Thinking model and philosophy

Our whole team has evolved its knowledge and thinking process with the critical support by the whole clinic over many years and developed a highly specific concept for helping children with severe feeding disorders with the emphasis on tube dependency.

Philosophy
Our philosophy is based on the knowledge of developmental psychology and the analysis of early childhood learning processes assuming that every child is born with a genetically determined learning potential. This means that for hundreds of years children have not learned eating because somebody showed it to them, but that every child has the competence of accomplishing this essential basic function within him- or herself. Already during the intrauterine months of life a coordinated drinking, sucking and swallowing of the amniotic fluid is detectable.

Concept of Self Regulation
Newborn babies and toddlers emit cues of all kinds to show their caregiver that he or she is hungry. They can focus visually, can turn their head towards their caregiver or divert it the other way (e.g. if the bottle is approaching), they can babble, cry, scream, smile or engage their caregivers in lovely communication. These cues are emitted “into the space” surrounding the child. When a child has spent many months in neonatal intensive wards and in hospitals of all kinds, its communicational repertoire might be smaller in range or confused in respect to the presence of the caregiver, his or her interpreter. And at the same time the mothers and fathers have gone through weeks of anxious fear, nervous expectation, they feel insecure and want to “help” their baby in every way. Well meant attempts of trying to help their child often turn out not to be constructive. It is the nature of mostly unwanted intrusiveness and exaggerated care, which can influence their baby in a way, that the baby feels the need to protect itself and to close its mouth instead of opening it.

"Wait, watch and wonder" - Selma Fraiberg (famous English psychoanalyst)

Self regulation means that the baby is equipped with biorhythms regulating basic things like the wake-and-sleep pattern and the hunger and satiety cycle. Self regulation also means that the grownups involved learn to trust in the baby's capacity to be able to do things in appropriate time by itself, to be able to regulate hunger and satiety, even if it has been suffering from many weeks or even months of great pains. Since the baby has the potential of becoming an eating child as any other child, self regulation will also solve the balance of increasing oral intake, but only in the case of reducing the enteral intakes (=tube feeds).

Conclusion
The understanding of the presenting problem from the child’s perspective (and not from what we think is important from an adult perspective) is the crucial prerequisite to find a path to the child’s personality and to estimate how to stimulate its sensory and motor abilities from a developmental point of view. The child’s strive for autonomy (starting at birth) and its explicit need to develop its own will power and motivation needs to be oppositional and resistant to any kind of aversive or suggestive approach. Thus, the child, independent of its age or possible disability, will show the direction and lead its individual treatment. In communication with the parents we try to find a specific treatment plan which will be individually cut and fitted for each child and its care giving system. This is why our program is called Early Autonomy Training.