The Role the Speech-Language Pathologist Plays

Feeding Assessment and Therapy

Speech-language pathologists play a very important role when working with children who have feeding difficulties and/or are picky eaters. Speech-language pathologists have knowledge of typical oral motor development and its relationship to feeding. All of the different types of oral motor skills are tied together with gross motor control. For babies ages 0-6 months, the typical oral motor skill is a suckle. But as the baby reaches 6-9 months, he/she needs to be rolling and sitting to ensure he/she can develop a good sucking motion. Chewing is directly tied to the gross motor skill of standing and walking. A vertical chew, therefore, occurs at approximately 8-12 months when the child is standing. When the child begins walking (12-36 months), he/she is learning a rotary chew which is a much more complex kind of chew that takes at least 2 years to fully develop. It is understandable, therefore, that feeding a child that is not developmentally ready will be very challenging. For instance, a child who does not have a strong core will have more difficulty with spoon-feeding. Working through the developmental stages and not looking at a child’s age is what is very important when a speech-language pathologist assesses and treats a child. Some Tips:

Spoon feeding plays a very important role in oral motor development. Parents can feed their child and teach them to manage the correct volume of food. Spoon feeding teaches lateral chewing and helps move the bolus of food from front to back. The oral motor pattern of spoon-feeding is important for munching and tongue lateralization.

By 24-36+ a typically developing child should manage a regular diet e.g. hamburger, chicken nuggets. At this stage, the child will be mastering a rotary chew.

Prior to eating it is helpful to slow things down for about 5 minutes e.g. sing some calm songs. Help get your child ready for mealtime.

In children who are picky eaters eating is the final goal but short term goals may include touching and licking non-preferred food.

When a child is referred to us for an assessment, we look at his/her oral structures, oral reflexes, non-nutritive suck, gross motor skills and respiratory skills. There are so many strategies and suggestions we can give to parents to help make eating a more enjoyable experience for the child. Medical referrals are made if necessary and working together with a dietician, primary care doctor or pediatrician may be an important part of the therapy process. The overall goal is to make eating a positive experience for the child and his/her family.