Mealtime Partners, Inc.
Specializing in Assistive Dining and Drinking Equipment
September 2014 Independent Eating and Drinking Newsletter
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This month’s Newsletter discusses some of the common roots of seating and positioning at mealtimes. This topic is important because correct posture while eating affects how the body handles the whole process of eating - from getting food to the mouth, to chewing, swallowing and digesting. There are a large number of factors that define how each person eats and drinks. This article does not hope to address all of them, but attempts to provide insight into some reasons people eat the way that they do. This information will help people examine their individual situation(s) and make adjustments to their seating and positioning if they are necessary. The overall objective of good positioning for eating is to provide the body enough stability that the muscles involved in eating can perform at their best. With a stable body, people are able to better control their muscles and, therefore, they are able to chew more productively, manipulate the food in their mouth with greater ease, and swallow safely.
How an individual sits while eating is determined by a variety of considerations: their age, ethnic background, the environment in which they live, whether they watch television (or use other electronic devices) while they eat, etc. The following will provide a little history on cultural differences in how people eat to help explain the evolution of eating behaviors.
Depending upon where someone lives, or in some cases, their country of origin, meals and eating are conducted differently from the European model where people sit on chairs at a table to eat meals. In many countries, including China, Japan, Egypt, and India, family dining is conducted on the floor. In some cultures cushions may be used for people to sit on, and in others the food may be placed on a low table. In the majority of countries a clean cloth is spread on the floor and dishes of food are placed on it. Family and guests sit around the food on the floor either with their legs crossed, or in some instances, crouching and sitting on their heels.
Culture also dictates how food is picked up and placed in the mouth. In European based cultures, utensils, like a spoon, folk and knife, are used to pickup the food and move it from the plate or bowl to the mouth. However, how the utensils are used vary from country to country. For example, in England the knife is held in the right hand and the fork in the left with the tines pointing downward. Once food is cut up, it is “loaded” onto the fork (which is still held in the left hand) either by sticking the food with the tines of the fork or by pressing food onto the back of the tines using the knife so that it stays on the fork. Regardless of how food is attached to the fork, the fork is held in the tine downward position and raised to the mouth with the left hand for the food to be taken off of it. In the United States, the knife is held in the right hand and the fork in the left only when food is being cut up. Once food is cut, the knife is placed on the plate and the fork is transferred to the right hand with the tines in and upward facing position. Food is stabbed with the tines and raised to the mouth, or it is scooped onto the fork using the tines like a spoon.
In Asian cultures, chopsticks are the preferred utensil. Originating in China, chopsticks can be traced back 4000 years. It is thought that they were created to handle the tiny pieces of food that were cut up and prepared for meals when there was a fuel shortage. (Small pieces of food cooked quickly and reduced the amount of fuel that was necessary to cook a meal.) Also, Asian countries eat short and medium grain rice which, when cooked, is sticky and thus easy to eat with chopsticks. Europeans eat mostly long-grained rice that does not stick together when cooked.
In many other cultures, including India, parts of Africa, and the Middle East, food is eaten with your hands (i.e., your fingers). Different cultures dictate different manners for eating with your fingers. The first rule across cultures is to thoroughly wash your hands before eating. The local food will dictate how food is picked up and placed in the mouth. In India, small pieces of flat bread, called naan, are broken off with the right hand. It is used to scoop a small amount of curry, meat or vegetables. The flat bread is held in the fingertips and should not touch the palm of the hand. The fingertips do not enter the mouth but the food is pushed into the mouth using the thumb. The plate should not be touched by the left hand or raised in any way. Instead, the head should be tipped forward to get the food in the mouth without spilling. In Africa, a root vegetable called fufu is boiled in water and then mashed. During the meal, a small portion of fufu is formed into a ball and a dent formed in the ball. This is used to scoop up soup or meat. As described earlier, this process is only conducted using the right hand; using the left hand is counted as disrespectful.
When a feeding device is designed and developed it is essential that the types of food that will be eaten and how the user will be seated are considered in the overall design. The Mealtime Partner Dining System was developed to support someone who sits in a chair at a table to eat. Its various mounting systems specifically address the needs of someone who is sitting at a table. For example, the Support Arm facilitates access to the device for someone who is sitting in a wheelchair and is unable to get very close to the table edge. The Mounting Legs allow for height adjustment when someone uses the Mealtime Partner when it is placed on a table for them to eat. Additionally, the method used to pick up food and serve it to the user, which uses three deep bowls and a spoon that scoops through the bowl to pick up the food, is designed to handle an American or European selection of foods. It is not designed to handle very sticky foods like sticky rice that is eaten in some Asian countries.
Click here for more information about the Mealtime Partner Dining System.
| The Mealtime Partner Dining System | |
| For those who have spinal cord injury, cerebral palsy, tremors, or another illness or disease preventing them from feeding themselves, the Mealtime Partner can provide mealtime independence allowing a pleasant dining experience that is totally under the control of the individual eating. | |
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The Mealtime Partner Dining System can be positioned to meet the specific
needs of each user. The user does not have to adjust their
position to eat using the device because the Partner’s flexible
mounting systems permit positioning to fit the user's needs,
making mealtimes a
comfortable, relaxed experience, with the user positioned safely
for eating. The Mealtime Partner empowers its user to eat what they want, when they want it. The Mealtime Partner Dining System is quick and easy to learn and has no complicated programming requirements. Each Dining System comes with a complete training video on DVD so new users and caregivers can learn to use it in just a few minutes. For more information about the Mealtime Partner Dining System, please visit Mealtime Partners website. There is no other assistive dining system that meets the needs of the users, like the Mealtime Partner. |
This article will discuss the impact of the use of television and other types of electronic devices by children and teenagers at mealtimes. Because Mealtime Partners has a special interest in helping individuals with disabilities, the article provides insight into the use of electronic devices for those with disabilities. However, the majority of the article applies to all infants, children, and teenagers regardless of their abilities.
Screen time is the terminology currently being used to describe the time spent using a computer, tablet, game console, phone or television. Screen time has significantly expanded since the advent of smart phones, tablets and social media. According to a recent study, children are spending as much as 8 hours a day accessing a variety of media. In many cases this is more time than they spend sleeping. The study reported that if a child has a television in their bedroom the time greatly increases.
Many of the new devices have alternate access methods available for them, and thus individuals who have disabilities are able to use smart phones, iPads, etc., using touch screens, voice access, eye gaze access, or adaptive switch access. Regardless of the method of access, these devices are providing easy access to both social and specialized needs for individuals with disabilities. However, because they are accessible, the overuse of electronic devices applies to children and young adults with disabilities as well as their able bodied peers.
In a Policy Statement issued by the American Academy of Pediatrics (AAP), recommendations for limiting the use of television and other hand held devices at mealtimes were published. The recommendation about turning the television off at mealtimes was issued several years ago. However, with the advent of new technologies that are more compact (like cell phones and ipads), it is easier for children to bring the media with them to the dining table. AAP strongly recommends that no one use any type of electronic device at mealtimes, including parents! The study found that families that allowed the use of electronic devices during mealtimes ate fewer salads, fruits, vegetables, fruit juice and milk. It also found that they consumed more sugary drinks, and that they have poorer family communication.
AAP also recommends that parents supervise the use of electronic media and set firm limits upon how much time can be spent using it. More than 60% of teenagers receive and send text messages after they have gone to bed. This behavior has led to them being tired at school. AAP recommends that phones, etc., are not allowed in the bedroom after it is time to go to sleep. It is estimated that approximately 75% of teenagers own their own cell phones. For 88% of teenagers, texting is their preferred method of communication. They talk on the phone less than any other age group. In the first quarter of 2011, teenagers each sent an average of 2,264 texts per month.
With such ready access to a wide variety of media, it is easy for children and young adults to be extremely attached to their assorted devices. In many ways these devices provide a wealth of helpful information: access to school and teachers, research, music, and lots of entertainment. However, the appropriate use must be guided by parents, otherwise children will spend the majority of their time looking at one type of screen or another.
Electronic devices can also be valuable as motivators in behavioral modification strategies. For example, eating and feeding problems can be so severe in infants, children and teenagers that it is necessary for them to receive services from a specialized feeding clinic. For some patients, screen time is used as a motivator or reward for participation in the feeding program. For instance, a child can be allowed to see a short snippet of a video or play a short section of a game as a reward after they eat or drink what they have been asked to do. A list of feeding clinics can be found at the end of Mealtime Partners January 2012 Newsletter.
Even though these devices are both fun and useful, there is a time and place for their use. Dr. Jenny Radesky, lead author of a study published in the Journal of Pediatrics, commented, “A lot of pediatric research literature shows that connections and interpersonal interactions during mealtimes are really beneficial to children’s health and development”. Children learn by example, and if parents are constantly using their electronic devices, children cannot be expected to do otherwise. Parents should be aware that too much screen time can lead to ignoring the people around you! Dr. Ari Brown, pediatrician and author of Baby 411, observes “When parents talk to their child less, their language development is affected. Think long and hard about using [your phone] when you have the opportunity to sit down and really talk and engage with your child.” Dr. Rahil Briggs, director of pediatric behavioral health services at Montefiore Medical Center in New York City says, "The single most powerful predictor of a child's vocabulary is conversations with the child. Dinnertime is an important time for those conversations, and if you're absorbed with your phone, that's a lost opportunity."
Remember - enjoy your meal, the food, the people you are with, and the opportunity for social interaction. Your devices will still be there when the meal is over.
| Did You Know? Did you know that if you put non-stick material like Dycem on the seat of a chair, it can help stabilize how a person sits on the chair. When people sit on a chair that does not have an upholstered seat, they find that their buttocks will gradually slide forward on the seat. This will cause their spine to curve at its base. Dycem, or other non-stick products, grip both the surface they are placed on, and whatever is put on top of it (in this case, the seat of the chair and someone’s buttocks). The ability of Dycem to grip declines as this non-stick material is used. However, rinsing the material with soapy warm water will rejuvenate its grip properties. |
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