Nutrition Interventions for Children with Special Health Care Needs

Chapter 8 - Oral-Motor Feeding Problems
Table 8-2: Nutrition Interventions for Oral-Motor Feeding Problems
Assessment Intervention Evaluation/Outcome
The feeding therapist evaluates feeding
skills and develops an intervention plan.
Improvements may be observed in basic
oral-motor skills, volume of food ingested,
decreased feeding times and/or safer feeding.
If observed, refer to a pediatric occupational,
physical and/or speech therapist for further
evaluation and intervention
Inability to ingest age appropriate food textures
and liquids
Inability to take age-appropriate amount of food/
liquids for adequate growth in a reasonable length
of time (see Chapter 1)
Presence of abnormal oral motor patterns (See
Table 8-1 Developmental Sequence of Oral-Motor
and Self-Feeding Skills)
Diet modifications to increase safety or ease
of feeding may be made based on results of
these interventions. If oral feeding is unsafe,
tube feeding may be necessary. See Chapter
10.
If observed, refer for a clinical feeding
evaluation and possible videofluoroscopic
swallowing study (VFSS).
Observe swallowing function: coughing, choking,
wet sounding breathing during feeding, difficulty
catching breath during feeding; frequent
respiratory infections
Improvements noted in acceptance of ageappropriate
food textures, an increase in
volume and more timely food ingestion
If observed, refer to occupational, physical or
speech therapist for an in depth sensory and
sensory integration assessment.
Observe sensory responses: gagging with food
or feeding tools; resistance to touch around face
and mouth; excessive selectivity of food tastes/
textures.
Feeding resistance or refusal is observed.
Differentiate underlying cause; consider medical
(GER, swallowing or respiratory problem) versus
parent/child interaction versus sensory issues.
98 Nutrition Interventions for Children With Special Health Care Needs
Greater ease of feeding for parent and child.
Interactional: see chapter 9
Medical: Refer to PCP or specialist such as
gastroenterologist
Sensory: Refer to feeding specialist
Improvements in parent/child interactions
and feeding behaviors.
If problems are noted with either parent/child
interaction or feeding behaviors, see Chapter
9. Referral to a behavior specialist may be
indicated.
Observe Parent /Child dynamics: this includes
behavioral interactions; parent expectations, and
emotional tone of meals; mealtime structure.