Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

July 2011 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

July Topics:

  • The July 2011 AMCSI Conference: A Memorable Event
  • Early Intervention to Gain Independent Eating Skills
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The July 2011 Arthrogryposis Multiplex Congenita Support Inc. (AMCSI) Conference: A Memorable Event

Throughout the year Mealtime Partners, Inc. exhibits its products at conferences and exhibits throughout the United States. This month Mealtime Partners, Inc. exhibited at the Arthrogryposis Multiplex Congenita Support Inc. (AMCSI) conference in Kansas City, Missouri.

The National Institutes of Health, Office of Rare Diseases Research, defines Arthrogryposis multiplex congenita (AMC) as a group of non progressive conditions characterized by multiple joint contractures (stiff joints) and abnormal muscle development throughout the body at birth. The term is currently used in connection with a very heterogeneous group of disorders that all included the common feature of multiple congenital joint contractures. AMC occurs in about 1 in 3,000 live births in the United States. Arthro means joint, gryposis means crooked, multiplex means multiple and congenita means existing at birth.

The AMCSI conference is a little different than most conferences we attend; it is a family affair that whole families attend. It is a time shared by young and old whose common thread is a family member or friend who has arthrogryposis. A few professionals will be there but they are mainly there as presenters rather than attendees. The vast majority of attendees are families. They attend because they are seeking the information provided in the diverse presentations that go on throughout the conference. They share their experiences in programs for mothers, fathers and siblings of AMC’ers. They also share individual knowledge and experience with each other. Young parents come with their new born babies and are welcomed and provided with a vast network of people who can give them advice and support. Adults come and discuss difficulties experienced with aging with AMC, etc. Generally, all of those attending are bound by the common thread of understanding one another, and sharing the accompanying comradery.

One of the reasons this conference was of great value to Mealtime Partners, Inc. is that many attendees were gracious enough to have shared their methods of eating and drinking with us, thus expanding our understanding of how independent eating and drinking can be achieved by people who have limited or no hand and/or arm function. This year someone explained how to twirl spaghetti onto a fork using their mouth, and how to lift each bite up to their mouth to eat, without using their hands! Several children demonstrated their methods of holding and manipulating a utensil to be able to feed themselves. The teens and tweens were interested in how each other performed eating and drinking, and some were surprised at how others accomplished the tasks.

Two common themes became very apparent: the necessity for the appropriate table height for successful execution of the various methods demonstrated, and, the use of cantilevering to fill and lift a utensil. Many examples of this strategy were provided.  The following paragraphs attempt to describe some of methods that were demonstrated in hopes of giving families and therapists some new ideas for the individuals they care for.

Cantilevering a utensil can be accomplished using two arms (without the use of hands!). The lower arm is placed on the table behind the bowl. The bowl rests at the bend in the arm to give it stability and something to push against. The handle of the utensil is rested on the arm with the bowl of the spoon inside the dish. The second arm is then placed on top of both the utensil handle and the bottom arm. The bottom arm is then rolled or rotated towards the bowl. This action (with a lot of practice) will load some food onto the spoon. The bottom arm is then rotated backwards keeping the upper arm on top of it. The backward action and the pressure of the upper arm on the utensil handle will lift the spoon bowl upward. The person then lowers their mouth to the utensil and takes the food off of it with their mouth. To successfully be able to reach the utensil with their mouth, the person must have the table height set at the appropriate distance below the bowl. This is a personal setting and can only be decided by experimentation and personal preference. However, if the distance is too great, the person will have to bend over a long way. This, for some, can be difficult or fatiguing. It should be noted that this is easier to accomplish if the bowl holding the food is shallow.

The same approach can be used but with a different method to raise the utensil upward. Once the utensil has food on it, both arms can be lifted upward by bending a knee under the lower arm. This raises and supports both arms at a level above the bowl allowing the user to take a bite of food. Once the food is removed from the utensil, the knee is lowered and removed and the process can be repeated.

For those who can hold a utensil but do not have the muscle strength or flexibility to bring it up and forward, raising the table height so that it is approximately level with the person’s underarm will remove the need for raising their arm/hand. It allows them to simply move the utensil forward and back, rather than having to lift it up and down, which is much more strenuous. Once the utensil has food on it, the person can lean into it using their body weight to flex their elbow without actually needing to have the ability to bend their arm.

I am always amazed at these conferences how many individuals can do so much with almost no limb function. For those readers who have other innovative methods to accomplish independent eating, we would welcome suggestions and pictures if you are willing to share with our Newsletter subscribers. Please email suggestions and pictures to:


Did You Know? Did you know that according to a recent MetLife study of caregivers, “The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for their Parents”, nearly 10 million adult children over the age of 50 are caring for their aging parents. These caregivers lose an estimated $3 trillion dollars nationally in wages, pension and Social Security benefits. Individually, average lost wages are $324,044 for women and $283,716 for men. To read this report click here and click on "the report", in the second paragraph.

Early Intervention to Gain Independent Eating Skills

The previous article in today’s Newsletter discussed methods of being able to self-feed despite limited hand and arm function. The discussion will be continued here and include reasons to consider adaptive technology for eating as an early intervention strategy.

If a child aged two years or older is not showing any signs of developing independent eating skills, then a different strategy to teach them to eat may be appropriate. Powered dining equipment, like the Mealtime Partner Dining System may be a way of providing a young child with both the concept of self-feeding as well as the ability to execute independent eating.

Self-feeding normally starts with finger food. The child learns to pick up small pieces of dry food, like cereal or small crackers, and put them in their mouth. This eventually will evolve to the use of a utensil, but using a spoon or fork is a far more complex task than finger feeding and requires significantly more coordination for proper execution. Without the use of a utensil, however, the range of food that can be eaten is limited. Soft foods like yogurt or apple sauce cannot be eaten without a utensil, unless someone feeds them to the child.

To address developmental needs, around the age of two the question should be asked: can the child pick up food with their fingers? (This does not necessarily need to be with their thumb and index finger. It can be accomplished using a scissor action with any fingers.) If the answer is no, using a utensil is not very likely to occur without the aid of some kind of assistive technology. This may be accomplished by using a small cuff or mitten that fits the child’s hand and that has a slot in it that accommodates the handle of a utensil. However, if finger feeding is not being employed, a cuff may not work for the child because they may have limited range of movement in their elbow and bringing their hand to their mouth could be difficult, or impossible. It should also be remembered that if a task is very arduous for a child to execute they will tire quickly and not be able to feed themselves an adequate amount of food at each meal, and need support from someone else.

In a practical sense a decision must be made of how the child will acquire their daily nutrition. Will someone feed them, or can they be provided the means to feed themselves? This is when powered dining equipment should be evaluated. For young children this should be seen as a beginning to self-feeding. The child, through the use of powered dining equipment becomes a self-feeder. Efforts towards finger feeding can be continued and the child should be free to move between the two methods of feeding at their own discretion. Over time, the child may develop additional skills and be able to feed themselves small amounts of soft food using a hand held utensil. With this approach, both the child and their parents, can be assured that they are able to eat enough food to be well nourished using the various strategies they are developing.

Using this methodology, young children will be able to reach the appropriate developmental milestones that relate to eating and move onto other goals at the same stage as their peers. Not only does this provide the child with a very practical solution to independent eat but it reduces the amount of time that their parents must spend feeding their child, and it normalizes family mealtimes.


We are having a very hot Summer!

A large portion of the United States is experiencing exceptionally high temperatures and drought. During this type of weather, it is essential to maintaining good health that everyone stays well hydrated, preferably drinking lots and lots of water.

For those who get out and about in a wheelchair and cannot use their arms or hands to access a drink, there are several hands free drinking systems that can be attached to a wheelchair. With a drinking system on a wheelchair, the person using it can maintain their hydration level independently.  No more need to be thirsty or constantly asking for a drink.

Mealtime Partners, Inc. has a variety of different drinking systems to provide independent drinking to those who cannot use their arms or hands to take a drink. They can be attached to a wheelchair, bed, or table for easy access. To see the complete selection of Mealtime Partners Drinking Systems, click here.

If you're not sure which system to choose? Call 1-800-996-8607, or email our staff for assistance by clicking here.

Front Mounted Drinking System

The Front Mounted Drinking System Mounted on a Wheelchair

The Front Mounted Drinking System provides easy access to liquid for those who have poor suction or have extremely limited range of motion. It is also excellent for children. They easily understand how to independently drink with this system, and, due to the shortened drink tube, it does not require as much suction as using one of the backpack mounted drinking systems. For ordering information, click here.

For more information about the problems resulting from dehydration, click here.

The Front Mounted Drinking System is only available from Mealtime Partners, Inc.

July 2011 Newsletter References:

This month's references are embedded within the text, above.

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