Feeding Therapy: What Is It and Would My Child Benefit?

To someone who has never experienced repulsion at the sight of a non-preferred food, difficulty tolerating certain textures, or an extremely limited food repertoire, eating might seem like an easy task: you sit down and you eat. What’s so hard about that? For someone who experiences feeding difficulties on a daily basis, however, it’s not so simple.

What is feeding therapy?
Many people are familiar with traditional therapies, including speech therapy, occupational therapy, physical therapy, etc. However, feeding therapy is a lesser known intervention that is becoming more widely available as feeding difficulties are more recognized in our society. There are a variety of different feeding therapy approaches across the nation based on your child’s individual needs. Here at PlayWorks, feeding therapy typically includes the following components:

  • Child driven, not volume driven: The goal of a therapy session is not necessarily for a child to sit and eat a full meal. The goal of a therapy session is for a child to interact with food in a way that is enjoyable and motivating. When the fear of trying a new food is removed, a child has the tools to become a successful feeder.
  • Family focused: Unlike other one-on-one therapies, feeding therapy is most successful when the whole family participates. This improves generalization of learned skills, as well as strengthens the social component of enjoying a meal.
  • Feeding should be FUN: Feeding should not be a traumatic experience! Many sessions will focus on simply interacting with non-preferred foods. When a child learns that new or non-preferred foods don’t have to be scary, he or she is more likely to take the steps to try (and actually enjoy!) new foods.

What will my child work on in feeding therapy?
Before deciding on goals for feeding therapy, a feeding therapist will evaluate your child’s feeding skills to determine the root of his or her feeding difficulties. Simply speaking, feeding difficulties typically fall into the following two categories:

  • Sensory difficulties: Children with sensory concerns related to feeding typically present with either hypersensitivity or hyposensitivity. Children who are hypersensitive can have mild to severe reactions to different types of foods. This is typically related to the item’s texture, color, consistency, etc. In this case, feeding therapy will work to increase a child’s comfort interacting with certain foods. For example, therapy may initially target a child tolerating a non-preferred food on his or her plate before moving to touching, smelling, and eventually eating the target food. If a child is hyposensitive to foods, he or she may prefer very spicy or sour foods and avoid foods with less texture or flavor. Additionally, he or she may overstuff his or her mouth or pocket food in his or her cheeks. In this case, a therapist may use varying techniques to increase oral sensation.
  • Oral Motor difficulties: Children with oral motor difficulties typically have difficulty chewing foods with a “tougher” consistency (e.g., meats, crunchy vegetables) and prefer softer and/or pureed foods. Additionally, a child with oral motor difficulties may have a hard time controlling the food in his or her mouth, leading to “messy” eating and, at times, coughing or choking on foods. A feeding therapist will likely implement oral motor exercises into feeding therapy to strengthen your child’s oral musculature.

There may also be feeding difficulties that are caused by reduced pharyngeal (i.e., the muscles in your throat that control swallowing) strength and coordination. In these types of feeding disorders, a child frequently coughs or chokes when eating or, more commonly, drinking. If your child frequently coughs when drinking liquids, he or she could be at risk for aspiration. It is important to have your child evaluated by a feeding therapist to determine the best utensils and strategies to allow him or her to safely tolerate an age-appropriate diet.

How do I know if my child would benefit from feeding therapy?
If you’re wondering when a child’s “picky” or “messy” eating becomes more than just a quirk and something that requires intervention, you’re not alone. While everyone has a food that he or she dislikes, feeding therapy is warranted when a child omits all or the majority of an entire food group or has a severely limited diet. Simply speaking, if your child’s eating habits impact your everyday life (i.e., making a separate meal for him/her to avoid a meltdown) and, most importantly, his or her nutrition, it may be time to consider a feeding therapy evaluation.

Questions or concerns?
If you have questions or concerns about your child’s feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: life is fantastic via unsplash.com

What to Choose? Self-Feeding Tools for Babies and Toddlers

If you’ve ever browsed the grocery store aisles looking for the perfect cup or utensil set for your child, you may have quickly found yourself overwhelmed with all of the options. With the wide variety of choices available nowadays, it’s hard to determine the best item to for your child. There is no “one size fits all” approach to finding a transition cup and/or feeding utensil that is right for your child, and it may take some trial and error to determine the best fit. However, throughout my time as a speech-language pathologist and feeding therapist, I’ve found some tools to be particularly useful as a child develops his or her eating and drinking skills.

I’ve heard sippy cups are bad? What cup should I choose?

I’ve had many parents tell me that they’ve heard that sippy cups are “bad” and that they’d like a better option for their child. While I don’t label all sippy cups as “bad” (and feel that they are a necessary option for some children with specific feeding needs), research has proven that use of sippy cups can lead to tooth decay, oral motor delays, and speech and swallowing delays. For more information, please see a recent blog post by one of PlayWorks Therapy’s speech language pathologists: http://playworkschicago.com/blog/page/3/

Straw cups and free flow cups are a great alternative to sippy cups. Here are some cups that I have found particularly beneficial for children from all feeding backgrounds:

  • Straw cups: There are a wide variety of straw cups on the market that are specific to babies and toddlers. Some of my favorites include the Nuby No-Spill Sports Sipper(a great option for transitioning from bottles to cups!) and Phillips Avent Straw Cup; however, there are several similar options on the market that work just as well. If your child hasn’t quite grasped the concept of straws yet, the Honey Bear Straw Cupis a great introduction to straw drinking.
  • Spoutless sippy cups: Commonly referred to as the 360 Cup, this no-spill cup is a great tool to teach the oral motor and swallowing skills necessary for drinking from an open cup. Munchin Miracle 360 Trainerand Playtex Spoutless 360 Cupare both great options.

I want my child to use utensils, but he can’t quite grasp a spoon or fork yet. What should I do?

Children learn to eat with their hands, and this is a goodthing! It’s important for children to be exposed to the sensory properties of food, and eating with their hands is the best way to do so. However, there comes a time when it’s appropriate for a child to use a utensil to feed himself. When children aren’t able to successfully use a fork or spoon, I like to incorporate some of the following:

  • Dippers: Dippers are similar to a spoon, except they have no spoon bowl. Children use dippers by dipping the utensil in a thick puree and bringing the dipper to their mouth. This teaches the motor skills necessary for using utensils without requiring as much coordination. Some of my favorite dippers include Numnum Pre-Spoon Goo-tensilsand ChooMee Starter Spoons.
  • Curved spoons: Curved spoons are another good option for children who have difficulty handling typical spoons. Curved spoons are made to match a baby’s natural grasp. Many have shorter, thicker handles which make the spoons easier to maneuver. Playtex Curve Infant Spoonsare a great option!
  • Child size spoons and forks: While I don’t have any particular brand of spoons and forks that I prefer, children learning to self-feed will have more control when using small utensils. Additionally, utensils with a wider handle will be easier for children to grip.

What can I do if my child is demonstrating feeding difficulties?

If your child is demonstrating difficulties transitioning away from the bottle and/or tolerating an age-appropriate diet, consider contacting one of our feeding therapists, who can provide your family with helpful tips and tricks to increase your child’s independence as they transition to the world of self-feeding.

Questions or concerns?

If you have questions or concerns about your child’s feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Hal Gatewood via unsplash.com

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