Assessment Series: Would a Feeding Assessment be Right for My Child?

One of the most significant events for parents of an infant is giving them “real food” (solids) for the first time. The highchair is set up, the food is all prepared (after MUCH thought and debate has gone into what it will actually be), and the video camera (pardon me, cell phone) is ready to capture the exciting moment. However, more often than not, the experience ends up being anticlimactic, with the baby either refusing to open his/her mouth, immediately gagging/spitting it out, or not moving past the first spoonful/bite. Rest assured, this is completely normal! As with any new skill, time and repeated practice is required for a baby to become comfortable and capable. Nevertheless, if this behaviour persists for longer than one month, an occupational therapy feeding assessment might be worth considering.

Why a Feeding Assessment?

Many occupational therapists have specialized training in feeding related challenges. A competent therapist has completed continued education in this area, and has experience working with children of all ages. Before intervention can occur, a thorough assessment will need to be completed to understand the underlying reason as to why the child is struggling. While “picky eating” is often reported, the occupational therapist will want to know why. Does the child have oral-motor challenges that are impacting his/her ability to chew food? Is the child averse to a certain texture group? Are iPads or other distractors a necessity at mealtimes?

If you find yourself agreeing with one or more of the statements below, and the behavior is consistent, you might want to consider a feeding assessment for your child.

• My child refuses to eat certain foods by throwing them on the floor
• My child won’t open his/her mouth to an approaching spoon
• My child can’t stand vegetables – even the sight of them
• My child gags on “chunky foods”
• My child will only eat when his/her favourite video is playing in the background

What to Expect

At Boomerang Health, feeding assessments take place in our clinic kitchen. The goal is to make the experience feel as natural as possible. We are set up with a highchair, booster seat, and various sized chairs. An intake form will be completed by the parents ahead of time, which the occupational therapist will review at the outset. Any pertinent/relevant details will then be discussed, as will any important medical/developmental history. Parents are encouraged to bring along a variety of foods to the appointment; these include preferred/tolerated and non-preferred/not tolerated items. Additional food will also be provided by the clinician. From that point on, the assessment takes the place of an unstructured feeding observation. The child will eat as much as they are able, with different levels of encouragement and prompting. The occupational therapist may listen to the child’s swallow using a stethoscope, but that is typically the extent of the physical contact. Time often permits for preliminary treatment strategies to be introduced. Families can expect to leave with a basic clinical understanding of the presenting concerns and specific strategies to work on at home. A summary report will be written and provided to families.

If you are still questioning whether a feeding assessment would be appropriate for your child, feel free to give our office a call. We would be happy to chat through it with you, and help to schedule one in, should you decide to proceed.