Clinical Feeding Evaluations and Treatment;

Feeding disorders are conditions in which an infant or child is unable or refuses to eat, or has difficulty eating, resulting in weight loss, malnutrition, lethargy, impaired intellectual and social-emotional development and growth retardation.

In the most severe cases, children cease oral eating altogether, necessitating nasogastric or gastrostomy tube placement and feedings.

Feeding disorders develop from a combination of medical/physiological, developmental, behavioral and psychosocial factors.

Our Feeding Disorders Program at Play Works is a multidisciplinary team consisting of:

  • Registered Dietitians
  • Occupational Therapists
  • Speech/language Pathologists

Our pediatric speech-language pathologists specialize in the evaluation and treatment of pediatric feeding & swallowing disorders. Specialized training includes the SOS Approach to Feeding , Talk Tools, and the Beckman Oral Motor Protocol. 

We are experienced treating children with: 

  • nervous system disorders (e.g., cerebral palsy)
  • gastrointestinal conditions (e.g., reflux)
  • prematurity and/or low birth weight
  • cleft lip and/or palate
  • autism
  • muscle weakness in the face and neck
  • multiple medical problems
  • problems with parent-child interactions at meal times

Every child has different needs, but some goals may include:

  • Increasing the types of food textures a child will eat
  • Helping the child accept new kinds of foods
  • Encouraging the child eat bigger amounts of foods
  • Assisting children who are at risk for G-Tube placement, to increase food intake and prevent the child from needing to be tube-fed.
  • Helping children who already have a G-Tube to increase oral food intake and decrease the need for tube feedings. (The long-term goal is to have the G-Tube removed.)

Feeding your child is emotional: It’s about nurturing, bonding, love and responsibility as a parent.  When feeding is challenging, it’s stressful and it impacts the entire family on a daily basis. Let our therapists guide you and your child through your child's individualized program. 

Sequential Oral Sensory (SOS) Approach 

The SOS (Sequential Oral Sensory) Approach to Feeding program is an effective way to address problematic feeding behaviors in a variety of settings and populations. Parents and caregivers of children who will not eat are faced with a difficult and often puzzling challenge. Because the interplay between weight gain and a child’s experience of food can be complicated, there is rarely an easy solution when a feeding problem arises. The SOS Approach assess the “whole child”: organ systems, muscles, development sensory, oral-motor, learning/behavior, cognition, nutrition and environment. The SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food and allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her; then moving on to touching, kissing, and eventually tasting and eating foods. Oral motor skills for safe and effective eating are also evaluated and treated. Movement patterns of the lips, tongue, jaw and cheeks are very important to a child’s successful eating.

Picky Eater? ... Or Problem Feeder?

Picky Eaters:

  • Decreased range or variety of foods that will eat = 30 foods or more
  • Foods lost due to “burn out” because of a food jag are usually re-gained after a 2 week break
  • Able to tolerate new foods on plate and usually can touch or taste a new food (even if reluctantly)
  • Eats at least one food from most all food texture groups
  • Frequently eats a different set of foods than the rest of the family, but usually eats with the family
  • Will add new foods to repertoire in 15-25 steps on Steps to Eating Hierarchy
  • Sometimes reported by parent as a “picky eater” at well-child check-ups

Problem Feeders:

  • Restricted range or variety of foods, usually less than 20 different foods
  • Foods lost due to food jags are NOT re-acquired
  • Cries and “falls apart” when presented with new foods
  • Refuses entire categories of food textures
  • Almost always eats different foods than the family
  • Adds new foods in more than 25 steps
  • Persistently reported by parent as a “picky eater” across multiple well-child check-ups