There have been many blog posts devoted to Josie's difficulty with drinking and our attempts to get her off the feeding tube. Unimaginable energy has been spent on this pursuit by ourselves, countless therapists, medical professionals, and well-meaning friends and loved ones. Always searching for answers, I recently read an article on a behavioral occurrence called "Shaping" ("Helping Children Cope with Everyday Activities, pg 11). In a nutshell, shaping is when continuous reinforcement leads to a gradual change in behavior. Shaping can intensify an undesired behavior but it can also be used to ultimately move an undesired behavior in a positive direction. Essentially, a behavioral change can occur by having the child take gradual steps towards the desired outcome and using positive reinforcement (bribery) to celebrate each success.
Desired Behavior: Drinking (Pediasure, people. We're not "shaping" at a frat party)
Gradual Steps: We started with 3 drinks per meal, built up to 5 drinks per meal, and we are currently on 10 drinks per meal
Positive Reinforcement: Sunglasses (Josie's latest obsession)
Unanticipated Outcome: I may have misinterpreted the article; I'm not sure if my "shaping" technique is actually teaching Josie to drink or to count to 10.
Please excuse Josie's sumo wrestler hair - it's the quickest way to get her hair out of her eyes before breakfast.
I'd like Josie to hold the cup by herself. She can; she just doesn't want to. Once again, "shaping" involves gradual steps. Ultimately, I'd like her to receive all of her required fluids orally and no longer use her g tube. We're still a ways off but it's progress. I'm getting what I want, and Josie is getting what she wants so everything is cool!