Therapy & Wellness Connection offers feeding & swallowing therapy for children with feeding disorders, swallowing disorders, and avoidant/restrictive food intake disorder (AFRID). Our dedicated Cleveland speech-language pathologists are highly skilled in assessing and treating a broad range of disorders and conditions that impede the critical life processes of eating, drinking, or swallowing.
When your child isn't eating well - whether because they physically can't or because they're extremely avoidant to most foods - the adverse impact can snowball into pretty much every other area of growth and development.
The American Speech-Language Hearing Association (ASHA) explains that feeding disorders are diagnosed when a child has a tough time with things like sucking, eating from a spoon, chewing, or drinking from a cup. Swallowing disorders, on the other hand, are identified when a child has difficulty (often related to a medical condition) with moving food or liquid from the mouth to the throat/esophagus to the stomach. Avoidant/restrictive food intake disorder is characterized by an apparent lack of interest in eating or food, sensory-based avoidance, or anxiety over adverse consequences of eating.
Kids who struggle with feeding & swallowing disorders may experience:
- Nutritional deficits
- Unhealthy weight loss
- Gastrointestinal issues
- Impeded growth/development
- Difficulty sleeping
- Trouble thinking
- Failure to maintain energy necessary for key life tasks
- Higher risk of choking
There's also the social component to consider. While we all must eat to live, the fact is that no matter where we come from, so many of our cultural traditions, community gatherings, and social connections as humans are centered around food: Regular evening family meals, big Sunday dinners, holiday feasts, birthday parties, and school cafeteria lunches. Children with feeding & swallowing disorders may feel excluded from these important bonding experiences.
Our Cleveland speech-language pathologists can help. We provide feeding & swallowing therapy interventions and strategies for kids of all ages - from infancy through high school.
Who Needs Feeding & Swallowing Therapy?
According to analysis by The Journal of Pediatrics, pediatric feeding & swallowing disorders are "woefully understudied," despite 1 in 4 children have some form of one or the other.
Kids with certain conditions like Down Syndrome, autism spectrum disorder, congenital heart defects, cerebral palsy, fetal alcohol syndrome, premature/low birth weight, or ADHD are at much higher risk of having a feeding and/or swallowing disorder. In fact, 8 in 10 children with developmental disabilities also has a feeding or swallowing disorder.
Golisano Children's Hospital identifies some of the root causes of feeding disorders to include:
- Poor oral motor skills
- Low muscle tone or high muscle tone
- Nervous system disorders
- Developmental delays
- Child temperament (easily over-stimulated, slow to adapt)
- Head or neck problems
- Breathing difficulties
- Slow emptying of the stomach
- Pain or discomfort (often due to allergy or reflux)
- Negative experiences while feeding (gagging, pain, coughing, vomiting)
- Negative experiences related to the mouth (prior oral surgeries, oral procedures, NG tubes, or being on a ventilator)
- Sensory differences (hypersensitivity to smell, texture, taste, etc.)
- Chronic health issues (regular seizures, dental issues, respiratory infections, ear infections)
- Certain medications
- Parent-child conflict/anxiety
Swallowing disorders, or dysphagia, are a type of feeding disorder that involves physical difficulty with swallowing. Lots of us take the act of swallowing for granted as an instinctual process. The reality is it's pretty complex. You have the tongue, mouth, jaw & throat muscles, saliva production, teeth - and all of these have to work in perfect synch and sequence to make more than dozen movements necessary to successfully swallow. You have to chew and moisten the food, push that food into the pharynx (and not the epiglottis/windpipe), and then move it by muscles/gravity into the stomach. Issues with any little part of that process, and your child will have a tough time swallowing.
As for the causes of swallowing disorders, it's often a structural defect, such as a cleft lip, cleft palate, or tracheosophageal fistula. It could also stem from chronic conditions like GERD. Sometimes problems start at birth, and sometimes we don't see it really become an issue until the introduction of solid foods.
And then we have kids with avoidant/restrictive food intake disorder (ARFID). This is especially common among children with autism and sensory processing difficulties. The condition is characterized in the DSM-5 as an eating or feeding disturbance that manifests with persistent failure to consume enough/the right kids of foods in order to meet appropriate nutritional and/or energy needs for a kid their age. Unlike other feeding disorders, this diagnosis takes nutritional deficiencies, rather than skill deficits, into account. In the past, these kids might have simply been dismissed as "picky eaters." But there's more to it than that, and the risk of not treating it can result in significant weight loss, major nutritional deficiencies, or dependence on enteral feeding or supplements. It can also have a negative impact on the child's psychosocial function.
How an SLP Can Help Your Child
Our Cleveland speech-language pathologists use various feeding and swallowing therapy interventions - uniquely tailored to each individual child's needs - to address these difficulties. Ultimately, our goal is for every kid to have the necessary tools and skills to enjoy a variety of nutritional foods that will keep them healthy, happy, growing, and connected.
Some of the intervention strategies our pediatric SLPs employed in feeding & swallowing therapy:
- Oral Motor Exercises: These exercises target specific muscles involved in feeding and swallowing to improve strength, coordination, and mobility. Examples include tongue exercises, lip and cheek exercises, and jaw stabilization exercises.
- Sensory Stimulation: SLPs may use different sensory techniques to increase or decrease oral sensitivity, depending on the child's needs. These can include introducing various textures, temperatures, tastes, and smells to the mouth, promoting desensitization or increased awareness.
- Positioning and Postural Strategies: Adjusting the child's body position during feeding can greatly impact their ability to swallow effectively. SLPs may provide guidance on optimal positioning techniques, such as adjusting the head, neck, and trunk alignment to facilitate safe and efficient swallowing.
- Modified Food and Liquid Consistencies: If a child has difficulty with certain textures or consistencies, the SLP may recommend modifying the food and liquid textures to make them easier to manage. This can involve thickening liquids, puréeing or blending foods, or gradually introducing different textures. Same can be done with textures.
- Feeding and Swallowing Strategies: SLPs often provide specific strategies to enhance safe and efficient swallowing during mealtimes. These strategies may include modifying bite sizes, using specific chewing patterns, utilizing compensatory strategies, or implementing pacing techniques to optimize swallowing function.
- Oral-Motor Feeding Therapy: This type of therapy involves providing the child with opportunities to practice feeding skills using appropriate food textures. The SLP may guide the child in learning and refining the oral motor movements necessary for chewing, swallowing, and managing food effectively.
- Environmental Modifications: SLPs may suggest changes to the feeding environment to support positive feeding experiences. This can involve adjusting seating arrangements, using adaptive equipment (e.g., special utensils or cups), and creating a calm and distraction-free environment.
- Parent/Caregiver Education and Training: It is essential to involve parents and caregivers in the therapy process. SLPs often provide education and training on techniques, strategies, and exercises that can be implemented at home to support consistent progress and generalization of skills.
Also, as a benefit of working with a multidisciplinary clinic, our pediatric occupational therapists can also help kids practice these skills as well.
Specific interventions and approaches will vary depending on the exact needs and goals of the child. A comprehensive assessment by one of our qualified Cleveland speech-language pathologists will help determine the most appropriate therapy interventions for your child's feeding and swallowing difficulties.
For more information about Cleveland pediatric feeding & swallowing therapy, speech therapy, occupational therapy, behavioral therapy (ABA) and physical therapy at Therapy and Wellness Connection, Contact Us Online or call our office (330) 748-4807. Our educational services and multidisciplinary therapy are available in Brecksville, Broadview Heights, Cleveland, Akron and surrounding communities.