10/13/2019 Tips to develop more mature feeding patterns Working - - PDF document

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Tips to develop more mature feeding patterns Working with children at meals Extra slides from Swigert

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Posture and position

• Be sure the child is in a stable and upright position
• “Wake up” the oral sensory system if needed before feeding
• Oral stimulation, massage, vibration, exercises, etc.

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SPOON

• initial trials resemble sucking food from spoon
• begin with smooth, runny pureed textures
• introduce only one change at a time
• runny peaches
• runny pears
• textured pears

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Spoon feeding

• Place spoon on midline
• Give downward pressure to encourage lip closure
• Give external jaw and lip support as needed *
• Stimulate upper lip as needed

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Spoon feeding

• Put only small amount of food on front of spoon so you can control

where it goes

• To avoid tongue thrust pushing food out, provide assist for jaw and lip

closure

• Providing jaw and lip support

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Spoon feeding

• Foods of mixed consistencies may be very difficult
• cereal with milk
• fruit cocktail
• green beans
• peas
• stewed tomatoes

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cup

• Careful positioning of head
• Place cup on the child’s lower lip, not the teeth or gums
• Provide jaw support
• Tilt only far enough to let liquid touch upper lip

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Spoon ‘drinking’

• Spoon turned sideways
• Spoon on edge of lips
• Liquid just to the lips

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Cup drinking

• Coordinated jaw stabilization may not be seen until 2 years of age
• Flow of liquid into the mouth may startle the child
• try thicker liquids
• for older children, use age appropriate thick drinks like fruit smoothies

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Chewing solids

• If child is not safe to eat solids, can begin to introduce things to chew

in a mesh holder

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CHEWING - solids

• Place food on lateral chewing surfaces *
• Use foods that are easily softened with saliva (e.g. cookie, cracker)
• Avoid foods that fall apart (e.g. pretzels) or don’t dissolve well (e.g. bread)
• Alternate sides for presenting

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Chewing - tongue lateralization

• Try foods with long, thin shape the feeder can hold

–French fries, cheese, potato

• Place pieces at midline of tongue for child to move laterally to

chewing surfaces

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Simulated chewing

• Can use therapy tools to practice chewing

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Biting

• Don’t introduce until child can move food from midline to lateral chewing surface
• You can assist moving it to the side
• Simulate by pulling slightly on food placed between lateral chewing surfaces, or scraping on

top teeth

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Straw drinking

• Great variability in typically developing children
• 1 - 3 years of age
• Don’t introduce until coordinated with cup drinking

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Straw drinking

• Precursor to straw drinking
• Use bottle that when squeezed, liquid will move up straw
• Fill bottle with liquid consistency that child is capable of handling
• As the child is learning to pull the liquid up through the straw with the

lips, the therapist can gently assist by squeezing the bottle

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Straw drinking

• Working to achieve saliva control, lip rounding,

and tongue retraction

• Try to avoid having the child rest the straw on the

tongue

• It should be between the lips

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Dipping the straw

• For children who can’t pull the liquid up in the straw at all, try dipping

straw in liquid and slowly releasing into mouth at midline

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Moving to harder straws

• Once child has mastered the squeeze bottle, move to a short and

wide straw

• Moves from shorter, wider straws to long complex straws

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