Is your child a severely picky eater? Do they gag, tantrum, or refuse to eat during meal times? Do they have difficulty swallowing, choke when eating, or get pneumonia often? Has mealtime become a battle in your home?
If you answered yes to any of these questions, your child may benefit from feeding therapy with a trained occupational or speech therapist. While there may be many reasons for feeding difficulties including sensory processing deficits associated with diagnoses such as Sensory Processing Disorder and Autism Spectrum Disorder, or motor deficits associated with neurological diagnoses such as Cerebral Palsy or Stroke, a feeding therapist can help ease stressful mealtimes.
How does feeding therapy work?
To answer the question, “how does feeding therapy work?” we should begin with a simple definition. Feeding therapy, in its simplest form, is when a trained occupational or speech therapist helps teach a child how to eat or eat better. Feeding therapy typically occurs once or twice a week for 1 hour each time, and at NAPA within its intensive model of 1 hour per day, 5 days per week, for 3 weeks. Dependent on your child’s underlying issues, whether they be sensory, motor, or a combination of both, your therapist will devise a plan for working on addressing the underlying barriers to your child’s ability to eat an age-appropriate meal.
If mealtime is a struggle and you believe your child needs feeding therapy, it is best to start by consulting your pediatrician. They will refer you to their recommended feeding therapists in your area, pending they deem it necessary.
A feeding evaluation will comprise of a review of the child’s complete feeding history, parental report on eating experience, an observation of the child eating a “typical for him” meal, and occasionally, a meal journal detailing the last three days of meals your child has had. Your therapists may also request a copy of your child’s most recent swallow study if he or she has a history of aspiration/dysphasia. Using this information, your therapist will use their clinical judgment to determine the cause of the feeding difficulties, which may include sensory issues such as hypersensitivity to texture or rigidity with food preferences, or motor issues that impact the ability to chew or swallow.
Feeding therapy treatment can take place at a therapy center, nutritionist office, hospital, or doctor’s office. The approach to treatment will vary based on the person administering the treatment, and your child’s specific condition.
There are many different approaches to feeding therapy including sensory, motor, and behavioral models—finding a good fit for your child is imperative. Find information on a few popular approaches below; your therapist may be trained in one or all of the below approaches. Whichever method your therapist utilizes, it is important to note that a feeding therapist should never force food into your child’s mouth without their consent.
The “Get Permission” approach outlines a treatment method based on the principles of healthy, trusting feeding relationships. Oral motor skills and mealtime treatment is most successful when the adults set goals and follow the child’s pace. It focuses on reading the child’s cues and moving forward as the child “gives permission. To start, your child may be instructed to simply look at the food. Over time, they will gradually be introduced to the next steps: smelling it, touching it, licking it, tasting it, and then finally eating it.
The focus of the Beckman Oral Motor protocol is to help individuals with oral motor barriers to eating to increase functional response to pressure and movement, range, strength, variety, and control of movement for the lips, cheeks, jaw, and tongue to support feeding.
In a behavioral approach, a reward system may be implemented. For example, whenever a child takes a bite from a new type of food, the therapist will reward them with a sticker. Once they eat the whole piece of food, they may be given a bigger reward, such as a small toy. Often times, if a child is willing to try a new food once, they will be more accommodating and require less reinforcement to try the same food in the future.
At NAPA Centre, we offer relationship-based developmental feeding therapy to address feeding issues. We have clinics in Los Angeles, Boston, Austin, and Sydney, Australia. Our occupational and speech therapists take a comprehensive approach targeting muscular coordination, sensory processes, and social experiences associated with eating. We also offer VitalStim for the treatment of dysphasia and dysphagia (swallowing difficulties). We take an individualized approach to therapy because we understand that each child is unique with very specific needs. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. If you’re interested in learning more about pediatric feeding therapy at NAPA Center, send us a contact form and our team will be in touch shortly!