Ever started a hobby and were instantly good at it? Maybe a foreign language in a new country came easily, or some new dance steps fell right under your feet. Chances are that past experiences like hearing different languages in the neighborhood or playing a high school sport came together to unwittingly make you an instant pro. While SLPs may not have thought about it, they possess the prerequisite knowledge to provide incredible feeding therapy and counsel parents and educators when a child is struggling with eating.
Great feeding therapy depends on knowledge of anatomy and physiology, behavior modification, motivation, sensory integration, experience extrapolating data, and an understanding of the communication of wants and needs. Successful feeding therapy can lead to an increase in the number of positive eating experiences, expansion of variety, and thereby greater nutrition.
In our talks with feeding therapy expert Amaka Ozah Winslow for her CEU course Confronting Barriers and Achieving Success in Feeding Goals in Schools, it became clear that we are all underutilizing our skillset and have a greater role to play with our families. Let’s start with a quick video with Amaka and then highlight why SLPs have all the prerequisites to provide amazing feeding therapy or counsel parents and educators who are facing tough feeding experiences with their little ones.
Tips for Speech Language Pathologists Who Are Working with Picky Eaters
Why Speech Language Pathologists are Perfectly Poised to Assist with Feeding Therapy
When we think of feeding therapy, we obviously think of food and eating. This is not something speech pathologists see too frequently unless they are providing direct feeding therapy to toddlers or are working in a pediatric feeding therapy setting.
However, when we see what is behind great feeding therapy, it’s clear that SLPs already possess most of the needed skills to provide incredible feeding therapy.
Behavior Modification
I don’t think SLPs give themselves enough credit for how patient most of us are and how willing we are to work through undesirable actions. Feeding is a high-stakes situation where mealtime can look more like a battle, and that’s assuming you can get the child to stay at the table.
An understanding of behavior modification strategies helps separate the specific food type from the event or even from what preceded the event.
Understanding and Employing Motivation
What is therapy if not a way to get a child to repeatedly complete a task that they are not familiar with, are embarrassed about, or even hate? When we boil our intervention down to these basics, I think it’s pretty magical what we do. Employing motivation gives therapists a way to get a child to act on faith (because they are having fun or are interested) when they are too young to understand that this applies to a bigger picture or a future goal.
Knowledge of Anatomy and Physiology
Don’t take this for granted. When children have any type of motoric or developmental issues that have affected cranio-facial anatomical development, feeding can be difficult. Some of the same knowledge that we employ to get a child to produce a sound beautifully is the same knowledge we need to understand the swallow stroke or how to clear the cheek or lips with the tongue.
Sensory Integration
Sensory issues lead to feeding issues in many circumstances. What makes this difficult with regards to feeding is that someone without experience with sensory deficits can mistake a child’s rejection of a food as a taste preference or non-compliance. Knowing that sensory issues could be the culprit can save weeks of missed nutritional opportunities.
Extrapolating Data
SLPs are scientists and at our core, feeding therapy requires analysis. Here’s an example comparing feeding therapy to articulation to think about how easily feeding intervention parrots communication strategies.
| A child’s SOUNDS are limited. | A child’s EATING PREFERENCES are limited. |
|---|---|
| An SLP tries 5 sounds. He says two that are bilabials. The SLP expands to try several bilabials (e.g. BUH, PUH, MUH, WUH…) They all fail. Turns out the two bilabials that worked were also in the final position. The SLP tries several final position consonants. The child says all of them. | An SLP tries 5 foods. He eats two that are yellow. The SLP expands to try several yellow things (e.g. corn, a cracker, pineapple…) They all fail. Turns out the two yellow things that worked were also cold. The SLP tries several cold things. The child eats all of them. |
Again, we can’t take this for granted. I know we do this day-in-and-day-out, but this type of thinking might not be natural to parents or teachers.
Communication
Lastly, eating is probably the best motivator to cajole even the most reluctant of speakers. Being able to use food and the sensory enjoyment of the smells and tastes is an amazing way to move a child through their goals. Except, when it’s done poorly and withholding of food creates an even worse situation. Thankfully speech language pathologists can counsel any school professional on the merits of positive reinforcement and the short duration and limited effect of negative reinforcement.
Hopefully you can see that SLPs are really good at this and have a lot to contribute to any team trying to meet the nutritional needs of a child. But a question remains:
Should SLPs be providing feeding therapy in the schools?
There are good reasons to think that pediatric feeding therapy or feeding therapy for toddlers should be left to our expert colleagues working in the medical settings. Or even that feeding therapy for picky eaters isn’t in our scope of practice on a campus.
Yes, definitely refer out for any medically specific situations. But as you can see above, there are plenty of ways we can support parents and teachers, as well as being the go-between who could find and reach out to the expert in your area of town.
And as you will read bellow, there are another dozen reasons we should not wait and should lend our very valuable opinion to anyone who is working with a struggling eater.
12 Reasons Why All SLPs Need Feeding Therapy Basics
There are short and long term negative consequences related to nutritional issues that feeding therapy can address. In the short term we see behavioral and education issues. If things persist, there can be complications for a lifetime. Certainly, here are some potential negative consequences of a child who does not eat well or has difficulties feeding:
1. Malnutrition:
Inadequate intake of essential nutrients can lead to malnutrition, which can impair physical and cognitive development.
2. Growth problems:
Poor nutrition can hinder a child’s growth and development, leading to stunted growth or delayed physical development.
3. Weak immune system:
Inadequate nutrition can weaken the immune system, making the child more susceptible to infections and illnesses.
4. Fatigue and weakness:
Insufficient intake of energy-providing nutrients can result in fatigue, weakness, and lack of energy, affecting the child’s ability to engage in physical activities and concentrate in school (Taylor, T., & Taylor, S. A., 2021).
5. Behavioral issues:
Nutritional deficiencies may contribute to behavioral problems such as irritability, mood swings, hyperactivity, and difficulty concentrating (Milano, Kim, Irene Chatoor, and Benny Kerzner, 2019).
6. Cognitive impairments:
Poor nutrition during critical periods of brain development can impair cognitive function, including memory, attention, and learning abilities (Malas, Kathy, et al., 2015),
7. Dental problems:
A diet lacking in essential nutrients can contribute to dental issues such as tooth decay, cavities, and poor oral health.
8. Bone health:
Inadequate intake of nutrients like calcium and vitamin D can impair bone development, leading to conditions like osteoporosis or rickets.
9. Delayed milestones:
Poor nutrition may delay the achievement of developmental milestones such as sitting, crawling, walking, and talking.
10. Social and emotional difficulties:
Children who struggle with feeding or have poor nutrition may experience social and emotional challenges, including low self-esteem, anxiety, and depression.
12. Increased risk of chronic diseases:
Long-term poor nutrition in childhood can increase the risk of developing chronic diseases later in life, such as obesity, diabetes, cardiovascular disease, and certain cancers.
It’s crucial for parents and caregivers to address feeding difficulties and ensure that children receive a balanced and nutritious diet to support their overall health and development. Seeking advice from healthcare professionals, such as pediatricians or dietitians, can be helpful in managing feeding challenges and promoting healthy eating habits in children.
Confronting Barriers and Achieving Success in Feeding Goals in Schools
Join Amaka Ozah Winslow, M.S., CCC-SLP of Children’s Hospital of Richmond at VCU’s Feeding Department as she discusses the role of SLPs in feeding, focuses on the basic tenants of every feeding therapy session, and how to achieve feeding success in the school environment.
Watch this 90 minute CEU Course.
Agreed. But how do we gain this experience? I’m 26 years into my career and have never been exposed to feeding therapy. How do I gain these skills now?