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Debbie's Blog - feeding therapy

Feeding Therapy - Moving Beyond Food Prep


Question: I am working with a 7 year old girl in feeding therapy who is refusing to open her lips and just purses. She has been involved heavily in food preparation which she enjoys foing and shows great participation.  However when it comes to the taste testing part she refuses all foods. She does eat ham and prunes.  I have tried to get her to chain to other types of ham but she refuses. I have gotten her to put a spoonful of food on a spoon and hold it in her mouth for ten seconds, but then she just spits it out. She lives with her grand parents who have been no help with the situation.  Any medical issues have been ruled out and she does not have any sensory or oral motor issues.  Any further suggestions?

Try having her actually manipulate and play with food.  Make faces with it, smash it, squash it, mold it, finger paint with it, etc.  It’s fantastic that she enjoys being involved with food prep, but she needs to manipulate it in her palms too.  So play with cookie dough as edible 'play dough' - cut out shapes and make cookie dough men.  Roll out a canvas and "paint" on it with yogurt or applesauce and so forth. Pinterest is a great source of inspiration here.

Go through a pattern of touching it to the hand first, then the arm, shoulder, top of head, nose, cheek, chin, touch it above the lips to make a “mustache,” run it over the lips to put on “lipstick,” use it as a “toothbrush” to brush the teeth, “paint” the tongue, etc. 

Regarding the food chaining, for some kids you can change the whole piece of ham / brand.  But for her, try backing up and making very tiny TINY adjustments.  For example, incorporate a little piece of a different type of ham (very small – smaller than your pinky fingernail) with the other ham she likes as a start.  

You can also try putting the mushy part of the prune (I think you can open up prunes and scrape out something spreadable?) on a ritz cracker and have her lick it off the cracker. Just licking the prune for now – she doesn’t have to eat the actual cracker (even if she licks a preferred food off of a new non-preferred food, that's progress).

If she’ll eat the ham with mayo, put a tiny tiny dot of mustard in the mayo. Next session put 2 dots. Work up from there very very slowly.

It's definitely not ideal that there’s no home follow-through, but she’s getting there!



Food Aversions & Spoon Feeding Issues

Question:  Hi, I have a toddler who is almost 2 years old, have sensory processing disorder.  He also has feeding aversion. and super sensitive to texture & taste.  Some goals I am looking to achieve: desensitize the oral aversion, teaching him to eat different textures, making spoon-feeding fun (he is now fighting spoon-feed) and teaching [...]

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75+ Feeding Therapy Tips & Strategies

For any therapist seeking to specialize in feeding, the best piece of advice I could give you is to become a sponge.  Take courses and workshops, read as many articles as you can, talk to and learn from your colleagues, join special interest groups on Facebook and ASHA etc., follow blogs, observe other therapy sessions, [...]

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The Oral Motor Benefits of Straws

Whenever a parent asks me what they can do to improve their child’s oral motor skills, one of my first questions is usually:  Are they drinking from straws yet? Drinking from a straw is a very simple yet effective way of improving one’s oral motor skills.  It works on lip seal, tongue retraction, cheek strength, correct [...]

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Feeding Issues from Reflux

Question:  I’m seeking help for our son. The short story is that my son was born at 25 weeks and was in the nicu for 3.5 months and has overcome many things.  When he left the nicu he was always a tough feeder (fussy) but always ate plenty by bottle. Then during a re admission, his [...]

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Food Pocketing in the Lips, Cheeks, and/or Gums

Question:  My four year old daughter pockets food in her lower gums.  Foods like pizza, chicken, egg whites, etc. (that do not melt like crackers or cookies).  She will simply let it stay in her gum pockets until she looks like a chipmunk and eventually we will have to remove it with our fingers.  She is not able [...]

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The Right and Wrong Way to Spoon Feed

Did you know that there is a right and wrong way to spoon feed?  The wrong way involves lifting your hand upward as you remove the spoon from the child’s mouth.  This method scrapes the spoon against the teeth, gums, and/or upper lip to get food off of the spoon. . . Scraping is not the normal, natural [...]

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“Think Outside the Plate” Feeding Therapy Techniques

Kids naturally like to discover and learn new things - that’s why they break things, take them apart, get into trouble, etc. - it’s all a part of the learning experience. But when it comes to feeding/eating, sometimes kids get stuck.  For one reason or another they stop trying new foods and exploring different textures.  When [...]

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The Importance of Supporting Children Who Have Eating Problems

Hello, I am the mother of an almost 12 year old daughter.  It has been a struggle ever since she moved from baby food to regular foods to get her to eat fruits or vegetables.  Thankfully, she remains healthy so far, but I am concerned about her health long-term with her limited intake of nutritional foods. [...]

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Training the Oral Musculature with Lip Bloks

Hi!  I have a 2 year old patient (12-14 month old skill level) who has significant tongue protrusion when attempting to drink out of a cup - this is not noted during any other feeding activities.  I think it's because she was exclusively bottle-fed for up to 20 months. I bought some lip blocks and the [...]

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