What Does Pediatric Feeding Therapy Look Like?

Pediatric feeding therapy is a personalized and holistic approach to support children in developing healthy eating habits and fostering a positive relationship with food. Feeding therapy is a specialized area of therapy that focuses on addressing a child’s difficulties related to eating, feeding, and mealtime behaviors. The treatment approach will depend on the root cause. For example, a child may have difficulty with the motor movements necessary to masticate food or sensory deficits such as overstuffing, gagging or aversion to the sight, smell or taste of food. Feeding is a complex task that involves all of our eight senses. Imagine how overwhelming this may be for your child if they are averse to a strong smell or frightened of the way a food item looks on their plate.

The good news is, feeding therapy can be creative and fun! A session often includes controlled exposure to different foods, textures, colors, and smells. This gradual approach allows children to acclimate to unfamiliar foods at their preferred speed, alleviates anxiety, improves nutritional intake, and rebuilds enjoyment to mealtimes.

The main approach I use with my picky/problem eaters during sessions is The SOS Approach to Feeding. The SOS Approach stands for “Sequential Oral Sensory,” and is a holistic and systematic approach to pediatric feeding therapy. It was developed by Dr. Kay Toomey, a pediatric psychologist, and Dr. Erin Ross, an occupational therapist. This approach is designed to address the multifaceted issues that many children with feeding difficulties face, including sensory aversions, oral motor challenges, and behavioral concerns. In SOS, we use children’s intrinsic motivation, allow children to move up and down the feeding hierarchy at their own pace, teach that learning to eat can be enjoyable and empower families to take part in the feeding journey.

We get messy during feeding sessions! From an early age, I advise parents to embrace messiness. This allows the full sensory experience – to touch and feel the diverse food textures. Children absorb knowledge most efficiently through play, so what better way to approach mealtime than through playful exploration. If a child’s goal is to progress toward eating crunchy snacks we may use veggie sticks as drums or pretend we are an alien with antennas. This motivates a child to progress through the feeding hierarchy, starting with food touching their hands and moving closer to eventually consuming the food.

I also love incorporating fun tools into feeding therapy. One effective tool is a silicone ice cube tray, which not only serves to separate foods but also presents them in a creative and novel fashion. This encourages individuals to sample a wide range of foods in a new and exciting way. Other tools include decorating laminated pictures, making food kebabs, using vegetable/fruit cutter shapes to cut out the food using them as stamps or decoration. Exploring food during a time that is not mealtime sets up a calm and pressure free environment. These are great tips to carryover in the home environment!

You can also involve your child in meal preparation and the preparations leading up to the meal. Sometimes taking your child food shopping will take the unknown out of what will be prepared for the week. This allows your child to build control and confidence surrounding food. Also, including your child in meal preparation may encourage exploration of novel foods. Have your child cut vegetables with child- safe knives, wear a chef’s hat or set the table. Keep in mind each individual’s feeding journey is different and one strategy may be helpful for one child and intimidating for another.

Feeding therapy is more than just getting a child to eat. In reality we do not “get” a child to eat but help them to learn that exploring food is fun and playful! Feeding therapy is about helping the individual gain confidence surrounding food and improve the relationship with food. We want to create a pressure-free zone where children are safe to experiment with different food textures. Keep in mind that every path is unique, and feeding therapy may employ a range of strategies and approaches!

Book Resources

Tool Resources

Written by: Siena Cardamone Viviano M.S. CCC-SLP, TSSLD
Speech-Language Pathologist/Feeding Therapist

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