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Brian, Picky Eater, 1-year-old (References (Cole, M.B., & Tufano, R.…

- - - - Brian eats only at the time when caregiver gives food.
      - There is no independence in self feeding
      - Brian eats a variety of fruits and vegetables in his puree-based diet
    - - Only eats a puree based diet
      - Eats only when administered from caregiver
      - Brian does not feed himself
      - Brian does not eat finger foods nor foods needing utensils
      - Refuses cups
    - - Mother would like Brain to start feeding himself.
      - Mother wants Brian to eat with the family
      - To wean Brian off of his strict puree diet.
- - - - Brian has two older brothers, Derek (5-years-old) and Michael (7-years-old)
      - Brian's parents are married
      - Brian's mom works from home
    - - Brian lives with parents and two brothers in their two-story home
  - - - Brian is emotionally attached to Mother
      - Dependent on mother
    - - 1-year-old boy
      - Parent's parents are classified as middle class family
    - - 1-year-old
    - - Brian watches television shows on his Ipad and TV at home
  - - - Brian strictly eats a puree based diet with exception to mini dissolvable chocolate chips
      - Brian refuses to pick up finger foods or use cups to drink from
      - Due to his specific eating patterns, his food schedule is different from his family members.
      - Brian only eats food when caregiver feeds him
      - Mom wants Brian to self feed so she can tend to other things such as her other son's needs and work
      - Accepts bottle with formula and puree foods but only from caregiver
      - Refuses foods other than purees
    - - Sleep
        
        Sleeping habits are reported as unproblematic by caregiver
      - Eating
        
        Brian's nutrition provides him with adequate amounts of fruits and vegetable servings
      - Feeding
        
        Accepts bottle with formula
      - Play
        
        Engages with others during play with positive affect
    - - Brian strongly prefers smooth-textured foods
      - Brian prefers to be held primarily by mother
      - Brian likes to watch Disney Movies & Mickey Mouse Clubhouse
      - Brian enjoys eating dissolvable pieces of chocolate chips
    - - He was born at 34 weeks via emergency C-section, due to fetal heart arrhythmia.
        
        He spent 2 weeks in NICU due to difficulty with breathing.
        
        He remained on a heart monitor with caffeine for one week, then without caffeine for one week.
        
        6-months-old - MRI and CT indicated normal results
        
        1-year-old - Brian underwent cranial vault surgery to repair prematurely fused cranial suture (craniosynostosis).
    - - Brian eats his meals an hour before family has meals
      - Brian wakes up from 7am-8am everyday
      - Brian goes to bed at 9pm
- - - - Give family members an object, or Brian's food, that Brian will cause him to initiate engagement with family members at the dinner table. This purposeful placement will promote Brian to initiate objects from family members thus initiating social interaction.
    - - Incorporate Brian's family members in the therapy session by provoking play with Brian while he is in prone position. This will cause Brian to be naturally interacting with his family during playtime. Brian will be more motivated to interact with family members at the dinner table if there are good, established relationships with family members through positive experiences such as playtime. Brian in prone positioning will also help with stretching his neck muscles which can help with swallowing mechanisms.
  - - - Reduce the number of distractions presented to Brian while new foods are being introduced. By limiting the number of distractions while new food textures are given to Brian, will force more attention towards the new food textures.
    - - Provide Brian with multiple stimuli simultaneously such as watching television as well as playing with a toy during the introduction of new foods. The new food textures presented will not be easily detectable with other sensory stimuli (the distractions) for Brian to percieve.
  - - - The OT will create a meal plan outline for caregivers to fill in necessary food requirements for Brian to gain weight. This will promote the caregivers to think critically about the serving sizes and food choices to prepare for Brian's meals.
    - - Providing Brian's caregivers a chart of nutritional facts that highlight foods higher in protein and fats in addition to creating an everyday meal plan. This preparation allows Brian's caregivers to easily access information as well as preparing ready-to-make mea
  - - - Place large beads in a bowl or bin and have Brian pick up the mini dissovable chocolate chips to work on his pincer grip as well as promoting self-feeding. Using smaller chocolate chips requires higher skilled fine motor abilities. The larger beans will provide a new texture for Brian that he will have to navigate through in order to reach the preferred item, the mini-chocolate chip.
    - - Spray whipped cream in a deep bowl or bin and have regular sized dissolvable chocolate chips dispersed throughout the whipped cream. The whipped cream can aid in Brian's texture exploration as well as providing an easier visual field to locate the chocolate chips. Chocolate chips are used to increase his engagement as well as promoting the pincer grip.