Bite Steps Cue Cards π½οΈ
Picture Cues Cafeteria & Lunch Table Visuals
Bite Steps Cue Cards β¨
Key Actions 1. To Mouth π₯ β’ 2. Swallow π§
1 Step One
π₯ͺ π₯
β
Pick Up Food
Hold spoon, fork, or snack!
2 Target Skill!
π
β¬οΈ π₯
Food to Mouth
Lift your hand right up to lips!
3 Step Three
π
π π
Take One Bite
Put yummy food inside!
4 Step Four
π¦· π₯
Munch! Munch!
Chew, Chew, Chew
Use teeth to chew it soft!
5 Target Skill!
π₯€ π§
Gulp! All Down!
Swallow Clean
Down into the tummy!
6 Step Six
π β¨
Mouth is Empty!
Ready for More
Take a breath or sip water!
βοΈ Cut along the dashed line for the student lunch tray strip!
Desk & Tray Strip
π₯ͺ
1. Pick Up
Hold food
ππ₯
2. To Mouth
Lift up!
π¦·
3. Chew
Munch munch
π§π
4. Swallow
Gulp down!
π‘ Point to picture #2 ("Food to Mouth") before offering a hand prompt! β Praise every clean swallow right away!
First Bites Reward Chart β
Day 1-2 β’ First Bites 5 Bites to Victory! π
First Bites Reward Chart β¨
π Lunchtime Champ!
π
Eater Name _________________
π
Date / Time _________________
π₯ͺ
Today's Yummy Food _________________
π
I Am Working For: 5 Stars!
Attach photo, sticker, or draw your prize:
π± π π«§ β π΅ β Pick your favorite!
π
My 5 Big Bite Badges
πβ¬οΈ Food to Mouth + π§π Swallow = Token!
1
π₯ͺ
Bite 1 Great start!
2
π
Bite 2 To mouth!
3
π₯
Bite 3 Chew & gulp!
4
π
Bite 4 Almost there!
5
π
Bite 5 β’ WIN! Prize Time! π
π₯β¬οΈ 1. Bring Food to Mouth
β’
π¦·π 2. Chew It Soft
β’
π§β¨ 3. Swallow All Clean
βοΈ Cut out these picture tokens to stick on your chart!
Reusable Tokens
β Yum!
π₯ͺ Bite!
π Great!
π Super!
π Hero!
π Staff Praise: βWoohoo! You lifted your spoon to your mouth and swallowed! Stick on your star!β
Staff Initials: _____
Paced Plate Reward Chart π
Day 3 β’ Level 2 10 Bites Trail Adventure! π
Paced Plate Reward Chart π½οΈ
π Chew β’ Gulp β’ Star!
Name
_________________
Date
_________________
Today's Big Prize π 10 stars gets: ___________
π
My 3 Steps:
πβ¬οΈ 1. Food to Mouth
β
π¦·π₯ 2. Chew Thoroughly
β
π§π 3. Swallow All Clean
π First Half: Bites 1 to 5 Stamp or sticker each bite!
1 π₯ͺ
To mouth
Swallow
Bite 1 β¨
2 π
To mouth
Swallow
Bite 2 π
3 π₯
To mouth
Swallow
Bite 3 π₯
4 π
To mouth
Swallow
Bite 4 π
5 π₯€
To mouth
Swallow
Water Break! π§
β‘ Second Half: Bites 6 to 10 Finishing like a champ!
6 π
To mouth
Swallow
Bite 6 π
7 π
To mouth
Swallow
Bite 7 π
8 π₯¦
To mouth
Swallow
Bite 8 π₯¦
9 π
To mouth
Swallow
Bite 9 π
10 π
To mouth
Swallow
GOAL! WINNER!
π
10-Bite Feeding Superstar! π
I lifted my food to my mouth and swallowed every bite cleanly!
Staff / Parapro Sign ______________________
Lunch Feeding Tracking Sheet Clinical Tracking IEP β’ OT β’ Mealtime Behavior Data
Lunch Feeding Tracking Sheet
Target Steps 1. To Mouth β’ 2. Swallow
Student _________________
Date / Time _________________
Staff Observer _________________
Utensil / Food _________________
Prompt Key:
I = Independent | G = Gestural/Visual | V = Verbal | PP = Partial Physical (Elbow) | FP = Full Physical
| Trial | Food Item / Texture | Step 1: Brought to Mouth
Prompt: I / G / V / PP / FP (+/-) | Step 2: Chewed & Swallowed
Prompt: I / G / V / PP / FP (+/-) | Clinical Observations / Notes |
| --- | --- | --- | --- | --- |
| 1 | | | | |
| 2 | | | | |
| 3 | | | | |
| 4 | | | | |
| 5 | | | | |
| 6 | | | | |
| 7 | | | | |
| 8 | | | | |
| 9 | | | | |
| 10 | | | | |
| 11 | | | | |
| 12 | | | | |
Session Summary Metrics
Total Bites ____ / 12
% Indep. To Mouth ____ %
% Indep. Swallow ____ %
Behavioral Check
Food pocketing observed
Rushed / stuffed mouth
Spitting or food refusal
Staff Notes & Tomorrow's Feeding Target: Total Meal Duration: _______ mins
Recorded by: ________________________ OT / Teacher Reviewed: ________________________
Lunch Champ Reward Chart π
Level 3 β’ Days 4-5+ Independent Lunchtime Hero! π
Lunch Champ Reward Chart π
π Weekly Star Board!
β
Lunch Champ Name _____________________
π
Week Of _____________________
Weekly Star Goal π― Earn 4+ Daily Badges!
π
π
Monday
Apple Kickoff
πβ¬οΈ Food to Mouth:
π§π Swallow Clean:
Badge π
π₯ͺ
Tuesday
Sandwich Star
πβ¬οΈ Food to Mouth:
π§π Swallow Clean:
Badge π
π₯
Wednesday
Carrot Crunch
πβ¬οΈ Food to Mouth:
π§π Swallow Clean:
Badge π
π
Thursday
Power Eater
πβ¬οΈ Food to Mouth:
π§π Swallow Clean:
Badge π
π
Friday
Grand Finale!
πβ¬οΈ Food to Mouth:
π§π Swallow Clean:
GOLD! π
π
Friday Celebration Prize
My Independent Lunch Champion Reward β¨
Prize: ______________________
β
Teacher / OT Sign: ___________________________ π Student Big High Five: [ β ]
Feeding Support Staff Protocol Staff Implementation Guide Paraprofessionals β’ Special Educators β’ Lunch Monitors
Feeding Support Staff Protocol
Target Skills 1. To Mouth β’ 2. Swallow
90-90-90 Posture Feet flat, hips back, chin neutral
Wait Time Rule Wait 5-8 sec before prompting
Swallow Check Look for throat rise & empty mouth
Least-to-Most Prompt Hierarchy (Fading Ladder)
Level 1
Independent
Student initiates without cue within 8 seconds
Immediate Star!
Level 2
Visual Cue
Point to Cue Card 2 ("To Mouth") or placemat
Silent gesture
Level 3
Indirect Verbal
"What is next?" or "Pick up your spoon"
Short phrases
Level 4
Partial Physical
Gentle upward nudge at elbow or forearm
Fade pressure
Level 5
Hand-Under-Hand
Place hand under student's hand to guide to mouth
Never force
1
Skill 1: Bringing Food to Mouth
Plate Position: Position tray within 6 inches of torso so elbow does not overextend.
Load vs. Lift: If utensil loading is hard, staff can pre-load spoon; student must lift spoon to mouth independently.
Finger Foods: Acceptable for snacks/sandwiches. Emphasize one piece brought to lips at a time.
2
Skill 2: Chewing & Swallowing
Visual Swallow Sign: Observe larynx (throat) elevate and lower. Do not present next bite until visible.
Pacing Pause: Keep utensil on table between bites. Do not permit scooping while food is still in mouth.
Pocketing Check: If student holds food in cheek, verbally cue: "Swallow your bite" or offer small sip of water.
Quick Troubleshooting Matrix
Rapid Mouth Stuffing Place only 2-3 bites on tray at once. Keep the rest in container until swallow is confirmed.
Food Refusal / Pushing Away Lower goal to 2 bites. Offer choice: "Carrot first or sandwich first?" Pair with preferred token reward.
Coughing / Wet Vocal Sound Stop meal immediately. Sit student fully upright. Check mouth clearance. Notify school nurse/SLP.
Praise Scripts (Use immediately upon swallow):