FEEDING THERAPY AND DYSPHAGIA MANAGEMENT

The clinical term for swallowing disorders is Dysphagia. Unfortunately, many children experience difficulties eating and drinking safely and enjoyably. Sometimes this is caused by a physical disability such as Cerebral Palsy, a genetic syndrome, brain injury or being born prematurely.  

Speech Pathologists are trained to work in teams, with children with disabilities who have difficulty eating and drinking. Our role is to assess and manage risks like choking, aspiration of food or drink into the lungs and also to support children to develop skills and strategies to enjoy the foods they love, safely! We often work with families alongside dietitians, doctors, occupational therapists and physiotherapists to support children with complex needs. 

Some young children, even babies, will frequently choke, cough, gag or vomit. These can be signs of a swallowing problem or an aversion to eating and drinking. Sometimes we recommend changes to the way babies are fed, other times, texture-modified foods, thickened fluids or adaptive utensils might be needed. We also train caregivers and mealtime partners to recognise signs of dysphagia and to support the person with a swallowing difficulty to eat and drink safely and enjoyably. 

Speech Pathologists also help with managing saliva and with complex behaviours at mealtimes. 

What happens in a swallowing assessment?

Before the assessment we ask lots of questions. Then we simply watch you eat and drink! 

We watch, listen and observe. We may offer a range of different textures to try during the assessment or  make suggestions regarding positioning or ways of eating. Sometimes environmental modifications in can ensure safe and enjoyable eating - such as moving away from distractions. Speechies also listen carefully to the key people involved in feeding and may offer support or advice if needed. 

After the swallowing/feeding assessment, a Mealtime Management Plan will usually be written up. Sometimes we use creative ways to make sure everyone can understand it and access it - such as incorporating pictures, videos or step by step routines to support the person with eating and drinking. 

Sometimes children have trouble with skills for chewing or moving food around with their tongue. Frequent episodes of stress, gagging, coughing, choking or vomiting can cause food worries and even food avoidance or refusal. Sometimes a child may have significant food worries but it is not really clear why. A Speech Pathologist is trained to assess physical skills for eating, as well as other factors impacting normal feeding development.  

Speech Pathologists sometimes work with children who seem to swallow normally and safely, but do not progress to eating a full, normal diet - varied in food groups and textures. Sometimes children get stuck on purees or mash, or they eat very few foods. 

Some children have very strong food preferences. For example, they may only eat crunchy, bland foods or plain white or beige foods with no sauce and no vegetables. Soft, mushy foods may be well accepted, but chewy foods are too hard to eat. Children may reject entire food groups (such as fruits, vegetables or meats) or accept something new for a while, then reject it again. Some children may become very overwhelmed if they have to try new foods.  

Understandably, it can cause a lot of stress for parents and caregivers when a child is anxious or extremely selective. Speech Pathologists working in Paediatric Feeding can support families to build happy mealtime habits, a healthy love of food and confident eaters who eat just the right way for their unique body. 

What happens in feeding therapy? 

At My Speech Life, Claire uses all evidence-based practices to support your child to eat with enjoyment and build awareness of their body's cues. Every child is different, so no two sessions will look the same. There is no 'one-size-fits-all' approach. 

Claire works very closely with parents to ensure your child has the best opportunities to learn and parents feel supported to manage the daily challenges of mealtimes.

Claire combines parent coaching with face-to-face sessions with your child. Working together, the goal is to build individualised strategies that suit your family and your child. Claire supports parents to take the pressure and stress out of mealtimes, while building little peoples' confidence and skills - including self-advocacy! We respect children's right to autonomy while offering opportunities to develop and explore in a safe way. 

Speak with your GP or Paediatrician if you are unsure whether feeding therapy is indicated for your child. They are very welcome to contact me, too.

If you feel worried about your child's nutritional intake - be sure to discuss a referral to an Accredited Practicing Dietitian with your GP or Paediatrician. https://member.dietitiansaustralia.org.au/faapd

Claire has many years of experience working with people with swallowing and feeding problems due to complex physical, medical, mental health and behavioural challenges. She absolutely loves this work! Claire is often attending workshops to become the best clinician she can, reading articles and meeting with colleagues and supervisors to discuss complex cases. 

In addition to her professional expertise, Claire has two children and has first hand experience of the trials and tribulations of breastfeeding, introducing solids and raising healthy, confident eaters! 

Claire has undergone additional training and clinical supervision in paediatric feeding and dysphagia and uses a Responsive Feeding Therapy approach. 

Claire is raising a neurodivergent child and identifies as neurodivergent herself. She never uses ABA or therapy approaches based on compliance or coercion.