INTRODUCTION TO FEEDING THERAPY

1. INTRODUCTION TO FEEDING THERAPY

2. 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.

3. SIGNS 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

4. INTERVENTION • 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

5. 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.

6. 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.

7. Speech 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.

8. Feeding 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.

9. 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.

10. Knowing a child’s feeding history is critical when you are providing speech and language services to a child with a speech sound disorder.