Can you guess what that is? Josiah’s food, while at the hospital is often challenging to identify.  It is chopped in such tiny pieces, I have difficulty figuring it out.

The speech therapist there suggested Josiah has oral dysphagia.  Dysphagia means trouble with eating or swallowing. I’m no expert, but this boy has rarely had trouble with eating.  He eats just about everything and anything we put in front of him.  He eats massive quantities of food at every sitting.  He appears to be swallowing it all just fine.

Oral dysphagia refers to problems with using the mouth, lips and tongue to control food or liquid. It can lead to aspiration, where food or liquids get into the lungs. Since Josiah was ‘diagnosed’ with this, though to my recollection no formal feeding evaluation was done, (I’m not with him 24/7 so it could have happened without my knowledge) his food now resembles mince meat at every meal.

The first day I took the lid from over his plate and saw teeny tiny pieces of food, I was stumped.  It smelled familiar but was unlike anything I had ever eaten before.  I asked the assistant in the room, “Do you know what this is?” She didn’t. It was only after peeking at the meal selection sheet we discovered it was pizza. Josiah didn’t care what shape it was chopped into.  He devoured it all.  The food at the hospital really is pretty good.

Josiah typically shoves large bites of food in his mouth all at once. These minuscule pieces give him ample opportunity to chew properly and swallow better, thus avoiding aspiration issues. We were given instructions on the proper way to feed Josiah including orientation of his head, (specifically his chin) in relation to the utensils approaching his mouth and the way to hold his cut away cup so he doesn’t have to tilt his head back too far when drinking. He no longer gets to gulp his apple juice. He must drink small sips at a time.

Basically, we are keeping Josiah from inhaling his food as if from a pig trough. We are teaching him to savor each morsel. He is becoming a refined and dignified diner. All we are lacking is the formal atmosphere and white linen napkin.  As for the exotic cuisine, have you figured it out? Do you know what that is on the plate pictured above?

Don’t feel bad.  Neither did I. It’s a peanut butter and jelly sandwich. Josiah ate it with a fork. He pierced small bits ever so carefully and guided them slowly to his mouth. But this my friends is a work in progress.

Two seconds later, he threw that fork down and started shoveling it in by the fist full.