Helping Children Overcome Feeding Struggles, Supporting Parents with Meal-Time Challenges

That’s where feeding therapy can come in. It’s a type of therapy parents might not know is available, yet it can be life changing for them and their child.

What is Feeding Therapy?

Feeding therapy is focused on helping target specific areas of concern for a child, such as expanding their food repertoire, increasing their ability to swallow safely, improving their chewing and supporting a positive mealtime structure.

Unlike traditional occupational therapy, which may address general daily living activities, feeding therapy homes in on oral motor skills and the sensory aspects of eating. And unlike standard speech therapy, which focuses on communication and language, feeding therapy targets the coordination needed for chewing and swallowing. This helps children manage challenges like prolonged chewing, gagging or concerns about choking.

Signs a Child May Need Feeding Therapy

While picky eating is common, there are times when feeding challenges may signal something more. Signs a child could benefit from feeding therapy include:

• Eating a very limited variety of foods (fewer than 20 total foods overall)
• Frequent gagging, coughing or choking during meals
• Avoiding entire food groups or textures, such as vegetables, meats, crunchy foods, or wet foods
• If there are concerns about growth or weight gain
• Mealtimes that feel stressful or require highly specific strategies to encourage the child to eat

For families navigating daily stress around meals, a feeding evaluation designed to uncover a child’s feeding challenges could be the key to understanding what is really going on and finding practical solutions.

What Happens During an Evaluation?

A comprehensive evaluation includes a multi-tiered approach and can last up to two hours.

“We start with an in-depth assessment of feeding history and current feeding concerns,” explained Kirstin Nelson, MS, RDN, CSP, pediatric dietitian at Northern Arizona Healthcare Children’s Health Center. “Each pediatric health care discipline, from occupational therapy, speech-language pathology and dietetics, assesses the child. We observe them eating a variety of foods, including both preferred and non-preferred items. During this observation, the speech language pathologist evaluates oral-motor skills, while the occupational therapist observes self-regulation and sensory processing.”

Evidence-Based Therapeutic Approaches

Therapists use a variety of approaches depending on the child’s needs:

• Sequential Oral Sensory (SOS) Approach: a child-centered, family-based therapy that uses intrinsic motivation to engage the child in play and exploration of foods. This is especially helpful for children with strong sensory sensitivities or oral-motor delays.
• Food Chaining: Expands a child’s diet by linking familiar foods to new ones with similar taste, texture or appearance.
• Responsive Feeding Therapy (RFT): Encourages trust and autonomy, allowing the child to decide if and how much to eat while parents provide structure around meals. This is especially helpful by building a positive relationship with food and fostering the connection that occurs with caregivers around the mealtime experience.
• Beckman Oral Motor Protocol: A hands-on approach that targets strengthening and coordinating the lips, tongue, cheeks, and jaw to improve oral-motor coordination for developing chewing and swallowing.

“These are just some of the approaches we explore with our patients,” said JunLi Gallagher, MS, CCC-SLP, speech language pathologist at Northern Arizona Healthcare Children’s Health Center. “Using a blend of elements from each approach creates a specific plan of care that is tailored to each child’s specific needs, ensuring mealtimes become safer, more positive and more successful.”

Parents are Key Partners

Parents play a central role in feeding therapy. As feeding struggles can take an emotional toll, this partnership ensures skills practiced in therapy carry over to daily meals.

“It can be very stressful when parents feel they are unable to feed their child,” said Nelson. “Children with pediatric feeding disorders may have skill deficits, sensory challenges or medical conditions making it difficult to eat a wide variety of foods.”

Nelson added because this can feel so daunting at times, they have a social worker on staff who can connect parents with mental health support, if needed.

Thoughtful Support

Ultimately, feeding therapy is about more than nutrition; it supports safety, growth, skill development and a healthier relationship with food.

For parents facing ongoing mealtime challenges, having an initial conversation with a pediatrician or feeding specialist can help determine next steps. FBN

By Mary Marini Parra, FBN

Courtesy Photo: Feeding therapy can expand meal options for picky eaters and meal-time peace for their families.