How a Dietician, a Speech-Language Pathologist, and an Occupational Therapist can Determine if your Child Needs Feeding Therapy
Dietician
There are many aspects of feeding to take into consideration when completing an initial feeding team evaluation. It is essential to have a team of therapists evaluating your child. First and foremost, a Dietician is an integral part of the team. They will calculate your child’s body mass index (BMI) to see if they fall on or off the growth chart. Next, the Dietician will look at the foods your child consumes each day and recommend foods that may add or eliminate calories. They 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.
Speech-Language Pathologist
The SLP will see if your child’s teeth are aligned enough to chew foods, to prepare for a safe swallowing experience thoroughly. Next, the SLP will look at the shape of the hard palate/roof of the mouth, symmetry of the tongue, cheeks. In addition, to and lips, as well as the size of the tonsils, if still intact. All of these structures play an essential 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 musculatures when swallowing. If your child does not, this may indicate signs of chewing and swallowing difficulties.
Occupational Therapist
Following these examinations, the Occupational Therapist (OT) will look at how the child reacts to various textures of foods. For example, some children are aversive to “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. Additional, the inability to chew and swallow foods correctly, or from histories of acid reflux and 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 see refusal, and this is where the Behavior Therapist comes into play. They will recommend strategies to turn this refusal around. It is essential to be evaluated by a team of people rather than one individual therapist due to the in-depth nature of feeding itself.