Pediatric Feeding & Swallowing
Children who have difficulty chewing or swallowing or have aversions to certain food textures, benefit from feeding and/or swallowing therapy. Our speech and language pathologists and occupational therapists work together to evaluate your child’s feeding challenges. Our team assesses the child’s oral structures, swallowing abilities, risk for aspiration, behavior, diet, fine motor abilities and other factors related to eating and drinking. We consult with your child’s other specialists, such as nutritionists, ENTs, GI physicians, psychologists, etc. to ensure that our therapy approach is supporting all the needs of your child. After an evaluation, we might recommend feeding therapy, a food chaining approach, and/or a home feeding program. We also can provide adaptive equipment for self feeding and/or to help properly position a child for safe swallowing.
Our goal is to improve your child’s swallowing, eating and behavior, improve his/her physical growth and development, and improve his/her nutritional status. Feeding and swallowing goals may include:
- Improve oral motor functioning required for mastication and swallowing
- Improve bolus control and timing of swallow reflex
- Decrease pocketing or oral residue
- Increase P.O. intake (food by mouth) to meet the nutritional needs of your child
- Increase acceptance of a variety of foods and food textures
- Decrease refusal behaviors associated with feeding
- Improve self-feeding by use of adaptive equipment, if necessary
- Eliminate G-Tube dependency
- Eliminate NG-Tube dependency
- Eliminate bottle dependency
- Decrease vomiting/gagging during meals
- Decrease crying and tantrums at mealtimes
- Caregiver training for carryover of skills to home environment
Frequently Asked Questions
If your child gags or chokes during meals, has difficulty managing food in his/her mouth, or is a very picky eater (refer to the question below), you should have your child assessed to determine if your child requires services.
Many children may be described by their parents as “picky eaters”, but intervention is required when feeding is problematic for the child and family. Feeding is problematic if he/she accepts less than 20 foods, refuses entire food groups (e.g. vegetables) or textures (e.g. wet foods), or does not try new foods even after 10 exposures to them. The child may cry when a disliked food is placed on his/her plate, or may even gag at the sight of it. All of these behaviors indicate a possible sensory-based feeding disorder and require a swallowing assessment.
All new patients must be assessed before beginning treatment; typically an assessment is completed in one 60-minute session and includes an evaluation of speech-language if needed. The clinician will ask questions regarding relevant medical history, complete an oral motor exam, and perform a feeding assessment. The child will be seated in a high chair or at a table, and the clinician will offer him/her various textures and types of foods so that his/her behavior may be observed.
You should come prepared with all required forms, including insurance information and the case history form. You should also bring and relevant medical documents and copies of past speech-language assessments or modified barium study results. It is also a good idea to bring any particular foods you would like the clinician to observe your child eating; while TVTS provides a variety of foods during the assessment, we are unable to maintain a supply of foods such as fresh fruits, meats, or milk.
If your child demonstrates signs and/or symptoms of aspiration or a history of aspiration pneumonia, an MBS is required to further evaluate your child’s swallowing and rule out aspiration. The speech pathologist will determine if a MBS is necessary after completing a swallowing/feeding assessment at TVTS.
A feeding therapy schedule typically consists of 2 sessions per week, for 30 minutes each. Temecula Valley Therapy Services also offers weekly feeding groups, which target oral motor, sensory, and feeding skills in a peer setting. These group sessions are 60 minutes long with a parent consultation during the last 10 minutes.