What is feeding therapy?

Feeding evaluations determine if a child’s feeding skills are atypical and if feed therapy would be beneficial to support development in this area . Feeding disorders work on a child’s ability to suck, eat from a spoon, chew, or drink from a cup or straw. Feeding therapy can also work on picky eating for children who are adverse to certain textures, food brands, or  food colors. Therapy uses strategies to make a child’s feeding experience more enjoyable. 

Who can do feeding therapy?

Feeding therapy can be done by either a Speech Language Pathologist or an Occupational Therapist. In both cases, the clinician must have training in feeding and or swallowing therapy.

Why may a child need feeding therapy?

There are many different reasons that a child may need to have their feeding skills evaluated. 

If you see the following during mealtime a feeding evaluation is recommended:

• arch their back or stiffen when feeding
• cry or fuss when feeding
• have problems breastfeeding
• have trouble breathing while eating and drinking
• refuse to eat or drink
• eat only certain textures, such as soft food or crunchy food
• take a long time to eat (45 minutes or more)
• pocket (which means to hold food in their mouth)
• have problems chewing
• cough or gag excessively during meals
• drool a lot or have liquid come out of their mouth or nose
• Nose drips during meals but not at other times
• have a gurgly, hoarse, or breathy voice during or after meals
• spit up or throw up a lot
• are not gaining weight or growing

How often should a child have feeding therapy?

Like therapy sessions for many other speech or language disorders, there are many factors that contribute to the frequency of therapy a child may need. It largely depends on the age of the child, the amount of support needed, and most importantly the severity of the specific case. The frequency of therapy is often recommended after the initial evaluation.

What are some common skills taught in feeding therapy?

• Oral Skills: Clinicians help patients create coordinated and control movements of their mouth for chewing, sipping, sucking, and/or swallowing for the purpose of eating and drinking. Working on these skills also develops and maintains strength and range of motion in the mouth. 
• Exposure: Some may need treatment to help increase the amount in portion and type of food he or she eats regularly. In doing this, the child is more likely to have more enjoyment and balance in their overall diet. This skill is especially important and useful for patients who are extremely sensitive to certain textures. It is also important and useful for patients who have had little to no exposure to certain textures or types of foods. Exposure helps limit or decrease the amount of sensitivity a patient may have for certain types of food. 
• Generally improving food experience: For different reasons, some children develop a negative association with food itself and even the experience or meal routine. So, feeding therapy sometimes works specifically working with both the child and family on developing new, positive associations to substitute and implement in their lives daily. This also includes teaching a child how to feed themselves, both eating and drinking, independently.

Why aren’t you working on eating in therapy?

Healthy, present, and complete feeding habits are very important for the overall feeding experience and general well being of a child. Whether a child’s feeding skills are genetic or acquired in some other way, proper feeding skills and therapy is necessary to avoid further progression or additional development of unhealthy feeding skills. 

Avoidant restrictive food intake disorder (ARFID) is a common symptom or result of forcing children to eat. This disorder, which is also known as “selective eating disorder”, creates a restriction as to how much and what types of food a child, who could eventually carry it on into adulthood, eats. 

It is extremely important to build a trusting relationship with the patient and sometimes pre-feeding skills need to be addressed before working directly with food. When food is introduced the therapist will not put any pressure on the child to engage with the food especially if it is new and foreing. Often therapists will have the child eat familiar foods to make them feel comfortable eating with the therapist. Feeding therapy is performed slow and steady because if it is rushed it can do more harm than good in terms of yours child’s relationship with food.