Feeding Therapy 101

Hello all- Cara here! This week, I am guest blogging on a topic I am very passionate about- feeding therapy! During my years as a practicing speech-language pathologist, I have completed specialized training and gained invaluable experience within the area of feeding disorders. It is an area of practice that I find especially rewarding. I began working at OWLS Therapy in July 2018 and have loved working with children and their families in the home environment. This treatment model works incredibly well with feeding therapy, as treatment sessions involve both the child and their family members. I am passionate about making feeding therapy FUN and FUNCTIONAL! 

Have you ever wondered if your child may need feeding therapy? Below, I have answered some commonly asked question about feeding therapy and concerns you may have. 

What is feeding therapy?

Feeding therapy helps a child learn how to eat or how to eat more efficiently and effectively. It targets oral motor skills and/or expanding a child’s diet to provide for more variety in fruits, vegetables, meats, etc. 

 How do I know if my child needs a feeding evaluation?

Red flags to be aware of:

  •   Decreased oral motor skills, such as:

    • Difficulty chewing different textures

    • Difficulty drinking from an open cup or straw

  • Minimal consumption at meals

  • Transitioning from G-tube feedings to oral feedings 

  •  Difficulty swallowing or refusing to swallow certain foods or textures

  • Gagging, choking or vomiting during meals 

  •  Arching of the body during feeding 

  • Avoidance of total food groups

  • Difficulty accepting changes in familiar foods, such as changes in:

    • Shapes

    • Textures

    • Temperatures 

    • Colors

  • Difficulty transitioning from one texture to another, such as puree to a mixed consistency 

  •  Brand specific, such as ONLY eating Wendy’s chicken nuggets

  • Mealtime taking longer than 30 minutes

  •  Physical reactions to food, such as crying, screaming, or refusing to sit at the table

 What’s the typical development of oral motor skills?

Below is a brief list of skills a child should have by a given age. NOTE: this is not an extensive list and doesn’t fully capture all of the skills a child should have, nor is every child exactly alike with their development. 

Around 6 months

o   Spoon feeding introduced, starts to accept pureed baby foods

o   Cup drinking introduced 

o   Holds bottle with both hands

6- 9 months: 

 o   Increases lip closure on spoon and helps caregiver with spoon

o   Sucks liquids from cup

o   Around 9 months, the child should be accepting table foods and chewing with an up down (munch) motion. 

9- 12 months

o   Drinks from an open cup with hand-over-hand assistance. (Personally, I am not a big fan of a sippy cup, but I recognize that it may have a time and place.) 

o   Gag is less sensitive, moving foods more posteriorly 

o   Consumes lumpier or thicker foods

o   Drinks from a cup with a straw

12-18 months:

 o   Develops a more mature, rotary chew and ability to transfer foods from one side of the mouth to the other

o   Uses pincer grasp to self-feed 

o   Clears lower lip with teeth

o   Increased stability to take bite from a larger piece of food 

18- 24 months:

o   Chews a variety of textures with their lips closed, controls bite on hard food (i.e. pretzel)

o   Decreased tongue extension during swallowing

o   Self-feeding with spoon 

o   Holds cup with one hand 

24+ months:

o   Eats a variety of foods. Continue to avoid choking hazards, such as whole grapes or hot dogs.

o   Drinks from open cup without spilling

o   Tongue retraction for swallowing 

o   Chews meats adequately 

o   “Fine tuning” all of their oral motor skills 

Who provides feeding therapy?

Either a pediatric speech-language pathologist (SLP) or occupational therapist (OT) provide feeding therapy. It is important to note that not all pediatric therapists are trained to provide feeding therapy services. Because it is an area of specialty, the treating therapist should have completed additional education courses and have experience working with this population. Also, the SLP or OT treating a child with a feeding disorder will often consult with a nutritionist/ dietician, pediatrician, or another specialist involved in the child’s care. 

 What do feeding therapy sessions look like? 

Feeding therapy sessions are family focused. Sessions can be done with the therapist and child or therapist, child and family member.

How long does feeding therapy take?

Session length and frequency depend upon the child’s individual needs. In general, feeding therapy sessions occur once a week and are typically between 30 to 60 minutes long. Prior to initiating feeding therapy, a feeding evaluation must be completed to obtain a past medical history, assess the child’s oral motor abilities, and analyze the child’s current diet. 

If you have additional questions, please contact us at OWLS Therapy to discuss more. I believe feeding therapy is extremely beneficial, as it helps your child create a healthy relationship with food. I want mealtimes to become less stressful, eating to become easier, and food to become FUN!