Early Childhood Intervention
This website is a place for families who are facing
challenges pertaining to their child's development and
It is a place to find answers and practical
suggestions. That's what Early Intervention Support is all
Whether a family has a child with a challenging behavior,
a disability or developmental issue, childhood is short - it
should be savored and enjoyed.
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Stage 2 to Stage 3 Foods
As on occupational therapist in the early intervention
field, parents often ask me, "Why won't my child eat Stage 3
This is a very common concern for parents, since
transitioning to new foods is a huge change for kids from
both a motor and sensory (texture) standpoint.
There are many differences between being fed Stage 2 and
Stage 3 foods. From a sensory perspective, visually the food
looks different when presented on the spoon. Stage 3 may
have multiple colors and different shapes so each spoonful
looks slightly different from the last. Instead of having
one smooth texture, your child is now faced with multiple
textures. Stage 3 can consist of combinations of squishy,
soft, chewy, rough, smooth, thin, thick, and any texture in
between (versus the one smooth texture of Stage 2). There
can also be different smells associated with Stage 3 as
opposed to Stage 2. Since the child is now required to chew,
he will also feel different types of movements in his mouth,
jaw and tongue. The pressure between the teeth is also
different and taste begins to vary more as the food is
Transitioning from Stage 2 to Stage 3 can also present
new motor challenges for a child. Whereas Stage 2 only
requires a child to move foods backward with the tongue for
swallowing, Stage 3 requires the ability to manage several
different textures within the mouth at one time. Some of
these textures can be easily swallowed, some require minimal
movement such as being moved to the side of the mouth with
the tongue so the food can be mashed between the teeth.
Other textures may require more sophisticated movements of
the tongue and jaw. A child will need to move food from one
side of the mouth to the other and use his jaw in a rotary
movement to tear the food into smaller pieces for
swallowing. In a nutshell, a child is required to be able to
do a combination of several different movements to manage
multiple textures of food when he eats Stage 3 food.
As you can see, although moving from Stage 2 to Stage 3
may seem like a small step to those of us who have been
managing cheeseburgers and pizza for years, the management
of Stage 3 's after experiencing only Stage 2's is actually
a quite complicated process. If your child is doing well
with Stage 2, but is having difficulty progressing to Stage
3, and is at least 8 months of age and developing at a
typical rate, here are some suggestions to try at home:
- Try having your child experiment with "hard
munchables" under direct supervision. Hard munchables
are foods such as celery sticks, bell pepper strips,
beef jerky and stale licorice. The goal of this
exploration is not to have the child bite off pieces of
the food to swallow, but to munch up and down on it,
feeling different textures and helping the tongue move
in different directions along with the food. A food net
can be used to minimize choking risks with younger
- Then progress to meltable solids such as graham
crackers, mum-mums, veggie sticks, or town crackers.
These are foods that will dissolve easily without
- Next, progress to soft cubes of food cut about pinky
nail size such as kiwi, bits of cooked potato, cooked
carrots, or bananas.
- After that try "soft mechanical" foods such as
muffins, pastas or lunch meats that are single textures.
- Once a child has mastered the above steps, it would
be an appropriate next step to try mixed textures such
as those seen in Stage 3 foods. Many children will just
progress to more types of table foods from here onward.
If your child is still having problems progressing past
eating Stage 2, he may have a delay in the development of
the oral motor skills necessary to manage these foods. He
may have a problem tolerating the sensory challenges these
foods present, or have a combination of these two problems.
It is also possible that your child may have other feeding
related challenges not addressed in this article. If this is
the case, talk to your pediatrician about getting a feeding
evaluation and/or call your local early intervention
provider to request a feeding evaluation. If you are in
Allegheny County in PA, call the Alliance for Infants &
Toddlers at 412-885-6000 to request an evaluation and then
request TEIS as your child's service provider.
By Mary Ann Allen, MOTR/L
Parenting Tips in Other Areas Include
Learn More About Early Intervention
Thankfully, there are many ways to deal with childhood developmental
delays and behaviors. These include in-home services, outpatient (you take
your child to a clinic), inpatient (following injury or surgery) and school
based services. Which type of therapy should you choose?
Visit our Therapy Options
area to learn more.
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