What is Feeding Therapy?
Your investment in your child’s feeding through this type of therapy helps children learn to accept new foods, increase the amount of food they are eating, and accept new textures of food.
Approximately 25-35% of average children will have mild feeding problems (Leung, 1994). Children with Autism have an extremely high rate of feeding difficulty, with 90% of children with Autism having some reported difficulty with feeding or foods, and 70% reported as at least picky or very selective eaters (Kodak & Piazza, 2008; Keen, 2008).
Feeding Therapy in infants and small children may look different and involve more oral motor exercises and techniques to facilitate appropriate movement of the jaw, tongue, lips, palate, and cheeks. Sensory tools may be used to stimulate and train the muscles involved with feeding.
OUR EVALUATION
Our evaluation is extremely comprehensive. We look at feeding across the lifespan because the feeding issues you are seeing now likely originated someplace in the past unless there was an accident of some sort. We look at a variety of factors that contribute to feeding issues including:
- Past feeding and medical history
- Chewing skills
- The structure and function of the mouth (including the jaw, tongue lips, and cheeks)
- How their body’s sensory system responds to different food textures
- Positioning
- The diet
The evaluation requires families to complete paperwork ahead of time so we can review it as well as send us videos of your child eating at home. We need time to review these before your appointment. The evaluation is 90 minutes and after it is complete we will have a follow up meeting on the phone to discuss the results and give you our final recommendations on what we see are the major issues as well as how to remediate them.
DOES MY CHILD NEED FEEDING THERAPY?
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If you are on this page, it would suggest that you are seeking help! Perhaps you have a picky eater, but there may be more to it than that. Our in depth evaluation and report (usually about 11-17 pages) provide a lot of insight and careful analysis as to why your child isn’t eating or is “picky”. The more we learn about feeding, the less I think of children as “picky” Only 8% of feeding issues are behavioral based. Yes that means that your child isn’t “just doing this to annoy you” – it is so much more involved!
Feeding is one of the most complex actions we perform as human beings. It requires all of our organs, 8 tongue muscles, coordinating respiration/breathing, and then add on top of it that food is a sensory experience. You can easily have a recipe for disaster! Our team has some of the most knowledgable and well trained staff when it comes to feeding.
It is so important to get this right when you evaluate because without the proper training, it is easy to dismiss certain behaviors or movements when in actuality they may mean something else entirely! We start all our feeding therapy with a thorough and comprehensive oral motor and feeding assessment. We are looking and all aspects of your child’s feeding ability (environment, posture, how they move their muscles, how they are breathing, how they react to sensory input). It is a multifaceted evaluation and you will leave with a really clear sense of what the problem truly is.
Take out quiz to determine if your child needs help! Only then can you make a plan to address those issues.
OUR THERAPY APPROACH
Based on the results of the evaluation, we will outline the issues and tailor a therapy program to be exactly what your child needs. There is no cookie cutter approach that can be used with feeding! At the heart of our approach is empowering parents and children. We view our clients as fully capable of achieving their goals. We guide you and teach you so that parents and children can take action when it feels right to them and move forward on your journey. We want you and your child to gain confidence in your own innate abilities to be successful. We use a variety of approaches…
Feeding/Sensory
We use a play based approach to feeding (i.e. the SOS approach), which is the most widely researched and successful model for feeding therapy. We move at a pace the child is comfortable at, helping them to overcome their blocks they have around food by teaching them how to problem solve sensory issues and showing them how they can make the food work with their bodies rather than against them. We never force children to eat, smell, or even touch foods they are not ready to handle. Doing do can result in catastrophic regression and worsening of their condition. We do not use token boards, or bribing/rewards of any kind. Our kids learn to enjoy food on its own! Kids move forward with food when they feel safe and we help create the space for kids to feel safe with food.
Oral Motor
We also are all trained to provide oral motor therapy to remediate poor chewing and tongue skills. In most cases, this is recommended as part of the therapy and will either be incorporated into feeding sessions if unable to participate in myofunctional therapy. Myofunctional therapy may be recommended if your child is over the age of 6 and can follow at least 2 step directions. Some mature 4 and 5 year olds may be considered.
Fear and Anxiety
If there is a strong fear base to their condition, we may recommend the Safe and Sound Protocol to help as well. Fear and anxiety surrounding food are usually not the source of the problem, but a side effect of being unable to handle the foods (either in their gut- causing discomfort; in the their mouth- from poor oral motor skills; or an overactive sensory system- causing a fight or flight response). While it is not the source of the problem, it still needs to be addressed. In some severe cases, we may recommend counseling or psychological therapy either prior to starting to concurrent with feeding therapy sessions.
Nutritional Status
If they have a limited diet that is lacking nutrients, we work with nutritionists and dietitians as part of your package to ensure they are getting all the vitamins and nutrients they need. If we suspect there is a gut related issue, we may refer you to do specific types of testing to determine if these issues are the cause of your child’s feeding issues. Many families have had testing done by allergists and GI doctors only to find that there was something missed. They just do a different type of testing, so sometimes that happens! We work with your providers so the foods we use in our sessions are ones that they feel would be beneficial and give your child what they need to thrive. Not all cases require this component to treatment!
Environmental/Positioning/ Family Training
Built into every session we discuss what changes you have implemented at home, and teach you things like what to say and importantly what not to say to your child at mealtimes. We go over things like how to make family meals successful, how to optimize their positioning to meals, what environmental cues we need to work on, etc.
Therapy sessions are 50 minutes in length and depending on your needs, more time may be spent with sensory, or we may do a lot of oral motor if that is your main issue. Talking through and problem solving what to do at home is also part of our sessions. Whatever the needs are, that is what we will focus on! We will likely ask you to bring in some foods from home and we also have foods in clinic we can use as well. If we are in your home, we will tell you what foods to have ready upon our arrival.
Our Success Stories
SLOAN
Sloan was averse to anything except the puree mixture his mom would make and at 7 years old, still considered failure to thrive, mom really wanted him to start chewing foods so he could eat a wider variety of foods. Sloan was on the Autism spectrum and nonverbal and parents would spoon feed every bite to him. Sloan had been through an intensive hospital program without success.
Within 7 months, not only was Sloan not afraid of foods, but he had started self feeding, chewing meltable solids, drinking from an open cup, and tasting new juices and flavors without fear!
ROHAN
Rohan came to us at 4 years old with a limited diet. Rohan was often sick. He ate mostly easy to break down foods, could not drink from a cup, and had lost many foods he used to eat. He hated touching foods and eating out was challenging. He seemed to fear foods at times. Rohan completed gut and micronutrient testing and discovered he was missing several key nutrients, as well as some gut issues. He completed the safe and sound protocol as well.
After a year of therapy, Rohan enjoyed foods so much! He even likes cooking food! He will try most foods and eats a wide variety of foods! After taking the supplements recommended by the dietician we work with, Rohan is rarely sick and has more energy. After completing the safe and sound protocol, he not only has less fear around trying new foods, but around other things! Like the pool and the ocean. He also became a lot more social. He now drinks from a straw and open cup independently!
RACHEL
Rachel came to us as an adult at 31 years of age because she wanted to be healthier and to do that, she knew she needed to expand the types of foods she was eating. Rachel’s oral motor skills were lacking and she had an undiagnosed tongue tie that really made moving food around in her mouth challenging.
After 3 months of feeding and myofunctional therapy, she incorporated foods like fish, which she previously would gag at. She mastered chewing and was able to chew foods like steak that previously would make her gag.
ALEXANDER
Alexander came to us at 4 years of age with a diet consisting of all brown, easy to dissolve and mash foods (cereal, pasta, toast). Mom really wanted him to add more foods to his diet before he started kindergarten. She didn’t know what she would send him with! Even pizza was a struggle.
After one summer, Alexander added so many new foods to his diet! He was able to try almost any food that came in front of him! He now eats food from all food groups without issue. He is now able to eat foods like pizza at birthday parties and mom doesn’t have to bring her own foods from home every time they go out!
DANIELLE
Danielle came to us at 9 years of age after a traumatic choking incident. A fear of food quickly set in and she became afraid to eat anything but puree, and started eliminating further from there.
Within 2 months of therapy, Danielle was back to eating all the foods she was eating PLUS was trying new foods as well!
EMILY
Emily came to us at 8 years old with a very limited diet. Mom reported she had ADD and would not sit at tables to eat but walk around the house. She wouldn’t eat at school and cried everytime a new food was introduced. She wouldn’t touch food unless it was with a utensil. Her chewing skills were poor.
After 4 months of therapy, Emily was sitting at the table for meals, stopped grazing, and added food from every food group into her diet! She picks and PACKS her own food for school. She no longer hates touching food and is starting to cook some food in the kitchen as well. She had learned to chew and with myofunctional therapy strengthened her jaw and tongue muscles and was now able to move food around in her mouth.
There are a number of potential causes for picky eating in childhood and we are here to identify those reasons during our comprehensive evaluation.
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