bananas and you want to get him to eat a regular banana by itself, you may have to go as small as taking one tiny piece of a banana and mixing that into 4-ounces of banana puree and have him eat it.  When that's tolerable, then use two pieces, and then three pieces.  It may need to be that scientific to get him to progress with the texture. It can take a really long time and needs to be methodically charted to know what level you are at with which food - how many bites you are putting in, the size of the pieces, etc. It has to be very structured for the family.  I have had good success with that, but you have to take it slowly.

Jennifer Dahms is a pediatric speech-language pathologist in Boise, Idaho. She received her bachelor's and master's degrees from the University of Wisconsin - Milwaukee. She has worked in pediatric outpatient clinics and Birth-to-Three programs in both Wisconsin and Idaho and currently has her own private practice, Valley Pediatric Feeding, LLC.


jennifer dahms

Jennifer Dahms, M.S., CCC-SLP

Jennifer Dahms is a pediatric speech therapist in Boise, Idaho.  She received her bachelor’s and master’s degrees from the University of Wisconsin – Milwaukee.  She has worked in pediatric outpatient clinics and Birth-to-Three programs in both Wisconsin and Idaho and currently has her own private practice, Valley Pediatric Feeding, LLC.  Jennifer has dedicated her continuing education and professional focus on pediatric dysphagia.  She has presented on pediatric feeding disorders at the Idaho Speech and Hearing Association’s annual convention as well as at the Inter Mountain Area Speech and Hearing Convention in 2008.  Jennifer also presented on pediatric feeding disorders in the schools at Idaho State University’s Winter Symposium in 2009.  She is also a previous presenter with speechpathology.com.  Jennifer received ASHA’s ACE award in 2010 and again in 2011.  She became a Board Recognized Specialist in Swallowing and Swallowing Disorders in August 2011.


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