How a Dietician, a Speech-Language Pathologist, and an Occupational Therapist can Determine if your Child Needs Feeding Therapy
There are many aspects of feeding to take into consideration when completing an initial feeding team evaluation. This is why it is extremely important to have a team of therapists evaluating your child. First and foremost, a Dietician is an important part of the team. He or she will calculate your child’s body mass index (BMI) to see if he or she is falling on or off of the growth chart. The Dietician will look at the foods your child consumes each day and will recommend foods which may add or eliminate calories. He or she will be able to provide a nutritionally dense program to meet your child’s individual needs. Next, the Speech-Language Pathologist (SLP) will take a look at the structures of your child’s mouth. The SLP will look to see if your child’s teeth are aligned enough to completely chew foods in order to prepare for a safe swallowing experience. The SLP will look at the shape of the hard palate/roof of the mouth, symmetry of the tongue, cheeks, and lips, as well as the size of the tonsils, if still intact. All of these structures play an important role in swallowing foods. Next, the SLP will look at the strength of the cheeks, lips, tongue, jaw and determine if the child displays proper strength to chew and swallow foods as well as observe if your child uses all of the oral musculature when swallowing. If your child does not, this may indicate signs of chewing and swallowing difficulties.
Following these examinations, the Occupational Therapist (OT) will look at how the child reacts to various textures of foods. Some children are aversive to foods that are “slimy” like pudding or mixed textures like sandwiches. Each child is different and the aversions each child exhibits will vary. The final component of a feeding team is the Behavior Therapist. So many children start to develop negative, controlling behaviors which stem from aversions, inability to properly chew and swallow foods, or from histories of acid reflux and/or constipation. When a child refuses food, it does not always mean they do not want that food; it may mean they cannot eat that particular food for the above reasons. As parents, we just see refusal and this is where the Behavior Therapist comes in to play. He or she will recommend strategies to turn this refusal around. All in all, it is extremely important to be evaluated by a team of people, rather than one individual therapist, due to the in-depth nature of feeding itself.