Feeding Difficulties: Cawn/Krantz & Associates: Speech Language Occupational Therapy


Eating is a highly complex act, relying on the respiratory, postural, oral-motor, and sensory systems of the body. Challenges in one of these areas may disrupt the intricate timing and coordination of the body's overall "eating system." This disruption can result in a child who experiences eating as a challenging, unpleasant job rather than as an enjoyable, rewarding experience.

All children display the tastes of a "picky" eater at some stage in their development. However, in situations where this behavior begins to significantly affect a child's health or emotional well-being, there is reason for concern. Eating patterns become a concern when they affect a child's physical growth, nutritional needs, and his/her happiness around mealtime.

Because numerous factors contribute to feeding difficulties, an extensive and comprehensive feeding evaluation is essential. Evaluations are provided by a team of therapists—including speech/language pathologists, occupational therapists, and a social developmental practitioner—who specialize in treating children exhibiting feeding difficulties. During the evaluation, therapists assess the functioning of the child's oral-motor, sensory processing, respiratory, and postural tone systems and examines the child's eating patterns with favored solids and liquids. A comprehensive conference with parents, caregivers, and associated medical professionals is also part of the evaluation process and includes discussion of the child's:

  • Medical history (e.g., surgeries, swallowing difficulties, structural anomalies)
  • Related health difficulties (e.g., gastric reflux, allergies, choking, non-oral feedings)
  • Respiratory difficulties
  • Development of eating (e.g., breast/bottle/cup, finger feeding and utensil usage)
  • Mealtime comfort, routines, and home and outside-home (e.g., restaurants or school vs. home) settings
  • Variety of textures and consistencies of favored foods
  • Sensory aversions to food (e.g., avoidance, gagging, shuttering, choking, spitting)
  • Caregiver/parents feeding interventions or attempted behavioral strategies

A treatment program that addresses the complexity of this disorder has positive and successful outcomes.

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