The Speech Therapy team has put together helpful reasons as to why the 90-90-90 method of eating is best.
When you are eating on the couch, in the car, or even in bed, have you ever noticed that you spill, cough, or even find eating more effortful? A big reason this happens is because we are not in an optimal position for eating during these moments. The same can be said for children while they are eating.
When a child is a picky eater, has sensory aversions to eating, and/or has oral motor difficulties with chewing and swallowing- adding in the additional effort of trying not spill or choke on the foods they are eating because of the way they are sitting makes it a very negative experience for the child.
Postural stability in summary is a child’s ability to keep their body in a controlled position against gravity. It requires the child to have strength in their back, tummy, and neck areas. If these areas are weak, more effort is needed to hold their body upright. Imagining having to do crunches while eating a snack? It would make most people not very hungry. Good postural stability in children while eating helps with breathing (the body’s most important job), support and security while sitting, and allows for better coordination between their hand to mouth.
This is where the 90-90-90 comes into play. An ideal position for sitting and eating is a 90-degree angle at the hips, a 90-degree angle at the knees, and a 90-degree angle at the ankles.
What this will look like:
- Feet are resting flat on the floor or on a footrest which will create a 90-degree angle in their ankles.
- Ways to support without an adjustable chair: using a stool, stacked heavy books, filled cardboard boxes.
- Knees are resting at a comfortable level but over the edge of the chair to create a 90-degree angle.
- If the chair is too big and you notice that their knees are not creating the 90-degree angle, try placing a pillow or cushion behind their back to eliminate the space from the chair being too big.
- Hips need to be touching the back of the chair or the cushion placed behind them to create a 90-degree angle.
- A wedge cushion can support a child that slouches in order to sit more upright.
- A rubber mat or shelf line can be placed on the chair to aid in wiggly sitters.
- This may be difficult for children that have high sensory needs.
- When pushed to the table, the table height should be in between their chest and belly button. Another way to gauge the height is if their elbows are the same height as the table.
- If the table is too small this might be a cause for slouching and a taller table is needed.
A great recommendation for a highchair is the Stokke Tripp Trapp chairs.
One of our first recommendations for feeding therapy is to assess your child’s seating and see if they are at a 90-90-90. If not, that is a great place to start!