Feeding and Oral Motor Therapy

Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow it. For example, a child who cannot pick up food and get it to her mouth or cannot completely close her lips to keep food from falling out of her mouth may have a feeding disorder. Swallowing disorders can occur at different stages in the swallowing process. Children with feeding and swallowing problems have a wide variety of symptoms. Not all signs and symptoms are present in every child. The following are signs and symptoms of feeding and swallowing problems in very young children:
  • Arching or stiffening of the body during feeding
  • Failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
  • Difficulty chewing
  • Coughing or gagging during meals
  • Excessive drooling or food/liquid coming out of the mouth or nose
  • Increased stuffiness during meals
  • Frequent spitting up or vomiting
  • Less than normal weight gain or growth
  • Irritability or lack of alertness during feeding
  • Refusing food or liquid
  • Long feeding times (e.g., more than 30 minutes)
  • Difficulty breast feeding
  • Difficulty coordinating breathing with eating and drinking
  • Gurgly, hoarse, or breathy voice quality
  • Recurring pneumonia or respiratory infections
As a result, children may be at risk for:
  • Dehydration or poor nutrition
  • Aspiration (food or liquid entering the airway) or penetration
  • Pneumonia or repeated upper respiratory infections that can lead to chronic lung disease
  • Embarrassment or isolation in social situations involving eating
Oral motor therapy works on the oral skills necessary for proper speech and feeding development. These skills include: awareness, strength, coordination, movement, and endurance of the lips, cheeks, tongue, and jaw. If you suspect that your child is having difficulty eating one of our speech-language pathologists who specializes in feeding and swallowing disorders will evaluate your child and:
  • Ask questions about your child’s medical history, development, and symptoms
  • Look at the strength and movement of the muscles involved in swallowing
  • Observe feeding to see your child’ s posture, behavior, and oral movements during eating and drinking
Perform special tests, if neccessary, to evaluate swallowing, such as:
  • Modified barium swallow – child eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray
  • Endoscopic assessment – a lighted scope is inserted through the nose, and the child’s swallow can be observed on a screen.
Treatment varies greatly depending on the cause and symptoms of the swallowing problem and can include direct feeding therapy, nutritional changes, increasing acceptance of new foods or textures, changes in positioning, and behavior management techniques. The focus of feeding therapy centers on making the muscles of the mouth stronger, increasing tongue movement, improving chewing, improving sucking and/or drinking ability, coordinating the suck-swallow-breath pattern (for infants) and if necessary altering food textures and liquid thickness to ensure safe swallowing.
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