Tackling Feeding Challenges: Feeding Therapy and Finding the Right Fit

May 7, 2017 early intervention, feeding/swallowing therapy, Guest Series, March 2017 Feature - Feeding Challenges, oral aversion, oral-motor delays, refusing food, Sensory Processing Issues, speech therapy, swallow study, Tackling Feeding Challenges 0 Comments

Feeding your child is one of the most basic ways you can bond, and yet can become the one most challenging aspects of parenting for many adoptive families.

In this three-part series, Speech Therapist Melissa Pouncey will provide practical places to start working towards peaceful and healthy eating habits, along with more therapeutic information regarding feeding disorders.



Part 1: Begin with Basics
Part 2: Oral Motor Differences and Feeding
Part 3: Feeding Therapy and Finding the Right Fit

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In the first post of this series, we covered basic strategies for feeding for all children and children who may be working through a feeding disorder. In the second post, we covered general oral motor development and how oral motor- based disorders might effect speech and feeding.

And as a third and final chapter, we’ll talk through some common questions about feeding therapy and how to find the right fit for your child and family.

For many families, a feeding disorder or difference in their child can be deeply frustrating. Since food and eating is so critical not only to health and growth, but to family life – it may be a deep source of stress. The most important first step is identifying when to ask for help.



Here are some questions to ask yourself as you consider whether it might be time to seek a professional’s help on your journey:

• How long has your child been in your care?

• Does your child experience strong emotions related to mealtime?

• Does your child exhibit behavior associated with mealtime that concerns you?

• Does your child lose food from their mouth while eating or drinking? Or do you have other concerns about the WAY that eating looks for them?

• Does your child have a very limited selection of preferred foods?

If your answers were yes to questions 2-5, a feeding specialist might be able to guide you to ways to help your child specifically. Keep in mind that every child is unique and their past experiences with food may take as much time to re-create as they took to create. This means that even with good feeding therapy, it may take years to create eating habits that are healthful and appropriate, so have patience.

This also means that if you answered less than a year to question one, barring weight or serious nutrition issues, you might want to wait a little longer.



Begin seeking out a feeding specialist with your local pediatrician, social worker, or International Adoption Clinic, whichever knows more local therapeutic resources. While other parents might be good resources as well, keep in mind that professionals like these may know more resources that are research based and accredited.

Here are some questions and ideas that might lead that discussion:

• If your child is under three, you might begin with a referral to the Early Intervention program in your state. These programs are free and natural environment based, which will mean your child will be treated in your home or their daycare. This is the best model for a child learning to build attachment with you and their caregivers.

• If your child is not eligible for Early Intervention due to their age, you might need a referral to outpatient speech or occupational therapy. Both sets of therapists have training in feeding.

Questions you might ask your pediatrician:

1. Is there any reason that my child might need some testing (like a Modified Barium Swallow) before we refer to a therapist?

2. Does this clinic commonly work with feeding disorders?

3. Have you ever referred a child here who has been in foster care or has been adopted?

4. Does this clinic use a multi-disciplinary team approach? (meaning professionals work together to benefit each child)

5. Will my insurance cover this therapy?


Once you get referral information, your gut is the best tool you have in discerning whether that professional is the right fit for your child. As one family expressed: “Bad therapy is worse than no therapy at all.” Your therapist should be working to benefit your child, so if anything is being taught that causes behaviors or emotions to escalate, you might be in the wrong clinic.

Never be afraid to be an advocate for your child – they need you to be their voice! You might use a phone call and/or an initial evaluation to build an impression of that professional.



Here are some questions you might ask or things you might look for in a clinic:

• Ask about feeding training and certification, and especially about licensure. Be sure that the professionals that you’re trusting are professionals. Speech and occupational therapists have a national and state board certification. They may also have other training specifically in feeding disorders, so ask what approaches they are trained in and do your research (potentially along with your pediatrician if you need guidance).

• Ask general questions about approaches to feeding. Are their beliefs grounded in child- led play and sensory exploration? Professionals that are more play- based will be more compatible with a child learning to build trust and attachment.

• Ask their general thoughts on behavior, and rewards/ disapproval. In general, therapy that is compatible with attachment parenting should never encourage parents to withhold attention or affection to encourage their child to eat.

• Will you be in room with your child and how involved will you be in therapy? Families of children learning to build trust should be very active participants in the entire process with their child.

• Ask about home planning and how involved that professional will be with carry-over at home. Will you be working together to build a plan for your family? Can other family members gradually participate in therapy so everyone is on the same page?



Finally, a pediatric speech therapist or occupational therapist should be joyful and fun. While feeding disorders can be very serious and stressful to families, choosing a professional that puts you and your child at ease is so important. You and your family may be spending a lot of time with this person – so choose someone who wants to truly know your child and approaches them with love. Give yourself permission to make this your priority as you are selecting the right person to treat your child.

Here are some places to start:
Love Me, Feed Me
SOS Approach to Feeding
Zero to Three: Health and Nutrition

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Melissa Pouncey graduated from the University of Alabama with her MS in Communicative Disorders in 2010. She has been joyfully serving children and families with United Ability since the day after graduation in the natural environment setting, inclusive preschool, and outpatient programs. She contributed knowledge to Lifeline Children’s Services in training for social workers, and training families in Crossings. In 2016 she travelled to China with Lifeline to train caregivers in Lifeline’s foster center and several orphanages. Her specialties include international adoption, Autism, AAC for children with multiple needs, oral placement therapy for speech and feeding, and child advocacy. Melissa is state board certified as well as American Speech and Hearing Association (ASHA) certified.



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