Feeding Therapy at Emerge Pediatric Therapy uses a treatment program that uses the typical developmental steps of feeding to create a systematic hierarchy of skills and/or behaviors necessary for children to progress with eating a variety of tastes and textures and achieving appropriate growth. The SOS Approach to Feeding is the primarily treatment approach used at Emerge and is appropriate for children who have a significantly restricted diet, SOS works to increase the range of foods that a child will eat. This program can be implemented in individual or group settings and includes a significant parent involvement and education component to ensure home carryover.
Our occupational therapists help children succeed in meeting the daily occupations of childhood: play, school, and self-help skills. Most of the children referred to occupational therapy at Emerge demonstrate difficulties in processing sensory input. These children misinterpret everyday sensory information, such as touch, movement and sound. They may feel bombarded by the sensory world or seek out intense sensory experiences. This can lead to difficulties with motor coordination, social/emotional challenges, school difficulties, behavioral problems, poor self-esteem and other issues. The occupational therapists at Emerge have advanced training in assessing and treating sensory processing and sensory integration disorders. They use a child centered approach, selecting activities designed to give each child the ‘just-right’ challenge to facilitate developmental and/or behavioral change and promote positive self-esteem.
What does feeding therapy look like at Emerge?
Depending upon the specific needs of the child, feeding sessions may be lead by an occupational or speech language pathologist. Feeding therapy is provided both individually and in group settings. Every feeding session begins with providing the child with organizing sensory input to prepare and regulate the body. This typically involves a structured activity in our state of the art sensory gym space. Then, the therapist, child, and caregiver transition to one of our treatment spaces. We follow a structured routine including washing hands, blowing bubbles, wiping down, and setting the table. Each person present in the session is involved in this process. The SOS Approach to Feeding emphasizes the importance of learning the routine and structure, to promote regulation and familiarity when exploring foods.
A hierarchy of foods are then presented one at a time on every individual’s plate. The hierarchy is made up of foods that are preferred and non-preferred by the child, but present with physical and sensory similarities (e.g. similar in color, texture, size, shape, etc.). Foods are explored through the sensory systems (e.g. sight, touch, smell, sound, and taste) and a play-based approach. The session is concluded when the child, therapist, and caregiver all participate in clean up.
Caregiver education is a valuable part of feeding therapy. Encouraging the caregiver to be present during the session can serve as a valuable tool for learning how to use the SOS Approach to Feeding at home with their child. Tips, strategies, and skills are provided during each session to support increasing the child’s food repertoire at home and school environments.
Here are some signs of feeding difficulties:
- Ongoing, poor weight gain, weight loss
- Ongoing gagging, coughing, and choking during meals
- Ongoing problems with vomiting
- More than one incident of gastro nasal reflux
- History of traumatic choking accident
- History of eating and breathing problems combined with ongoing respiratory issues
- Inability to transition to baby purees by 10 months
- Inability to accept any table foods by 12 months
- Inability to transition to cup by 16 months
- Has not weaned off all or most of baby food by 16 months
- Avoidance or aversion to foods of a specific texture or food group
- Food range of less than 20 foods
- An infant who cries or arches their back during meal time
- The family is fighting about feeding and meal time.
- Caregiver reports the child is difficult for everyone to feed.
- Family history of eating disorder, combined with a child with poor weight gain
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Books about Feeding
While nothing can replace the value of having a trained- feeding speech or occupational therapist to evaluate, treat, and help guide you through picky eating challenges, we cannot dismiss the importance of a good book. Additional reading will help you further develop understanding of the complexities of feeding – an act we often take for granted as simple.
Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet (2007) by Cheri Fraker. This book explains what Food Chaining is (focusing on the relationships between different foods) and how to use it to expand the diet of a child who is a picky eater.
Raising a Healthy, Happy Eater: A Parent’s Handbook: A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating Paperback (2015) by Nimali Fernando and Melanie Potock. This book provides advice specific to age/stage, real-life stories, insights into how different cultures approach food, and information related to the sensory system to help parents and caregivers expand a family’s diet, avoid picky eating “traps,” and how to identify special feeding needs.
Broccoli Boot Camp: Basic Training for Parents of Selective Eaters Paperback (2018) by Keith E Williams and Laura J Seiverling. This book is a guide for parents of picky eaters using behavioral interventions to expand a children’s diet. The basis of the book is that children are encourage to try very small portions of new foods repeatedly. The book includes real-life case studies and research findings that support the behavioral interventions suggested to improve compliance and strategies to shape behaviors surrounding meal time. The authors provide 5 intervention plans, explained step-by-step, for parents to choose from depending on needs.