Swallowing & Feeding Therapy

Feeding therapyA Speech-Language Pathologist sets realistic goals with the individual and his/her family to attain the least restrictive oral diet.  Specific feeding guidelines and/or strategies may be trained to improve the safety of oral food intake and eliminate or minimize the risk of food/liquid entrance in the airway (aspiration).  The guidelines and strategies are individualized and designed to help with safe oral intake.

Common feeding guidelines /strategies may include

  • No distractions or talking while eating
  • Thickening liquids
  • Alternate consistencies- liquid after solid to help clear residue
  • Slow rate and small bite size
  • Swallow two times each intake
  • Finger sweep to remove food collection in the inner check
  • Postural changes to improve control of the food/liquids and airway protection (e.g., Chin down to chest, head turn etc.)

Swallowing therapy exercises that may be trained include

  • Oral motor exercises to improve strength/range of motion of facial muscles and timing of the swallow.  These involve lip, cheek and tongue exercises. Tactile, verbal and visual cues are used to prompt the patient during these exercises. 
  • Airway closure exercises to reduce risk of liquid/food entrance into airway (e.g., Supersupraglottic Swallow, which is a multistep swallow that involved holding your breath).
  • Pharyngeal pressure exercises to improve squeeze of the swallow and clearance of food in the throat (e.g., Effortful Swallow, which is a strong, squeezing swallow).
  • SEMG (Surface Electromyography Biofeedback) and/or Neuromuscular Electrical Stimulation (NMES) may be incorporated in a treatment plan as indicated to maximize the swallow skills.

Sensory/Behavioral Feeding Impairments in Children

In children, where a sensory/behavioral feeding impairment is diagnosed, feeding therapy may be implemented to reduce food avoidance and behavioral issues. Our Speech-Language Pathologists can provide a 6-session parent/caregiver feeding therapy training program typically over several months’ time to improve the child’s feeding skills. A parent/caregiver signed commitment to the 6-session program is required.  Home carryover is necessary to obtain the best outcomes.

Program overview: The Speech-Language Pathologist  will begin the program by educating and providing models of specific techniques and strategies. This may include desensitization of the facial muscles (cheeks, lips, and tongue) and/or behavioral/environmental adjustments. Hand-over-hand parent/caregiver training from the Speech-Language Pathologist will facilitate improved parent/caregiver feeding skills in therapy sessions.

As the parent/caregiver training continues, the Speech-Language Pathologist  will fade prompting to allow for independent feeding by the parent/caregiver. The parent/caregiver will use his/her trained skills to carryover the therapy at home and continue to facilitate improvements in his/her child’s feeding abilities. Success/failure of techniques/strategies will be reviewed in sessions and necessary adjustments are made to meet the individual needs of your child.

For some children it can take a long period of time for improved feeding skills to develop and if indicated a follow up reassessment will be discussed on completion of the 6-session parent/caregiver training program.

If a child requires an intensive feeding program, a referral list can be provided.