Our Philosophy Of Tube Weaning
Shaped By Our Experiences
The knowledge and experience of our team results from the clinical work of many years at the University Hospital Graz. At this hospital, Marguerite Dunitz-Scheer and Peter Scheer developed the specific concept for helping children with severe feeding disorders with the emphasis on tube dependency based on previous research in the field.
Rooted in Real, Practical Results
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.
Over the past two decades, we have identified 2 core areas of any treatment based on the Graz model:
- On the physical level (somatic approach): let the child be hungry
- On the developmental level (psychological): increase autonomy
These two simple goals must be respected and understood on various levels by the child itself and the caregivers involved. However, each family system and patient is different and this makes it necessary to custom-tailor each weaning process, even though the philosophy beneath is the same.
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 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 parents have gone through weeks of anxious fear, nervous expectation, they feel insecure and want to “help” their baby in every possible 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.
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 the baby’s capacity to be able to do things in appropriate time by itself, to be able to regulate hunger and satiety, although if it has been suffering from many weeks or even months of great pain. 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).
Understanding the Child’s Perspective is Key
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, commonly referred to as the “Graz model”.
Application of the Graz Model
We travel the world attending conferences and workshops involving desperate families, presenting the “Graz Model”. Currently, we focus all our attention in providing the Graz Model to 2 main groups:
- Parents of tube-fed children with our online and onsite programs
- Professionals working in the field of tube feeding and weaning
Download Guide: How Does Tube Weaning Work?
Learn about our proven six-step process to wean your child from the feeding tube. Proven 3,000 times.
You’ll learn how to
- get your child interested in food
- avoid common parental behaviors that prevent success in tube weaning
- create the ideal environment for tube weaning