anna blee speech pathologist

Anna Blee

Anna is a passionate Speech Pathologist who works with small children and makes them feel special and celebrated as they tackle challenges.

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mealtime intervention

Mealtime intervention

Feeding difficulties in children can be a challenging and stressful experience for both the child and their caregivers. These difficulties can manifest in a variety of ways, including picky eating, food refusal, aversion to certain textures, or difficulties with chewing and swallowing.

At Nurture Nest, Speech-Language Pathologists have conducted additional professional development in Paediatric Feeding in order to provide family-centred, evidence-based support for mealtime challenges in the early years.

Some of these include:

  • The SOS Approach to Feeding
  • Babble and Munch Paediatric Feeding Essentials – Infant Feeding, Tongue-Tie and Oral Motor Skills
  • Measuring Up – Centre for Orofacial Myology
  • Orofacial Myology Symposium
  • Neuromuscular re-education post frenectomy
  • Best Practices in Paediatric Feeding, Speech and Mouth Function (Diane Bahr – Talk Tools)
  • Paediatric Feeding Assessment and Management of the NDIS Client (Sarah Starr)

We also adhere to the Principles of the Responsive Feeding Framework, outlined in 2024’s White Paper.

What is responsive feeding therapy

Responsive feeding therapy is a feeding intervention framework that focuses on promoting healthy eating behaviours and developing a positive relationship with food in children. It is based on the idea that feeding is not just about nutrition, but also about building trust and positive associations with food.

The responsive feeding therapy framework is grounded in the principles of responsive parenting, which emphasises the importance of attunement, sensitivity, and responsiveness in parent-child relationships. In the context of feeding, this means that caregivers need to be sensitive to their child’s preferences and dislikes, skill levels and any additional external factors that might impact mealtimes.

At the heart of the responsive feeding therapy framework is the belief that children are born with an innate ability to regulate their food intake. However, this ability can be disrupted by a variety of factors, including medical conditions, sensory issues, and negative experiences with food. Responsive feeding therapy aims to help children re-establish their ability to self-regulate their food intake and develop healthy eating behaviours.

The responsive feeding therapy framework consists of several core components:

Respect for the child’s autonomy

This means that the caregiver trusts the child’s ability to regulate their own food intake and does not force them to eat more than they want or restrict their food choices.

Attention to hunger and fullness cues

Caregivers are encouraged to pay attention to their child’s hunger and fullness cues and respond accordingly. For example, if a child is showing signs of fullness, the caregiver should stop offering food.

Exposure to a variety of foods

Children are more likely to develop a positive relationship with food if they are exposed to a variety of tastes, textures, and colours. Caregivers are encouraged to offer a variety of foods, even if the child initially rejects them.

Positive mealtime environment

Mealtime should be a pleasant and positive experience for both the caregiver and the child. This means that the caregiver should avoid pressuring the child to eat or engaging in negative behaviours, such as criticising the child’s food choices.

Developmentally appropriate expectations

Caregivers should have realistic expectations about their child’s eating behaviours based on their age and developmental stage. For example, young children may be more likely to reject new foods, while older children may be more willing to try new things.

The responsive feeding therapy framework has several benefits for children and caregivers. For children, it can help promote healthy eating behaviours, reduce picky eating, and prevent the development of negative associations with food. It can also help children develop a positive relationship with their bodies and reduce the risk of disordered eating behaviours later in life.

For caregivers, responsive feeding therapy can help reduce stress and anxiety around mealtime and promote a positive relationship with their child. It can also help caregivers feel more confident in their ability to support their child’s healthy eating habits. However, it is important to note that responsive feeding therapy is not a one-size-fits-all approach. Every child is unique and may have different needs and preferences when it comes to food. We can liaise with your child’s team to construct a mealtime support plan that best meets their diverse needs.

Team members might include:

  • Paediatrician
  • Dietitian
  • Occupational Therapist
  • Physiotherapist
  • Paediatric Gastroenerologist
  • Orofacial Myofunctional Therapist

SOS Feeding Intervention program

In contrast, the SOS Feeding Intervention program is a detailed framework that looks at the skills and processing that mealtimes require, in order to build capacities in various domains (e.g. sensory processing, emotional regulation, oral-motor skills). Therapy can occur individually or in small groups (Nurture Nest run SOS Feeding group programs with Octavia Therapies – Occupational Therapy on an annual basis pending need).

SOS stands for Sequential Oral Sensory, which refers to the five senses involved in eating: taste, smell, touch, sight, and sound. The SOS approach was developed by Dr. Kay Toomey, a paediatric psychologist, and Dr. Erin Ross, an occupational therapist, to address the complex nature of feeding difficulties in children.

The SOS approach is a family-centred therapy that involves the child, their caregivers, and a team of professionals. The goal of the therapy is to help children feel comfortable and confident with a wide range of foods and textures.

The SOS approach is based on the premise that feeding is a complex process that involves many different factors, including sensory processing, motor skills, behaviour, and nutrition. The therapy is designed to address these factors in a step-by-step, sequential approach.

The therapy begins with an evaluation of the child’s feeding history and behaviour, as well as their sensory processing and motor skills. The team will also assess the child’s nutritional needs and any medical concerns that may be affecting their feeding. Based on this evaluation, the team will develop a personalised treatment plan that addresses the specific needs of the child. The plan will include strategies for introducing new foods and textures, as well as addressing any behavioural issues that may be contributing to feeding difficulties.

One of the key components of the SOS approach is the concept of “food chaining”. This involves introducing new foods that are similar in taste, texture, or colour to foods that the child already likes. By gradually expanding the range of foods the child is willing to eat, the goal is to eventually introduce a wider variety of foods and textures.

The SOS approach also emphasizes the importance of play-based learning. During therapy sessions, the child is encouraged to explore and play with different foods in a supportive and non-threatening environment. This can help to reduce anxiety around new foods and create a positive association with eating.

In addition to working with the child, the SOS approach also involves coaching and support for caregivers. Caregivers are taught strategies for creating a positive mealtime environment, including setting a consistent schedule for meals and snacks, providing a variety of healthy options, and avoiding pressure or coercion around eating.

The SOS approach has been shown to be effective for a wide range of feeding difficulties, including picky eating, food refusal, and aversion to certain textures. Studies have also shown that the therapy can improve nutritional intake and reduce mealtime stress for both children and their caregivers.

A good starting point

There are a range of therapy techniques and approached that can be incorporated within mealtime intervention programs based on structure and function, and therapy should always commence with a detailed assessment and case history.

If you want to start the process at Nurture Nest Speech Pathology, get in touch.