About Us --> Our Approach

The Center for Pediatric Feeding and Swallowing uses an Interdisciplinary approach to assess and treat children’s feeding difficulties. A team approach consisting of a medical, speech pathology, occupational therapy, physical therapy and behavior analysis has been found to be the most effective in helping children with feeding problems. A single discipline, working alone, is often ineffective when children have severe feeding difficulties because they often focus on one area of the feeding problem. Feeding difficulties are often the result of a complex interaction between medical, motor, oral-motor, and learned behaviors.

• Medical problems such as GER or constipation may make eating uncomfortable or even painful.
• If a child has difficulty breathing or supporting his or her head, eating will be very difficult.
• Some children do not have the oral motor skills needed to consume higher textured foods.
• Behavior problems such as batting at the spoon and crying may develop making it difficult if not impossible for the child to acquire the necessary feeding skills and/or consume adequate amounts of a variety of foods.

The Center for Pediatric Feeding and Swallowing uses a team approach to evaluate and treat your child’s feeding difficulties. The contributions and integration of expert members of this interdisciplinary team makes the program at St. Joseph’s unique and effective.

The Center provides:

1. Outpatient Services are offered for evaluations and follow-up. An initial outpatient evaluation consists of a multidisciplinary assessment of your child including a comprehensive history, physical examination, oral motor exam, motor exam and feeding observation. Outpatient follow-up services are typically provided for one hour every two to three weeks. During outpatient visits, treatment strategies will be discussed and may include medication changes, tube-feeding changes, motor exercises, oral-motor techniques and/or procedures to optimize mealtime structure. These procedures will be demonstrated to you and you will be able to practice the techniques before implementing them at home. Based on your report on how your child has progressed at home, recommendations will be adjusted as needed.
    
    
2. The Day Treatment Program is designed for children who require more intensive therapy to achieve their goals. The Center is goal oriented and data driven.
    
   • For children who participate in the Center’s Day Treatment Program specific goals are identified during the first week of the admission.
      
   • The children participate in several feeding sessions per day conducted by trained feeding specialists. During these sessions specific techniques are implemented to
     
     1. maximize the child’s motivation to practice accepting and swallowing new foods or textures and/or
     2. increase the child’s oral-motor skills.
         
   • During these feeding sessions the feeding specialists are also recording how the child is responding to these techniques during each bite.
      
   • By doing so, the team is able to better determine if the child is making progress, if changes to the techniques are needed, when new skills can begin to be taught and how the child’s medical status is effecting their eating.
      
   • Each day during the child’s admission the entire team meets to review each child’s progress. Caregiver training is a large component in the treatment of children’s feeding difficulties. Beginning in the first or second week of the child’s day treatment admission, caregivers are introduced into feeding sessions. Once the caregivers are comfortable implementing the procedures at the Center they will be instructed to conduct meals at home implementing the recommended procedures. Caregivers will also meet weekly with the Center’s family counselor so that any issues that might hinder the family‘s ability to carry out the recommendations. The Center’s registered nurse monitors the child’s growth and health status, as well as administering any needed medications and tube feedings.
      
      
3. Members of the interdisciplinary team are available for Inpatient Consultations at St. Joseph’s Children’s Hospital as needed.

The information provided in this website is not intended to be a medical opinion as to a specific child or patient, and should not be relied upon for purposes of diagnosis or treatment. All questions or issues with regards to a specific situation should be directed to your physician. In addition, information may be exchanged between persons visiting this website. St. Joseph's is not responsible for any such responses, suggestions, comments, exchanges or information.

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