Jessica Hunt – Pediatric Complex Feeding Issues: 2-Day Intensive Training

Outline

The Complexities of Feeding

• Definition and prevalence – new information; move toward Pediatric Feeding Disorder
• Overlap of sensory processing skills, oral motor skills and behaviors
• Normal developmental key points
• Neurological foundations
• Trauma, feeding and impact on brain
  • NICU and medical trauma, NG Tubes, trachotmesty, etc.
  • Negative experience around feeding gagging, retching, pain with eating …

Evaluation of Feeding Skills

• Differentiate between sensory overload and behaviors during feeding
• Activity analysis of feeding – Evaluation videos and group analysis
• Information obtained – what questions to ask
• Oral motor evaluation – jaw, lips, tongue strength; range of motion for feeding
• Hands-on draw to learn lab

Sensory Integration Strategies

• Research-backed sensory play-based approach
  • Decrease sensory over-responsivity to foods
  • Use food exploration/cooking for older kids
• Self-regulation to engage body during feeding
  • Core engagement
  • Breathing exercises
  • Therapeutic use of music
  • Heavy work

Oral Motor Skills

• Lab – Oral motor exercises, kineseotaping, stretching
• Children who don’t swallow safely – saliva management, increase swallowing …

Food in Therapy
Taste Lab – Sensory feedback and motor requirement needed for each food texture

• Progression of food texture
• Match food presented in therapy to child’s sensory needs and motor skills
• Nutritional considerations

Behaviors During Mealtimes: Environmental Strategies to Set Children Up for Success

• Manage common mealtime behaviors – throwing foods, not sitting, crying during mealtimes
• Increase cooperation using the “just right challenge”
• Shift between treatment frameworks
• How to use the “feeding roadmap”

Special Considerations

• Autism
• Cerebral Palsy
• Down Syndrome
• Children who don’t eat by mouth/G-Tube
• Medically complex children

Promote Carry-Over At Home

• Educate parents who are stressed and in survival mode
• Help families have realistic expectations
• Easy-to-implement home programs that parents will do
• Help parents to change the relationship between child and food