Toddler, Preschool, and School-Aged Eating/Feeding Therapy
Toddler, preschool, and school-aged feeding therapy helps children 18 months and older with a wide variety of feeding difficulties which may have led them to become extremely picky eaters. Our feeding therapists, Alex Alleman, MOT, LOTR, and Meredith Brown, CCC-SLP, use the well-known SOS (Sequential Oral Sensory) Approach to Feeding designed by Dr. Kay Toomey. This approach considers a child’s individual differences as it relates to the child’s approach to the mealtime experience.
These individual differences include medical and feeding history, current mealtime strategies utilized by caregivers, oral motor skill, environmental concerns, sensory sensitivities, food qualities of preferred foods, as well as coordination and postural control, among other qualities. In addition to the holistic, sensory-based SOS Approach to Feeding, our therapists are also well-trained in oral motor therapy that is sometimes necessary to improve a child’s motor skills (for example, tongue movement, chew pattern, jaw stability, coordination of swallowing and lip closure) used for eating. One oral motor program used by our therapists to facilitate oral skill development is Talk Tools Feeding Therapy: A Sensory Motor Approach (Talk Tools Feeding Therapy).
About the Evaluation
- Parents will be called by a therapist prior to the evaluation to get more information and to let them know if they need to bring anything.
- The typical evaluation lasts about 80 minutes.
- It is conducted by a therapy team consisting of a speech-language pathologist and occupational therapist.
- Evaluation observations include sensory processing, oral motor skill development, regulation and attention, fine motor skill and sensory modulation.
- Additional considerations include parent role(s) and involvement in the mealtime experience, feeding and developmental history, learning style and cognitive processing.
- The evaluation will consist of 1) a family meal, 2) feeding trial therapy, 3) an oral motor assessment, and 4) a gross motor skill evaluation.
After the evaluation is complete, the following goals are often considered:
- To increase positive experiences with food
- To participate in a mealtime routine
- To learn cues to eating/ hunger
- To decrease aversion and resistance to touching, manipulating, tasting and eating foods
- To increase range of foods child with taste
- To increase the amount of foods ingested
Additionally, parent training, education and involvement in the home environment are essential to gaining a large food repertoire. With adequate carry over, the typical length of the SOS program is 6 months to 2 years. Criteria for discharge includes: 10 starches, 10 proteins and 10 fruits/ vegetables that can be eaten across environments (e.g. at therapy, at home, and at school) as well as an ability to taste new foods. If you question your child’s ability to eat this amount of foods, it is encouraged that you to keep a food diary log for three days. List all of the foods eaten within these three days as well as the time of ingestion. Consider your child’s quantity of foods, variety of food textures, colors and temperatures as well as frequency of mealtimes.
Feeding is a multi-step process that requires sustained organization and attention to wholly understand and explore foods. Our therapy team follows the Steps To Eating, which is a hierarchical model from the SOS Approach to Feeding that breaks down the individual steps that constitute a child’s acceptance, presentation to swallowing. Throughout treatment, parents are educated and involved in sessions so that climbing the Steps to Eating becomes second nature both in the treatment and home environments.
Would my child benefit from feeding therapy?
Characteristics of an Extremely Picky Eater
Here are stories about children whose parents agreed to share their journey. These children are currently, or have in the past, benefited from feeding therapy. Their stories may help other parents have a better understanding of what feeding therapy is and how it might help their child. Results and duration of therapy are dependent on a number of factors, including the individual differences of the child and parental involvement.
Aven started our feeding program in September 2016. He was unable to manage foods in his mouth and had a limited diet of 3-4 foods that he would only inconsistently eat. The majority of his calories were consumed through chocolate milk and Pediasure. He was not comfortable touching his preferred foods that were of pureed consistency (often referred to as ‘baby food’). Since he started therapy, many pieces of Aven’s puzzle have been addressed and worked through, not only through direct therapy, but also by his feeding therapist helping to identify possible issues that required medical intervention. Aven’s mom reports that mealtimes are more pleasurable and he is now very comfortable being messy. His ability to manage a wider variety of foods is improving and he is eating a greater volume of solid foods instead of the 3-4 Pediasures he once required. While the journey for Aven isn’t over yet, mealtimes are no longer a fight and he is happier boy now that his nutritional needs are being met. Way to go, Aven!!
Books and Websites
- Book: Helping Your Child with Extreme Picky Eating (http://www.extremepickyeating.com/)
- Oral Motor therapy tools (https://www.arktherapeutic.com/therapy-tools/)
- Curious Chef kid’s cooking supplies (http://curiouschef.com/shop/kitchen-tools/mixing-measuring-prep/27-piece-foundation-set)
- Family Support for parents of children with feeding difficulties (https://www.feedingmatters.org/)
More Handouts Coming Soon!