Does my child need feeding therapy?

What is Feeding Therapy? How do I know if my child qualifies?

Contributed by one of our pediatric Speech-Language Pathologists, Stacey Rosensteel, M.S., CCC-SLP

pediatric utensils

Raising a happy, healthy eater is a difficult job for anyone, however with the right tools and support your child can be thriving. Early feeding development includes finding the correct utensils for little hands. Here are some suggestions and things to look for:

  1. Utensils with a short, wide handle: To set kids up for success, give them something to grip that won’t easily fall out of their messy little hands. Adults may prefer a long, narrow handle on a utensil, because our fine motor skills are more developed to poke, scoop and rotate towards our mouth.
  2. The end that goes into their mouth matters too! Spoons should have some curve to them and not too wide for their mouths. An often-made mistake is to give kids a deeper spoon, with the thought that it will hold more food with a deeper “bowl” and therefore the kids will eat more food, faster. Actually, the opposite is true. When kids have too big of spoon, filled with too much food for their little mouths, the experience is overwhelming.  This leads to spilling, coughing, choking or gagging. A flat spoon or one that is not too deep will help kids develop lip closure skills.  Lip closure is  an important part of learning to eat. To be able to keep our lips closed around the food not only keeps it in the mouth, but assists in chewing and swallowing foods safely. Lips play a big role in manipulating food in our mouths and propelling the food backward for swallowing. This is also helpful for early speech development as well.

What is Feeding Therapy?

Feeding therapy helps individuals learn how to eat or how to eat better.  This specialty is provided by trained Speech Pathologists and Occupational Therapists. Occupational Therapists evaluate and treat those with picky eating from a sensory perspective (aversion, avoidance, refusal based on smell/appearance/presentation), as well as teaching utensil use and more. Speech Pathologists provide feeding therapy for those with feeding mismanagement, as in low oral muscle tone and coordination, difficulty chewing and swallowing, acceptance of new foods, increasing diet repertoire, bottle feeding, tolerance of new foods and more.

Feeding therapy begins at different stages depending on an individual’s needs. Therapy is spent teaching how to eat new foods (limited diet) or how to eat (if they don’t know how to chew or manage food in their mouth).

Depending on the child’s underlying challenges, you may see your child participating in sensory integration activities or completing exercises to strengthen the muscles they need for eating.  Exercises will likely be things like blowing bubbles, making silly faces, or using whistles.

Before therapy can begin, an evaluation is completed which will consist of observations of feeding and parent interview. Recommendations will then be made and goals will be written that guide the direction of therapy anywhere from cup drinking, utensil use, increasing dietary intake and learning to chew and swallow.

picky-eater

Who Needs Feeding Therapy?

Depending on the challenges a child is facing, age does not matter.  From newborns to adults, feeding therapy may be needed. For infants not able to latch, picky eaters and everything in between, feeding milestones are important and should not be ignored. Tongue-ties, sensitive gag reflux, enlarged tonsils, low muscle tone/coordination are just a few of the causes of feeding disorders. In these cases and more, your child may end up qualifying for therapy where you will get suggestions and activities to try at home.

What Should you Expect with Different Feeding Approaches?

As you can imagine, there are different approaches to feeding therapy, some of which you may be comfortable with, and some that you may not, but most of them can be summed up into two different categories:

  1. Behavioral– This is the traditional method of feeding therapy that uses rewards to gain new foods in a child’s dietary preferences. For example, your child may be given a sticker, toy, candy for successfully taking a bite of a new food. To get another sticker, toy, or more candy, they need to take another bite. Over time, these rewards should be phased out, so the child does not become so dependent on them, they will only eat if rewards are given.
  2. Child directed– This is a more modern approach and is positive in nature. Parents are more involved with this type of treatment and there is a focus on addressing the underlying cause of the problem (i.e. sensory, medical, etc.). While this approach can take longer to see results initially, there is research that supports the effects and benefits are longer lasting.  The SOS or Sequential Oral Sensory, approach to feeding falls under this category.

If you or someone you know is struggling with eating, do not hesitate to reach out to our team!

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