Feeding and Swallowing Program
Mealtime is a natural part of every day for children and their families. Early nutrition is the foundation for good growth and nutrition and healthy eating. As infants, feeding is a special time with a child and caregiver. Mealtime is a social component of children’s experiences at home and school. When children experience difficulties with feeding and swallowing skills, mealtime can be a challenge for the family. Deirdre Patch has brought a Pediatric Feeding and Swallowing Program to Peer Projects - Therapy from the Heart, focusing on supporting the whole child and their family in developing skills for successful and positive mealtimes.
Services
You may read Deirdre's biography for more information on her credentials.
American Speech-Language-Hearing Association (ASHA) Feeding and Swallowing (adapted):
Feeding and swallowing disorders (also known as dysphagia) include difficulty with any step of the feeding process, from accepting foods and liquids into the mouth to the entry of food into the stomach and intestines. Dysphagia includes developmentally atypical eating and drinking behaviors, such as not accepting age-appropriate liquids or foods, being unable to use age-appropriate feeding devices and utensils, or being unable to self-feed. A child with dysphagia may refuse food, accept only a restricted variety or quantity of foods and liquids, or display mealtime behaviors that are inappropriate for his or her age.
Dysphagia can occur in any phase of the swallow:
Signs and symptoms of swallowing and feeding disorders vary based on the age of child, but may include:
Common causes of pediatric dysphagia include:
Children with feeding and swallowing difficulties may experience:
Mealtime is a natural part of every day for children and their families. Early nutrition is the foundation for good growth and nutrition and healthy eating. As infants, feeding is a special time with a child and caregiver. Mealtime is a social component of children’s experiences at home and school. When children experience difficulties with feeding and swallowing skills, mealtime can be a challenge for the family. Deirdre Patch has brought a Pediatric Feeding and Swallowing Program to Peer Projects - Therapy from the Heart, focusing on supporting the whole child and their family in developing skills for successful and positive mealtimes.
Services
- Evaluation
- Individual Treatment
- Mealtime Groups
Children discover the joy of eating, and develop skills to support mealtime in a positive peer group experience. - Consultation
Training and support is provided for caregivers at early childhood centers and schools to help children join in mealtime in their natural environment. - Education
In-services on a range of feeding and swallowing topics are offered for individuals looking to learn more.
You may read Deirdre's biography for more information on her credentials.
American Speech-Language-Hearing Association (ASHA) Feeding and Swallowing (adapted):
Feeding and swallowing disorders (also known as dysphagia) include difficulty with any step of the feeding process, from accepting foods and liquids into the mouth to the entry of food into the stomach and intestines. Dysphagia includes developmentally atypical eating and drinking behaviors, such as not accepting age-appropriate liquids or foods, being unable to use age-appropriate feeding devices and utensils, or being unable to self-feed. A child with dysphagia may refuse food, accept only a restricted variety or quantity of foods and liquids, or display mealtime behaviors that are inappropriate for his or her age.
Dysphagia can occur in any phase of the swallow:
- ORAL PREPARATION STAGE—preparing the food or liquid in the oral cavity to form a bolus-including sucking liquids, manipulating soft boluses, and chewing solid food.
- ORAL TRANSIT PHASE—moving or propelling the bolus posteriorly through the oral cavity.
- PHARYNGEAL PHASE—initiating the swallow; moving the bolus through the pharynx.
- ESOPHAGEAL PHASE—moving the bolus through the cervical and thoracic esophagus and into the stomach via esophageal peristalsis (Logemann, 1998).
Signs and symptoms of swallowing and feeding disorders vary based on the age of child, but may include:
- breathing difficulties when feeding
- swallowing;
- crying during mealtimes;
- decreased responsiveness during feeding;
- dehydration;
- difficulty chewing foods that are texturally appropriate for age (may spit out partially chewed food);
- difficulty initiating swallowing;
- difficulty managing secretions (including non-teething related drooling of saliva);
- disengagement cues, such as facial grimacing, finger splaying, or head turning away from food source;
- frequent congestion, particularly after meals;
- frequent respiratory illnesses;
- gagging;
- loss of food/liquid from the mouth when eating;
- noisy or wet vocal quality noted during and after feeding;
- prolonged feeding times;
- refusing foods of certain textures or types;
- taking only small volumes, over-packing the mouth, and/or pocketing foods;
- vomiting (more than typical "spit up" for infants);
- weight loss or lack of appropriate weight gain.
Common causes of pediatric dysphagia include:
- neurological disorders
- factors affecting neuromuscular coordination (e.g., prematurity, low birth weight);
- complex medical conditions
- structural abnormalities
- genetic syndromes
- medication side effects
- sensory issues as a primary cause or secondary to limited food availability in early development
- behavioral factors
- social, emotional, and environmental issues
Children with feeding and swallowing difficulties may experience:
- poor weight gain velocity and/or under nutrition (failure to thrive),
- aspiration pneumonia and/or compromised pulmonary status,
- food aversion,
- oral aversion,
- rumination disorder (unintentional and reflexive regurgitation of undigested food that may involve re-chewing and re-swallowing of the food),
- dehydration
- ongoing need for enteral or parenteral nutrition (ng or G-tube).
