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Feeding Disorders - Oral-Motor & Sensory Issues
It's 6:00pm and you've just pulled together another nutritious meal for you family. Everyone is at the table and you dish up steamed rice, vegetables and chicken. Two-year old Sammy turns red in the face, screams and throws his plate to the floor. Another hope for a pleasant family gathering is smashed.
This is typical of many mealtimes across the nation. An estimated 25% of children experience feeding disorders and upwards of 80% of children with developmental disabilities suffer from them as well. More than unpleasant mealtimes, feeding disorders can result in serious nutritional deficiencies that negatively impact a child's ability to learn.
Autism, PDD, food allergies, gastro-esophogeal reflux, cerebral palsey, oral motor dysfunction and other developmental delays often contribute to feeding disorders. Symptoms include refusal to consume certain types of food and/or drink, difficulty with sucking, chewing and/or swallowing, drooling, gagging, dislike of specific textures, mouthing and chewing of non-food items, drooling and disruptive behaviors during feeding/meals.
At CLASS, Inc., we have an experienced team of speech-language pathologists and occupational therapists trained to work with children and their families to develop sound treatment plans. Referrals are also made to nutritionists, counselors and other medical professionals as appropriate. We consider the child's cultural background, sensory system, oral-motor skills, developmental level and behavior needs as we develop a dynamic intervention plan organized around the family's lifestyle and the child's unique needs. For example, providing calming music may be beneficial for one child, while playing with edible textures such as pudding, dry noodles or colored mashed potatoes may provide a positive introduction to food for another child. Systematic straw drinking through a variety of different types of straws and different thicknesses of liquids is beneficial to other children. Some children need additional input to their mouths and faces through controlled, systematic presentation of texture, vibration and/or temperature to normalize the oral-motor sensory system enough to tolerate a range of foods.
Mealtimes need not be a frustrating experience. Our expert team can assist your child in developing the skills to both eat a healthy diet and enjoy family meal-time.
CHARACTERISTICS OF PICKY VERSUS RESISTANT EATERS
| PICKY EATER |
PROBLEM OR RESISTENT EATER |
| Has a history of smoothly transitioning from pureed baby food to baby foods with texture |
Has a history of difficulty in transitioning to different food textures as an infant or young child |
| Easily transitioned to table foods and finger food |
Has a history of not eating table solids by 12 months of age |
| Able to fully transition from baby foods to table foods by 167 months |
Unable to transition from a diet composted of baby foods to one consisting of table foods by 16 months |
| Smoothly transitioned from breast and/or bottle to cup by 16 months (not sippy cup) |
Unable to transition to open cup by 16 months and remains on bottle or breast for most liquids |
| Typically eats at least one food from every food group |
Eliminates entire food groups and eats only one or two food groups, typically carbohydrates |
| Typically eats a variety of textures, (i.e. ice cream, hot dogs and cereal with milk) |
Prefers a single texture, usually either crunchy, (i.e. crackers) or smooth, (i.e. applesauce) |
| Eats a variety of different flavor types |
Sticks to mainly one or two flavor families such as salty, (i.e. pretzels) sweet, (i.e. cookies) bland, (i.e. mac & cheese) or spicy, (i.e. ketchup) |
| Enjoys foods in a range of colors |
May only eat certain colors of food, often white to brown colors |
| Appears to be able to drink, chew and swallow without difficulty |
May have difficulty with the mechanics of eating and drinking; chokes, gags, coughs or looses food through nose while eating |
| Feeds self at an appropriate age |
Relies on adults to feed some, if not all meals at an age when most children are feeding themselves |
| Eats most meals in a reasonable amount of time |
Takes an abnormally long amount of time to eat a meal (30 minutes or more) |
| Is able to sit and behave appropriately during meals as expected for a child of his or her age |
Frequently pouts, whines, cries, tantrums, refuses, distracts, gets up from table and other inappropriate behaviors |
| Is generally polite and happy at mealtimes |
May demonstrate behavioral problems such as hitting, biting, kicking, and vomiting at mealtime as an attention-getting strategy |
| Enjoys similar foods of different brands or from different restaurants, (i.e. frozen chicken nuggets, nuggets from MacDonald's, Burger King & Red Robin) |
Notices small differences in similar foods and accepts only specific brands or from a single restaurants |
| Tolerates the presence of new and/or different foods on the table or plate |
Displays anxiety in the presence of new and/or different foods |
| Willing to touch and/or smell most new foods |
Finds the smell and or texture of new foods noxious |
| Willing to taste most new foods |
May gag or vomit when tasting new foods |
| Preferences for different foods will wax and wane across time |
Often starts with a variety of different foods and eliminates foods or entire food groups over time |
| Will eat non-preferred foods at a later date |
Once foods become non-preferred, they are not regained into the food repertoire |
| Usually eats more than 20 different foods |
Typically eats fewer than 15 different foods |
| Will not make themselves ill |
Restricted diet may negatively impact growth and development |
| Often no underlying medical conditions |
Frequently has another underlying medical condition, (i.e. ADD, sensory integration disorder, low tone, history of tube feeding, etc.) |
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