A Tour of Our Feeding Room
This week we’re on to our Feeding Room! As you might guess, this is where we do a lot of our feeding therapy.
When you come into the Feeding Room one of the first things you might notice is our variety of seating options. When we first start feeding therapy we give careful consideration to postural stability. We want to have your child sitting in a chair in such a way that it best promotes chewing and oral motor skills used for feeding and swallowing. We have different modified seating options from babies up to elementary age or even teenagers. We can adjust the footrest so that your child is sitting at a 90-degree angle with a good base of support.
Food and Visuals
We keep a variety of food in the building to supplement whatever you send with your child. We have a well-stocked pantry in the Feeding Room, plus a refrigerator and freezer.
One of the things we do in feeding therapy is we provide visuals for your child to help them describe how they feel about the food, in addition to words to describe what the food tastes like. You might hear them come home and talk about the “Yum Scale.” This is a scale we give them so that they can rate their food. We also provide them with different word options they can use to describe their food. Quite often our kiddos come in and tell us that a food is “good” or “bad” or “yucky.” We have different words that we can show them to help them find better ways to describe the food. This also helps us and you pinpoint what it is about the food that’s making them uncomfortable.
Steps To Eating
You might also see the “Our Steps to Eating” chart. You might think that all there is to feeding is that we bring the child in and they take a bite of food, they chew it and swallow. But it’s so much more than those three steps involved in eating. In fact, there are 32 steps! We detail those steps with you and your child so that you will understand the process.
We do what’s called the Sequential-Oral-Sensory (SOS) approach to feeding which was developed by Kay Toomey. We have seen so much progress using this method from so many of our kids who are picky eaters! Along with those 32 steps to eating we also introduce foods to your child in a food hierarchy. For one example of how this works, we’d start with one of your child’s preferred foods, like regular orange Goldfish. Then at each next step, we’ll change either the color or the shape of the item. For instance, if your child is not as comfortable with red foods we might first move from orange Goldfish to red Goldfish. Then we might move from red Goldfish to pomegranate seeds. Then we might change shape and move to red bell pepper, followed by cherry tomatoes, and then sliced strawberries and pepperoni. We can keep the same colors or the same shapes, or we can work with both. We can also add in some kind of puree like ketchup, something your child has to touch that’s a different texture. We also try to include some type of liquid or drink into this, such as a colored fruit juice.
Introducing foods in a sequence like this means we’re not overwhelming your child with something that’s totally unfamiliar. We can take little baby steps while we’re helping your child move up those 32 steps to eating.
We keep a chart in the Feeding Room where we write everything down so that if your child sees a different therapist, that therapist will know exactly what your primary therapist has been helping your child with, and the next therapist can pick up where the other one left off. (And besides this chart we therapists talk with each other about your child outside of their therapy session so that we always know what’s going on with your child.)
How We Work On Oral Motor Skills
Besides food, we have an oral motor tool section in this room. we use these tools to help your child develop tongue lateralization and chewing skills so that they can better manage the food in their mouth. Some of the tools we have include jaw stability bite blocks which help them to develop more jaw stability as a base of support, vibrating spoons to provide sensory and tactile input, and different types of chewy tubes which let them work on that chewing pattern even without real food in their mouth (although of course, we want to facilitate them with real food as quickly as possible).
We also have equipment that provides neuromuscular electrical stimulation for feeding and swallowing. The unit we use is called VitalStim. If your child has had a swallow study done and that resulted in knowing that they have the aspiration of thin liquids or aspiration of other types of food items, we can recommend neuromuscular stimulation therapy. We use this as a modality, and we can do a laryngeal placement (on your child’s throat), or even a facial placement (on the child’s cheeks). This stimulates certain muscles in a way that essentially re-maps your child’s brain to help those muscles work more efficiently.
If you have any questions about Feeding Therapy, please let us know! We look forward to helping your children with feeding!