Feeding Therapy
Feeding & Swallowing Disorders
10-25% of children experience feeding challenges.
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Feeding & Swallowing Disorders in Children

Feeding Therapy

Trouble eating can lead to health, learning, and social problems. Our feeding therapists can help children with feeding & swallowing problems.


  • Arches her back or stiffens when feeding
  • Cries or fusses when feeding
  • Falls asleep when feeding
  • Has problems breast feeding
  • Has trouble breathing while eating and drinking
  • Refuses to eat or drink
  • Eats only certain textures, such as soft food or crunchy food
  • Takes a long time to eat
  • Has problems chewing
  • Coughs or gags during meals
  • Drools a lot or has liquid come out her mouth or nose
  • Gets stuffy during meals
  • Has a gurgly, hoarse, or breathy voice during or after meals
  • Spits up or throws up a lot
  • Is not gaining weight or growing
feeding therapy

COMMON SIGNS by diagnosis

Common causes of feeding disorder

Autism Spectrum Disorder

●  Behavioral challenges
●  Sensory sensitivities, such as avoiding certain food textures
●  Food refusal or selectivity
●  Motor challenges that affect chewing, swallowing, and self-feeding

Global Delay and Developmental Disabilities

●  Delayed oral motor and self-feeding skills
●  Poor nutritional intake
●  Vomiting
●  Sensory sensitivities and food aversion
●  Swallowing difficulties
●  Longer than usual mealtimes
●  Motor challenges that affect positioning, oral motor skills, and self-feeding

Gastroesophageal Reflux and Gastroesophageal Reflux Disease (GERD)

●  Vomiting and/or gagging
●  Poor nutritional intake
●  Food refusal or selectivity

Food Allergies

● Negative associations with eating due to discomfort
● Food refusal or selectivity

Seattle Therapy: Skills for Life

Feeding Therapy at Seattle Therapy

Participation in mealtime is one of the most important daily activities for all people, including infants, children, and adolescents.  Many children love mealtime and look forward to their favorite snack or food. 

However, when participating in mealtime is difficult for a child, it makes mealtime hard for everyone! 

Challenges in the area of mealtime participation can include a limited or restricted food repertoire, difficulty sitting still and attending to eating, difficulty chewing foods and negotiating foods orally for breakdown and swallowing, and challenges with utensil use or cup drinking. 

Difficulties in one or more of these areas can make participating in daily meal and snack times a challenge at home, at school, and in the community.


Our Process

In order to begin to assess a child’s participation in mealtime and further examine their feeding skills the following steps are taken:

Step 1


Initial intake appointment with primary caregiver(s) to discuss the child’s typical food and drink intake, mealtime routines, and presenting concerns as well as relevant medical history and background information.
Step 1

Step 2


Appointment will be conducted in the clinic which includes assessment by both occupational therapy and speech therapist. This assessment of mealtime participation skills includes further examination of:

  1. Oral motor skills
  2. Sensory processing differences and motor control
  3. Mealtime routines and related behaviors
Step 2

Step 3


A written report will be completed following the comprehensive multidisciplinary feeding evaluation. A follow up home visit will be conducted to further assess the environment where mealtimes occur. This allows for an opportunity for treatment to take place in the home and for initial home suggestions to be established to support the treatment process.
Step 3


Treatment Phases

Working with the family and client to increase mealtime opportunities to 4-5 times daily


Opportunities for daily practice of oral motor and/or sensory based feeding techniques worked into daily mealtime routines.

Goals made around length of time at the table if applicable.

Seating accommodations are made and in place at home and at school if needed.

Connect with a nutritionist or with the child’s physician regarding any concerns regarding caloric intake especially if the child is eating very little.

Consult with physician regarding any other medical concerns (ie. Constipation, frequent stomach upset, etc).

School visit conducted during lunchtime if applicable.

Formal treatment sessions 2 times weekly conducted in clinic, in home, in school, or a combination of environments. Home visits are recommended to help with generalization of skills if treatment is not taking place there.

Working with the family and client to increase mealtime opportunities to 4-5 times daily

Once skills begin to increase and a trusting relationship is established the goal is to work on increasing foods that are present at each meal to match sensory and oral level.


Have at least 5 foods present at each meal (breakfast, lunch, dinner) and 3 foods at snack. There should be at least one food available at each meal that the child has shown they can successfully eat.

Goals are to increase time at the table and # of foods the child can tolerate and move up the oral and/or sensory ladder.

Treatment sessions occur at a frequency of 1-2 times per week and are happening at home, school, or in clinic. Combination of environments for intervention is recommended depending on the child’s age and where they need to eat.

The key here is to keep things dynamic in terms of types of foods presented and environments where we eat if that matches what is required of the child in their daily life, this supports the child’s ability to generalize their mealtime skills across people and environments.

Once skills begin to increase and a trusting relationship is established the goal is to work on increasing foods that are present at each meal to match sensory and oral level.

Expand skills and develop independence in all aspects of the mealtime process.


Develop up and clean up routines, utensil use, cup use, scooping, and pouring.

Address additional skills needed for eating in the community including restaurants.

If the child is old enough more cooking can be incorporated here.

Goal is to really increase independence in the entire mealtime process.

This may include a decrease in frequency of treatment (moving to just once per week or twice per month).

Also may include moving treatment sessions out of home or clinic and into school or restaurant.

Expand skills and develop independence in all aspects of the mealtime process.

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