What is Feeding Therapy?
To keep in simple terms, feeding therapy helps children learn how to eat or how to eat better. Feeding therapists provide feeding therapy and are usually occupational therapists or Speech-Language Pathologists (SLPs). Some dietitian/nutritionists provide direct treatment, but more often provide support with additional services for some children to manage any weight or growth concerns when it is necessary.
When Should I seek out Feeding Therapy?
If your child has any of the following, it’s recommended you seek out a feeding therapist for an evaluation:
Child not gaining weight or growing
Refuses to eat or drink
Spits up or throws up a lot
Cries or fusses, or arches her back when feeding
Has trouble breathing while eating or drinking
Has problems chewing or coughs or gags during meals
Has a gurgle or breathy or hoarse voice during or after meals
How often might my child need Feeding Therapy:
Feeding therapy often happens on a weekly basis, but can be every other week or once a month during a scheduled block of time, usually 30-60 minutes long. Most often, this time is spent teaching your child how to eat new foods (if they have a very limited diet) or how to eat (if they don’t know how to chew or manage food in their mouth).
Medical issues, delays or disorders in gross motor development, and sensory processing issues may contribute to feeding disorders.
Children with sensory regulation problems may or may not be able to organize themselves for feeding. Those with oral sensory issues may not feel the food in their mouths, or they may be overly sensitive to the feeling of the food in their mouths. In addition, they may not feel the hunger. Sensory processing issues can cause feeding disorders such as food refusal and self-limited diets.
Is it just behavior?
A few common ideas and misconceptions we hear include:
1. They will eat when they’re hungry…
2. It’s just behavior…
3. They have not been disciplined enough to try new foods…
There are very successful behavioral feeding programs. These programs use preferred foods, toys, books, or television to reinforce children for eating challenging foods. While these programs can help children overcome behaviors impacting their success in feeding, there should be an exploration on any sensory motor issues that are contributing to food avoidances.
Sensory processing issues can cause feeding disorders such as food refusal and self-limited diets. Unfortunately, these feeding issues are often viewed as behavioral issues, when they are actually adaptive responses to primary oral phase feeding disorders. The oral phase of feeding includes intake of food into the mouth, chewing of the food, and movement of the food in preparation for swallowing.
Things to be aware of if there is a sensory motor issue:
If there are any oral-motor sensory issues, you might observe these quite often with your child:
1. gagging
2. vomiting
3. choking
4. sub sequential food refusal
Children who have feeding delays due to motor skills may have had negative sensory experiences with food. If behavioral feeding techniques are resisted by a child, a sensory-motor based feeding program could be implemented with oral sensory-motor exercises and activities. This will allow the child to develop the motor plans for safe feedings.
A Successful Journey to Feeding Therapy:
When completing a feeding evaluation, the first area of success relies in adequate oral-motor skills of the oral phase of feeding. Once this skill has developed, the sensory techniques and behavioral reinforcements can be used to expand the diet and increase food quantity.
Talk to your Speech/Occupational Therapist about a PRE-FEEDING Program
A pre-feeding program is to develop the motor skills needed for feeding. The clinician then designs a program to help the child develop skills needed to support safe and successful eating. This plan should include parent carry over and education for home and how to use each new skill at meal times.
References:
Books: