The occupational therapists here at San Diego Occupational Therapy are experienced in treating children with feeding challenges related to organic and sensory disturbances. Our therapists watch your child eat, observing mealtime behaviors, oral motor skills, and sensory interactions with foods. When feeding therapy is determined necessary, San Diego Occupational Therapy uses the Sequential Oral Sensory (SOS) approach to feeding, as well as other behavioral, oral motor, and medical management strategies to support your child’s feeding development .
For tips on feeding, or if you would like to know more about typical oral motor and feeding development, please contact us for educational resources.
Is my child a candidate for feeding therapy?
Yes, if they present with any of the following:
- Ongoing poor weight gain (percentiles falling) or weight loss
- Ongoing choking, gagging, or coughing during meals
- Ongoing problems with vomiting
- More than one incident of nasal reflux
- History of traumatic choking incident
- History of eating and breathing coordination problems, with ongoing respiratory issues
- Inability to transition to baby food purees by 10 months of age
- Inability to accept any table food solids by 12 months of age
- Inability to transition from breast/bottle to a cup by 16 months of age
- Inability to be weaned off of baby foods by 16 months of age
- Aversion to or avoidance of a wide repertoire of tastes, temperatures, and textures of foods
- Diet consists of less than 20 foods, especially if accepted foods are being dropped over time with no new foods replacing those lost
- An infant who cries and/or arches during most feedings
- Family is fighting about food and feeding (meals are battles)
- Parent repeatedly reports that the child is difficult for everyone to feed
- Parental history of an eating disorder, with a child not meeting weight goals
- Child over-stuffs his/her mouth with food
A child who exhibits any of these difficulties is likely a candidate for a feeding evaluation. As part of the assessment, the parent and child will be observed eating and engaging with a variety of preferred and non-preferred foods. An occupational therapist will observe the child for signs of oral motor difficulties, as well as sensory defensiveness and/or hypo-responsiveness, which may contribute to the child’s eating difficulties. Upon completion of the evaluation, a comprehensive assessment report complete with findings and recommendations will be forwarded to the client and referring physician.
What is a feeding disorder?
A child with a feeding disorder has difficulties related to eating or drinking. There are many different types of feeding challenges, and no two children have the same problem. For example, some children do not eat food by mouth and may be fed by a tube. Some children do not eat enough or do not have a balanced diet because they eat a limited number of foods, leading to poor weight gain and growth. Sometimes, a child may have behavioral challenges during meals, such as screaming or throwing tantrums, which causes the meal to be very stressful for the child and family. Other children may have problems with effective chewing or swallowing. Finally, medical factors, such as vomiting from GI issues, reflux, or respiratory issues, may play a role in a child’s feeding disorder.
There is no exact reason as to why some children have feeding problems. Some children experience feeding difficulties because of underlying medical problems (ex: reflux) that cause eating to be painful or effortful. Some children who are premature or very sick as infants are unable to eat orally at first, and they never learn how to utilize efficient chewing patterns or that eating is fun! Some children may have oral motor deficiencies, and they do not seem to know how to manipulate food in their mouths or swallow. Children may have oral sensitivities or defensiveness, causing them to seem afraid of food, or things coming near their face or mouth. Some children may have a decreased appetite and don’t care to eat! Regardless, children who do not eat enough or who do not eat a variety of nutrients, tastes, and textures may be at risk for learning and behavior problems later on.
Over time, we have realized that parents feel very alone when it comes to their child not wanting to eat. In fact, food refusal is a growing epidemic in children. Recent statistics reveal that one in four children have some sort of feeding disorder. Food refusal can take the form of food selectivity, G-tube (gastrostomy tube) or NG-tube (nasogastric feeding tube) dependency, bottle dependency, texture selectivity, or poor oral intake in general.
For more information on Feeding Therapy, please contact us.