There is an art to the use of crumbs in feeding therapy. Not all crumbs are created equal and their different characteristics allow for a multitude of options in helping children stretch feeding skill and sensory enjoyment and competence.
Crumbs can be used to provide carefully graded texture, flavor and skill experiences. The grading is where the ART comes in. The crumb characteristics we choose are specifically related to the experience we want to give the child. Crumbs are small (and often not too scary) and the sensory characteristics can be controlled by the adult to provide specific experiences. We start with familiar foods that the child feels are safe and slowly grade the sensory experience with crumb texture, size or flavor changes to promote more mature skill. Crumbs can be prepared in many different consistencies from fine to rough, smooth to sharper, even to uneven and meltable to more lingering and even dry towards wet.
Crumbs can help children get comfortable with food texture transitions. Many sensitive and cautious children like smooth purees but NOT textured purees, or like varied purees but are worried about lumps. They may like smooth wet foods, but not crunchy foods. For those children stuck on the slippery smoothness of commercial baby food, crumbs can thicken and very gradually change the texture. The crumb can be one that does more thickening (ex fine graham crackers that absorb the moisture) or adds more noticeable texture (food processed coconut “crumbs” that stay firm). Textures can change slightly with a few powdery crumbs or obviously with lots of granola crumbs. The crumbs can be IN or ON the food.
Crunchies can be crushed with fingers creating finer to rougher or even to more uneven crumbs. We use rolling pins, food processors, coffee bean grinders, graters, zesters, and spoons for smashing. We often have older children help us make the crumbs by putting them in a plastic bag and having them smash them with spoons, or rolling pins or by stomping on them.
Where to place crumbs?
~Crumbs can be offered on the lips as a “crumb kiss” so the child can get used to the texture and take them in the mouth as confidence is gained. Children often like the crumb kisses better if they kiss the crumbs from their own palm rather than someone else putting the crumb on the lips.
~Crumbs can be mixed into pureed food to change texture. Clearly the crumb you use and the amount will create different sensory opportunities. We start with the careful amount of change that allows for the child to be slightly challenged but not overwhelmed.
~Crumbs can be sprinkled on the puree so they touch the palate as they enter the mouth.
~A spoonful of familiar food can be dipped in a pile of crumbs so they adhere to the bottom of the spoon and enter the mouth touching the tongue.
~The spoonful can be dipped in the crumbs on the side of the spoon so the crumbs enter one side of the mouth. Children need to build confidence handling texture on the side of their mouths to inspire tongue lateralization and prepare for chewing.
Each of these different placements can help the child notice a different part of the mouth and make appropriate adaptive responses. Because the crumbs are small, the fear factor can be lessened (for children and their parents) and confidence can develop as the amount or size of crumbs is increased.
Most therapy clinics and treatment bags have some variation on the Ritz® or Saltine® cracker, Cheese It®, or Goldfish® crackers. But, think creatively to expand taste opportunities. Tastes can be graded from quite bland to “big” flavors. We can therapeutically offer texture without much taste (ex “finely crumbed unflavored baby rice crackers) or strong “wake up, NOTICE” flavors. Strong flavors can be sweet such as Gingersnap or Anise cookies OR savory such as ranch, garlic or teriyaki croutons or freeze-dried seaweed. We can give many flavor options to discover what the child LOVES.
Bridge to Wet
Crumbs can help the child bridge from the dry cracker snack crumbs to a wetter crumbs. We can have a child learn to crumb with familiar dry foods , and then gradually grade to a crumb with more moisture such as dry toast or breakfast bar. We work towards corn muffin crumbs, other bread crumbs, waffle crumbs and gradually waffle pieces! Grated cheeses are also a moister crumb choice.
Some families prefer less “snacky” foods choosing healthier food crumbs. Freeze dried peas or corn or fruits crumb nicely with fingers or in a coffee bean grinder. Cheese can be finely grated as Mexican Four Blend ® “crumbs” or powdered, as in parmesan cheese. Seeds such as sesame, flax seeds or chia seeds add still another texture with some nutritional benefits.
Children who like crunchies but have no fruits or veggies in their diets, can dip in freeze-dried fruit or veggie crumbs and add a whole new food group to their diet.
Add needed calories
Crumbs can be a calorie add on to a familiar food using dips and dippers. For example, children can dip an apple slice in yogurt and THEN nut crumbs, or a chip in refried beans and then grated cheese “crumbs”. The dipping can be a motivator and the crumbs a calorie boost.
Wake UP value of crumbs
Many children swallow every mouthful whole with little manipulation of the food in their mouths. Crumbs can be sprinkled on the mac and cheese, for example, and help the child “notice” the texture more. Often the sharper more uneven crumbs will work here to “wake up “ the mouth! Big crumb flavors can also alert the mouth!
Crumbs can be made in lots of colors and can add motivation value and interest. Brightly colored cereals or freeze dried fruits can add the motivation of color. For children too worried to try the crumb initially, we can provide crumb “rehearsals” by having them make them, and use them in art projects, or draw with their fingers in a cookie sheet of crumbs. These activities help the worried child get used to the smell and texture of the crumbs.
Crumbs as a DISGUISE
For children worried about the slippery feel of very wet soft foods, familiar crumbs can disguise the worrisome texture. For example, canned slippery peaches or pears can be covered in crumbs to bridge that texture challenge.
Chewing confidence building
As the child is used to crumb flavors and small textures, the pieces offered can be bigger and bigger as the child demonstrates better and more confident chewing. We can place them, or help them place them in their own cheeks or over their own teeth to chew or “make a noise” crunching the crumb. We can grade the sizes and textures and “meltability” as the child’s skill develop. Because crumbs can scatter in the mouth, a pile of crumbs can be too much for some children. We, however, can grade the input to build their skill and confidence without pushing the child to a disorganized response. If they are responding negatively to the scatter, WE need to change the input.
Crumbs can be a terrific tool in our therapeutic toolkit! Creating just the right texture or skill experience for the child is an ART.