A Feeding Device
Sandra S. Rife, O.T. Reg. *
Edgar Kennedy, Special Devices Technician *
The ability to feed himself not only provides the handicapped individual with a degree of independence in a personal function, but also releases an attendant from a time-consuming task three times a day, seven days a week. Patients who are unable to feed themselves because of limitations of control or movement in the upper limbs may be helped by a feeding device (Fig. 1) that was recently developed at the Ontario Crippled Children's Centre from a design seen in Chailey, England.* This report describes the feeder and its use at O.C.C.C.
Indications for Use
Although this feeder is suitable for all ages, our results are based only on trials with handicapped children, particularly those with cerebral palsy, 5 to 18 years of age. Each of these children has learned to manipulate the controls and to feed himself, either independently or with minimal assistance.
There are three physical requirements for satisfactory operation of the feeder:
1. The patient must have sufficient coordination in one arm to depress, push, or pull the knobs. However, functional hand grasp is not essential; a fist, wrist, or forearm can be used to operate the knobs.
2. The patient must be capable of bringing his head forward toward the spoon in a fairly controlled manner.
3. Oral musculature must be sufficient to effect lip closure. Of course, chewing and swallowing should be adequate to ensure proper digestion.
In order to use the feeder properly, the patient must be seated comfortably, with his trunk erect and well supported. The feeder may be placed on a table, wheelchair, or chair tray, and must be positioned correctly so that the elevated spoon is aligned in front of the patient's mouth.
Description of Feeder
The feeder (Fig. 2) is mounted on a plastic-surfaced board made from kitchen countertop material. Four suction cups secure the board to a flat surface. The food plate is a standard Corning Ware pie plate, fastened to an adaptor so that it may be quickly secured to a rotary spindle. The plate can be rotated by pushing or pulling a knob (b) located near the side of the plate.* A special acrylic spoon is mounted with a thumb screw (c) to a linkage arm that suspends it above the plate. The linkage arm is mounted on a spring-loaded hydraulic damper (door closer) (e). When the knob (d) located on top of the arm near the spoon is pressed down, the spoon is partly released, so that it hangs downward. If the knob or any part of the linkage arm is further depressed, the spoon contacts the plate and slides forward to scoop up the food. The arm and the spoon remain in this position until released by pressing knob (a). The spring-loaded damper then causes the arm with the spoon to rise to the appropriate level. The level to which the arm rises can be adjusted (f). In some models of the feeder, a hole is provided near the plate for holding a drinking glass. The feeder is available in both left- and right-hand models.*
Selection and Preparation of Food
The food to be served should be soft (e.g., mashed potatoes, pudding) or in small pieces (e.g., meat, peas, fruit). Foods such as spaghetti or macaroni are only practical if cut up very finely. Soup is not suitable.
To facilitate serving, the plate can be removed from the spindle by rotating about 30 deg while gently lifting it upwards. The food should be placed around the edge of the plate, with each type separated so that the operator may make the desired selection by rotating the plate.
To place the plate back on the feeder, allow the arm holding the spoon to rise by pressing knob (a). Center the plate over the spindle so that the adaptor falls into the slot, then rotate the plate about 30 deg in a direction opposite to that produced by knob (b). The feeder is then ready for use.
Operation of Feeder
1. Push knob (b) until desired food is in position to be scooped up (Fig. 3).
2. Press knob (d) and, in doing so, push the spoon down into the plate (Fig. 4). (Some people may find it easier to push the spoon into the plate by pushing down on the arm.)
3. Press knob (a) to raise the spoon, and bring mouth forward to the filled spoon (Fig. 5 and Fig. 6). Continue this cycle until the meal is completed.
Care and Adjustments of Feeder
Proper handling and cleanliness will ensure that the feeder remains in good working order. After each meal, the plate should be removed and washed in detergent and water, and the plastic top wiped clean. The thumb screw (Fig. 2, c), when loosened, allows the spoon to be removed for washing.
A screw (Fig. 2, f) allows adjustment of the height to which the spoon rises. If this must be lowered or raised, the screw is loosened, and the metal stop is pushed closer to or farther from the rod. The screw is then tightened.
Results of Feeder Trials
Twelve cerebral palsy children, both spastics and athetoids, are successfully using the feeder. Their reactions to the feeder are similar; they truly enjoy feeding themselves. For most, this is the first time they have ever fed themselves, and their feelings of excitement, pride, and independence are very evident.
The parents of these children are similarly very delighted that their child can feed himself. The mother now can perform some of her mealtime chores as well as eat her own meal without having to constantly attend to this child. Some children still must have their mouths wiped after every few bites, but this takes considerably less effort on the mother's part than feeding her child every mouthful.
All in all, the results and the reactions we have observed of the feeder trials have been very satisfactory and promising.