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Feeding Therapy

Feeding Therapy

The goal of feeding therapy is to help children develop normal, effective feeding patterns and behaviors.

What is a feeding disorder?

A child with a feeding disorder is more than a picky eater. Children with feeding disorders often have had serious medical and developmental issues that led them to fear some or all foods. Your child may have a few "safe" foods but will panic when asked to eat any other foods. Some children have sensory food aversions, or consistently refuse to eat certain foods related to the taste, texture, temperature, smell and/or appearance.

What is sensory food aversion?

Sensory food aversion is a type of feeding disorder that describes a sensory overreaction to particular types of food. The heightened sensory issues are trigged by the qualities of certain foods such as taste, texture, temperature and smell. In children with a diagnosed sensory processing disorder or Autism spectrum disorder (ASD), food selectively feeding issues are a major issue, with food texture and consistency being one of the most cited underlying factors in whether the child will consume or reject specific foods. Sensory food aversions can lead to restricted diet, nutrient deficiencies, increased family stress, and social isolation.

What is feeding therapy?

Feeding therapy is more than just “teaching a child to eat.” Feeding therapy is performed by a trained occupational or speech therapist. 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 and make the entire process of eating easier and more enjoyable.

Symptoms of Feeding Disorders:

• Choking/coughing during meals
• Gagging or vomiting while eating
• Spitting out food
• Refusal to eat all or most foods
• Weight loss or failure to gain weight
• Mealtime distress or tantrums
• Overreliance on supplement drinks (e.g., Pediasure)
• Trouble with different textures, avoids foods with certain textures
• Refusal or inability to chew or swallow
• Problems with oral motor coordination, such as difficulty using a straw or food spilling from mouth
• Slow eating, long meal duration
• Trouble self-feeding
• Food selectivity or extreme picky eating (only eating from 1 food group or only eating 1-2 foods) that leads to nutritional deficiencies
• A food range of fewer than 20 foods, especially if foods are being dropped over time without new foods being added to replace them
• Has not weaned off baby foods/purees after 16 months

What skills are taught in feeding therapy?

During feeding therapy, therapists work with children to provide them with the skills they need to make mealtime more enjoyable and nutritious. The skills taught to each child are determined based on the child’s needs and may differ from those below. The most common skills taught include:

Oral motor skills: Some children may lack the skills needed to eat and/or drink due to developmental delays, illness, allergies and a variety of other factors. When this is the case, the therapist works with the child to teach them how to control and coordinate chewing, sipping, sucking swallowing and the like while eating and drinking. Therapists also work to increase each child’s oral strength and range of motion.

Food orientation: Due to sensory aversion or developmental delays, some children may need assistance broadening the amount and type of foods they eat. This will allow the child to better enjoy meals and eat a more balanced, healthy diet. Therapists work with children and their families to increase the amount and types of foods the child is willing to eat. Many children, especially those with sensory aversion or those who have had limited exposure to a variety of foods, may be taught skills on how to reduce their sensitivities to foods and their textures.

Improve the overall eating experience: Whether a child has struggled to eat because of a sensory aversion food aversion and/or reduced oral motor skills, he or she may have developed negative feelings toward eating and mealtime in the process. As a result, many children, and their families, benefit from learning how to create positive eating and drinking experiences. Therapists work with patients and their families to improve the child’s overall mealtime routine and create positive associations with food. Therapists also work with children to help them gain the self-feeding independence that many of them crave by teaching skills like drinking from a cup, eating with a spoon or fork or drinking from a straw. By teaching the child how to enjoy mealtime and training the child’s caregiver on how to create a positive mealtime experience, meals and snacks may become easier for the entire family.

What roles do caregivers play in feeding therapy?

Caregivers play an important role in feeding therapy. As a vital member of the child’s care team, your therapist will stay in close contact with the child’s family in between appointments so that the therapy and strategies used can be changed as needed. While the child is learning skills in order to become a better eater, caregivers must learn the skills and strategies they can use at home in order to help the child progress and become a better eater and/or drinker. The child’s caregivers and therapist are a team, working together to make sure the child receives the therapeutic, physical, social and emotional support to improve his or her feeding skills and habits. In order to provide the child what they need at home, your therapist will teach the child’s caregivers:

• Feeding strategies and general advice for eating at home.
• Tactics for addressing negative mealtime behaviors.
• How to continue encouraging the child to eat the new foods introduced during therapy at home.
• To keep a food log of what the child eats and how he or she acts at mealtime and reacts to foods.

Working as a team, the caregivers and therapist decide which foods to introduce or target during the therapy. This decision includes many factors including the child’s oral motor skill level (what he or she is able to chew, sip or swallow), the family’s culture and lifestyle choices, the child’s specific nutritional needs and any sensory or food texture experiences the overall therapy is addressing. After sharing a meal with the child and caregiver or observing a meal between the child and caregiver, the therapist may provide feedback and advice on ways to incorporate things being learned in feeding therapy and make the meal more enjoyable.

How long does feeding therapy take?

The length and frequency of therapy depends upon each child’s needs. The child’s therapist will work with the child and his or her caregivers to make sure the child gets the right amount of therapy so that he or she can progress without feeling too overwhelmed.