Oral Motor and Feeding Therapy

What feeding therapy addresses

Feeding is one of the most complex things a young child does. It involves the coordination of dozens of muscles, an intact swallow, the sensory tolerance to accept a texture and a smell, the postural stability to sit upright, and enough calm to be willing. A difficulty in any one of those areas can make eating hard, and from the outside they can look identical at the dinner table.

Our first job is working out which of them is actually the problem. A child who gags on lumps because of sensory sensitivity needs a different plan than a child who gags because they cannot manage the texture with their tongue, and both differ from a child who is not swallowing safely. Treating the wrong one wastes months and can make a child more resistant.

This is why we start with a careful evaluation rather than with a strategy. When there is any question about swallowing safety, we coordinate directly with your child’s physician, and we will recommend further medical assessment when that is the right call rather than working around it.

Most of the children we see for this are toddlers and preschoolers. Feeding therapy for toddlers looks different from what parents picture: less mealtime and more play, and often running alongside speech and language therapy, because the same muscles and frequently the same evaluation are involved.

Picky eating and something more

Most young children go through a phase of narrow preferences, and most of it resolves. What concerns us is a pattern that is getting narrower over time, a child whose accepted foods number in the single digits, distress that goes beyond refusal, or growth that is falling off. Those are worth assessing rather than waiting out.

We are deliberate about not turning meals into a battle. Families who arrive here have usually tried pressure, rewards and negotiation, often on well-meaning advice, and have found the situation getting worse. Pressure at the table reliably increases refusal in children who are struggling. A large part of early feeding therapy is lowering the temperature at home so a child can be curious about food again.

Who feeding therapy helps

Reasons families come to us for feeding support:

• Accepting only a very small number of foods, with the list shrinking over time
• Gagging, choking or coughing during meals
• Refusing entire textures or food groups
• Long mealtimes, often more than 30 to 40 minutes
• Difficulty moving from purees to lumps or from bottle to cup
• Distress, crying or escape behavior at the sight of food
• Poor weight gain or growth concerns raised by a pediatrician
• Wet or gurgly voice during or after eating and drinking

We support children whose feeding difficulties occur alone and children whose difficulties relate to:

• Sensory-based food avoidance
• Oral motor skill difficulties
• Autism spectrum disorder
• Prematurity and early medical history
• Reflux and other gastrointestinal conditions
• Tube feeding and transition to oral eating
• Cleft palate and other structural differences
• Developmental delay

This list is not exhaustive and nothing on it is a diagnosis. If something here sounds like your child, an evaluation is the way to find out what is actually going on.

What a session looks like

Feeding sessions move at the pace the child can tolerate, which is often slower than parents expect at first. That pacing is deliberate and it is usually why progress holds.

1. Building safety before bites

   For a child who has learned to fear food, early sessions may involve no eating at all. Tolerating a food nearby, touching it, or exploring it is real progress and the necessary first step.

2. Working up the ladder

   Your therapist moves gradually through steps of interaction with a food, from proximity to touch to taste, never skipping ahead past what a child can manage.

3. Oral motor skill building

   Where the difficulty is skill rather than tolerance, sessions build the specific chewing, tongue and lip movement a food requires.

4. Coaching the family table

   Your therapist works with you on how meals run at home, including seating, timing, what is served and how the family responds, because that is where most of the eating happens.

Credentials

Our feeding therapy is delivered by licensed clinicians with additional training specific to pediatric feeding:

• Licensed speech-language pathologists holding the CCC-SLP, and licensed occupational therapists holding the OTR/L
• Current Georgia licensure in their discipline
• Additional continuing education specific to pediatric feeding and swallowing
• Coordination with your child’s physician on any concern involving swallowing safety

This page is not a diagnosis and nothing on it is medical advice. If something here sounds like your child, an evaluation is how you find out what is actually going on.