Picky Eaters & Swallowing Problems in Kids

A Speech Therapy Perspective

By Katie Brink, MA, CCC-SLP

Speech-Language Pathologists (SLP) play an important role in diagnosis and treatment of feeding and swallowing problems in kids of all ages. Difficulty with feeding can be demonstrated in many ways and look differently from child to child. Some challenges may begin before food even gets to the mouth. For example, a child may have difficulty with the feel of food on his or her fingers or maybe has difficulty getting food onto a spoon. Other challenges may emerge at a later stage, such as with chewing, sucking or swallowing.

Let's take a step back. In previous blog posts, we discussed picky eaters and problem feeders and how physical therapies and occupational therapies can help. Before we dive too deep into how speech therapy can help with swallowing problems in kids, let's go back to the difference between picky eaters and problem feeders, because the two are NOT the same.

The Difference Between Picky Eaters & Problem Feeders

Picky Eaters:

  • Poor food variety (30 or more)
  • Burns out on preferred foods but will try them again
  • Will attempt to try new foods with use of touch & taste
  • Will eat with the family but eats different foods sometimes

Problem Feeders:

  • Poor food variety (20 or less)
  • Burns out on preferred foods & not attempted again
  • Will tantrum or melt down with new foods
  • Refuses particular group of food
  • Will always eat different foods than the family

*List provided by Dr. Kay Toomey, Pediatric Psychologist

Feeding and swallowing problems in kids can be treated using a transdisciplinary approach which includes the incorporation of an Occupational Therapist (OT). An OT would further assess and treat sensory feeding components or fine motor impairments while a SLP would treat oral strength, coordination and swallowing.

Dysphagia is a common diagnosis that is treated by a SLP. Dysphagia is the medical term SLPs use to describe difficulty with feeding or swallowing and breathing while bottle-feeding or drinking from a cup or straw. Other symptoms of feeding and swallowing problems in kids include coughing, choking, trouble chewing, a wet vocal quality during or after feeding, changes of breathing rate with feeding, and failure to gain weight.

Treatment for dysphagia and swallowing problems in kids is based on the nature and severity of the child's feeding and swallowing problem. A SLP may implement various treatment techniques to develop strength, range of motion, and coordination of the lips, tongue, cheek, and jaw muscles for efficient eating and drinking. They may also assist to decrease oral sensitivity and/or oral aversion and decrease behavioral resistance to feeding. A SLP may also recommend a change in food textures or in the thickness of liquids, a change in the feeding equipment, such as the nipple, bottle, cup or utensils and other strategies to help with drinking and eating.

Feeding Intensives and Programming Coming to the S.P.O.T.

Katie Brink, MA, CCC-SLP and Allison Blakeley, MS, OTR/L will be conducting summer groups targeted towards Picky Eaters vs Problem Feeders, utilizing pediatric occupational therapy. The Sequential Oral Sensory (SOS) approach in conjunction with oral motor strengthening components will be essential elements targeted in the group. 

Each week, we will focus on the use of food color, shape, texture, and smell with the use of speech and occupational therapy theories of practice to further encourage children to explore and try new foods! We hope to use our training and knowledge to offer intensive programs for our picky and problem feeders. Further program development is currently being researched and explored.

The programs will take place at our pediatric occupational therapy center in Sandusky. See the full schedule for the Children's S.P.O.T. summer groups here.