A feeding disorder can occur alongside developmental delays or medical conditions, such as autism spectrum disorder, Down syndrome, cerebral palsy, or respiratory disorders.Young children with feeding difficulties typically demonstrate a delay in or difficulty swallowing, sucking, chewing, and display food aversions, food refusal, texture selectivity, and food selectivity. Many factors can cause a young child to become a picky eater.Feeding therapy involves improving the the child’s oral motor and underlying feeding skills and their eating habits. We assess the child’s sucking, swallowing, chewing patterns, diet, behavior, and the home environment during meal time time. Once we pinpoint the underlying problem(s), we create a family treatment plan. Some children require additional one-on-one feeding therapy, and we demonstrate to the parent how to tackle their child’s feeding or eating delay.Read about Early Childhood Developmental Milestones.

Several factors can cause a child’s feeding and swallowing disorder. Infants who were hospitalized at birth and received tracheotomy for an extended time will often have difficulties adopting proper feeding patterns. In some cases, even children with no known conditions or relevant medical histories can develop a fear of food.Other possible factors that could lead to feeding and swallowing disorders include:

Feeding and swallowing disorders in children are often difficult to spot at first. Most of the time, children who struggle during mealtimes are simply assumed to be picky eaters. And while this is true for many, there are other signs and symptoms that family members can consider to distinguish between a child who is a picky eater or one with a feeding problem. These include:

Meanwhile, a child who is a picky eater may sometimes exhibit similar behaviors as someone with a feeding disorder. However, there are key differences to monitor. Typical signs of a picky eater are:

Treatment for feeding or swallowing disorders starts with getting a comprehensive check on the child’s general health. A pediatrician can assess the child’s growth and weight based on what is appropriate for his or her age. Children must also be checked for any condition that interferes with feeding skills.If your child’s doctor determines that there is cause for concern, a speech-language pathologist (SLP) may be consulted to conduct a feeding evaluation and provide a diagnosis.During the feeding evaluation, the speech-language pathologist will:

Once a diagnosis is made, the SLP or therapist may work closely with a team to design a feeding therapy plan to address the child’s needs. This team may include a physical or occupational therapist, a dietitian or nutritionist, a physician or nurse, or a developmental specialist.As part of the multidisciplinary team, the SLP can help your child address the following issues:

The Sequential Oral Sensory (SOS) approach to feeding therapy addresses not only the child’s needs and eating difficulties but also its underlying causes. It is based on the feeding steps, stages, and skills found in typically developing children. The SOS approach relies on several factors, including motor, oral, behavioral/learning, medical, sensory, and nutrition, in determining the root cause of a child’s feeding problems and managing it successfully.In conducting SOS feeding therapy, it is important to create an environment wherein a child can interact and get familiarized with food in a non-stressful way. Feeding therapy may be done individually, as a group, or at home, with the primary goal of helping the child develop and master the necessary skills to become a healthy and safe eater.Feeding therapy meals are done to help children work on feeding skills and expose them to new foods. It typically starts with foods the child is already familiar with and able to tolerate before moving on to new ones. The therapist encourages the child to smell the food, learn about its texture, and explore its taste. Modeling and reinforcement are crucial during feeding therapy in order to help the child develop a positive relationship with food.The SOS approach can also be applied during family meals, wherein the goal is to improve the volume or amount of the child’s food intake. Pediatric feeding therapists use several strategies that may include:

At Staten Island Letters, our pediatric feeding therapy involves improving the underlying feeding skills and eating habits of babies, toddlers, and preschoolers. We assess the child’s sucking, swallowing, chewing patterns, diet, behavior, and the home environment during meal time time. Once we pinpoint the underlying problem(s), we create a family treatment plan. Some children require additional one-on-one feeding therapy. Our pediatric feeding therapists work closely with parents on how to tackle their child’s feeding or eating delay.

Danielle is wonderful! Night and day compared to our other feeding therapist that was outside the Brooklyn Letters network of providers.

My son is now 6 years old and he just graduated from Christina’s feeding therapy sessions!

I noticed that my son had difficulties with food since he was 1 year old. Everybody I talked to (even my pediatrician) told me that I was worrying for nothing and that he was only a picky eater. I always felt that it was more than that. After fighting over and over and trying out every little trick or piece of advice I could find I finally decided to get him evaluated at NYU when he was 5. It turned out that my son had sensory issues when swallowing. They recommended feeding therapy.

I reached out to Craig who put me in contact with an amazing person Christina R.
Christina has a tremendous experience and is incredibly gentle and patient with kids.
She connected right away with my kid (and with us!) and started to help him through play and positive reinforcement. She immediately understood my sensitive son and found her way through him, helping him to become more confident and to change his perception of food and mealtime into something positive. She also helped me with my struggles. Always here for me and my family. Each time I was lost and didn’t know how to react I would text her and she would answer me right away, texting me or calling me back with the best advice or tips, or just to reassure me and tell me that I was doing great.

Christina has been incredible and helped my family and especially my little boy who is now comfortable with a lot of different food but most importantly he is not afraid to try new things and enjoys mealtime.

Today was time for our family to say goodbye to Christina as her work with us was over. It was bitter-sweet. I was so happy that my little boy overcame his issues and fear but I was really sad to have to let Christina go. She feels like part of our family and we will definitely miss her.

If your kid is struggling with food, I highly recommend you to ask for Christina, she is just terrific and I have no doubt she will bring you the help you need.

Many thanks
Sincerely

I highly recommend you

I would like to thank you, Craig, for the wonderful work you are doing with my daughter Rivka. When you started, she was not eating much- just cheese and crackers and most of her caloric intake was from the formula. As of today (six months later) she eats so much more solid food and eats a more diverse diet. Craig, your approach is very gentle and Rivka has liked you from the start.

Sarah is a New York State licensed clinician who received her undergraduate degree from CUNY Brooklyn College and a Master’s degree in Communication Sciences and Disorders from Teachers College, Columbia University. She holds her Certificate of Clinical Competence in Speech-Language Pathology from the American Speech-Language-Hearing Association (ASHA) and is a recipient of ASHA’s Award for Continuing Education. Sarah is a member of ASHA’s Special Interest Group in Swallowing and Swallowing Disorders and the National Association of Neonatal Therapists (NANT). She serves as an Adjunct Professor/Clinical Educator at New York Medical College training post-graduate clinicians in the diagnosis and treatment of pediatric feeding/swallowing disorders.

Sarah has received extensive post-graduate training and education in the diagnosis and treatment of feeding/swallowing disorders in infants, children, and adolescents. Sarah has worked in the Neonatal Intensive Care Unit (NICU) since the beginning of her career. She has also worked with pediatric patients admitted to the hospital who present with diagnoses related to airway disorders, respiratory/pulmonary disorders, gastrointestinal disorders, and congenital/acquired neurogenic disorders. Sarah has also worked with patients in the outpatient setting who present with sensorimotor and/or behavioral feeding/swallowing disorders.  She has treated babies who struggle with bottle feeding, helped transition infants to purees and solids, worked on introducing PO feeding to medically complex patients, and helped patients expand their food repertoires and transition to age-appropriate textures/consistencies. Sarah considers infant feeding/swallowing to be a specific area of passion, but she finds great pleasure in helping all children/families establish and reach their respective goals.

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