INTRODUCTION TO

FEEDING THERAPY

WHAT IS FEEDING THERAPY?WHAT IS FEEDING THERAPY?

• Feeding disorders include problems with accessing and/or appropriately responding to food and the ability to suck, chew, or swallow it. For example, a child who cannot completely close her lips to keep food from falling out of her mouth or who gags at the sight of food may have a feeding disorder.

SIGNS AND SYMPTOMSSIGNS AND SYMPTOMS

• Difficulty coordinating breathing with eating and drinking

• Refusing food or liquid

• Failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)

• Difficulty chewing

• Coughing or gagging during meals

• Recurring pneumonia or respiratory infections

INTERVENTIONINTERVENTION

• Medical intervention (e.g., medicine for reflux)

• Direct feeding therapy designed to meet individual needs• SLP vs. OT vs. Registered Dietician• increasing acceptance of new foods

• Oral-motor skills vs. Oral-sensory• food temperature and texture changes• postural or positioning changes (e.g., different

seating)• behavior management techniques

Aha Moment!!!Aha Moment!!!

We DO NOT have two oral-motor systems

•Feeding and speech control systems are related.

•Feeding skills are not pre-requisites to speech-sound development; however, children with feeding disorders are at risk for delayed speech development and/or speech sound disorders.

Clinical experience and evidence from the work of Suzanne Evans Morris, Ph.D. supports the view that when a child experiences difficulty with oral control in feeding, there is a strong likelihood of that child having similar oral control problems in sound production and speech development.

Speech Sound DevelopmentSpeech Sound Development

Cooing, Babbling, Oral-exploratory play:

Allows the child to practice oral-motor movement associated with sensory input and sound to support later developing speech sounds and the flexibility in movement needed for more complex sound sequencing.

Feeding DevelopmentFeeding Development

• The infant transitions from breast or bottle feeding to spoon feeding with smooth pureed textures to finger feeding with higher textured foods (soft solids to something more crunchy but melt-able like a graham cracker.)

• As a toddler, the child begins to experiment with an increased variety of food types.

Feeding development also allows the child to develop a flexible oral-motor system critical for speech sound

production.

• A parallel in development occurs in the movements considered necessary for speech production and the movements that occur in the development of feeding skills.

• There are many similarities between the movements that an infant would experience during feeding and those movements that are combined with sound play at a slightly later time.

• Infants do not usually develop the movements in their sound play before those movements appear in feeding.

• The tongue, lips, cheeks and jaw are engaged in the process of sensorimotor differentiation that sets the stage for speech

EX: By 6-9 months, when babbling emerges and reaches its heights, lip movements have been used to eliminate the loss of liquid during bottle feeding and to remove food from the spoon.

Knowing a child’s feeding history is critical when you are providing

speech and language services to a child with a speech sound disorder.