How does an occupational therapist treat pediatric feeding conditions?
When I tell people I'm a pediatric occupational therapist (OT) it is not unusual to get confused looks and questions such as "why do these kids have jobs?" It's a common misconception that "occupational" refers only to professional or paid work. In actuality "occupations" refer to the activities people of all ages do to live functional and meaningful lives.
Among the many "occupations" OTs focus on are activities of daily living (ADLs). These include tasks such as dressing, grooming, self-care, and feeding. Feeding difficulties can present in pediatric populations for a variety of reasons. Occupational therapists provide therapy interventions to promote improved feeding skills for children of all ages. Here are 5 treatment strategies an occupational therapist may use to address challenges related to feeding:
1. An occupational therapist may use sensory integration to promote increased tolerance to non-preferred food smells, tastes, and textures. Usually this happens through food play and exploration initiated by the child and guided by the therapist. Occupational therapists use the movement-based senses (proprioception and vestibular) to promote integration of the sensory systems. In preparation for feeding activities a therapist may engage a child in activities such as swinging, spinning, deep pressure and heavy work. Since the proprioceptive and vestibular senses set the stage for the other senses (vision, hearing, taste, and smell) these activities are important in facilitating the development of the sensory system.
2. OTs dedicate significant amounts of time during their training learning about typical development in children. This includes the development of feeding skills. Feeding difficulties can arise when the structures of the mouth and the coordination of their movements experience delays. An OT will address these challenges by providing a child with foods or other tools, to promote side to side movements of the tongue, rotary chewing patterns, and proper lip closure, all of which are necessary to prepare food to be swallowed. Manual therapy may also be used to increase muscle tone to reduce food pocketing.
3. When it comes to fine motor skills, OTs are experts. Feeding may be impacted by a child's limited fine motor coordination. An OT may help a child develop self-feeding skills through developing functional grasp patterns and increasing strength in the muscles of the hand. Adaptive devices may also be used to provide proprioceptive sensory input, reduce spillage, and facilitate successful feeding experiences.
4. An OT may make recommendations about seating to improve feeding skills in children. As with handwriting and other fine motor development, feeding skills develop best with proper positioning. An OT may recommend foot rests, back supports, or side supports to ensure a child maintains optimal positioning including the hip, knee, and ankle joints each forming a right angle. A home safety assessment may be performed to ensure a child is safe (from choking, falling, etc.) while participating in feeding activities.
5. Many children feel nervous or worried about trying new foods. An undeveloped sensory system may result in fearful responses in children when exposed to non-preferred or unfamiliar foods. Occupational therapists are trained in neuroanatomy and understand the nervous system responses that can occur when a child feels "threatened" by an unfamiliar food experience.
Through sensory integration and cognitive behavioral approaches, an occupational therapist may teach coping strategies to facilitate emotional regulation, stress management, and flexible thinking to successfully engage in feeding activities. If your child has feeding difficulties, schedule a consultation with an occupational therapist at Ability Innovations.