Feeding therapy plays a vital role in supporting the health, development and overall well-being of children, particularly those facing feeding challenges. At Northern Arizona Healthcare (NAH) Children’s Health Center (CHC) in Flagstaff, feeding therapy is designed to address a wide range of difficulties that can affect a child’s ability to eat safely, efficiently and comfortably.
CHC offers general pediatric wellness and specialty services throughout the region. The CHC team, which includes dedicated specialty health care providers, is committed to providing one-on-one care for children.
These days, more families have higher schedule demands so families are eating at separate times and consuming more convenient, less-balanced meals since it takes extra time to present a well-rounded meal consisting of proteins, grains, fruits and vegetables. Less time at the kitchen table together could lead caregivers to increase reliance on strategies focused solely on “getting them to eat,” i.e., using screen time as a reward and/or distraction, and only providing foods that they know their kids will eat without a struggle.
If a parent becomes concerned about their child’s eating habits, CHC recommends a professional evaluation. Early identification and intervention are especially important because feeding difficulties can have a significant impact on a child’s physical growth, nutritional status and energy levels. Over time, they may also affect speech development, social interactions and family routines. By providing feeding therapy in a specialized children’s health care setting, families gain access to professionals who understand how feeding skills develop and how medical, developmental, and behavioral factors intersect.
The CHC feeding team’s evaluations are conducted by an occupational therapist (OT), a registered dietitian (RD), and a speech language pathologist (SLP) who assess and diagnose which specific feeding challenges a child experiences and what factors may be contributing to them. The initial evaluation at CHC typically takes 1.5 to 2 hours.
First, we complete an in-depth assessment of feeding history and current feeding concerns. The RD assesses for nutrient deficiencies and growth, the SLP focuses on oral motor skills and the OT focuses on sensory skills. The team then observes the child eating a variety of foods, both preferred foods and non-preferred foods are offered. The SLP evaluates oral motor skills to determine if the child is chewing and swallowing as expected for their age. At the same time, the OT observes the child’s self-regulation and sensory processing during the mealtime experience.
Afterward, we reconvene with the family to offer recommendations that address the concerns that family discussed and determine a therapy focus and plan of care that works for the family.
Types of therapies
The CHC team will create a personalized therapeutic strategy to address each child’s unique eating challenges, using various feeding therapy approaches. Some of the approaches that our team members may use during treatment sessions are as follows:
- Sequential Oral Sensory (SOS) Approach uses a step-by-step process to help children gradually become comfortable with new foods. SOS is a child-centered, family-based therapy that uses intrinsic motivation to engage the child in play and exploration of foods. This is especially helpful for children with strong sensory sensitivities or oral-motor delays.
- Food Chaining builds on foods a child already accepts. Therapists create “chains/hierarchies” of presented foods that link familiar foods to new ones with similar taste, texture or appearance. This gentle expansion helps picky eaters broaden their diets while maintaining a positive mealtime experience.
- Responsive Feeding Therapy (RFT) focuses less on the food itself and more on the relationship between caregiver and child. It emphasizes trust and autonomy, encouraging parents to provide structure around what, when and where food is offered while allowing the child to decide if and how much to eat. This is especially helpful when children are just beginning their feeding journeys by building a positive relationship with food and fostering the connection that occurs with caregivers around the mealtime experience.
- Beckman Oral Motor Protocol takes a more hands-on, physical approach with stimuli to target strengthening/coordinating use of: lips, tongue, cheeks and jaw. By improving oral motor strength and coordination, children gain the physical skills needed for chewing, swallowing and managing food safely in the mouth. This method is particularly useful for children with muscle weakness or poor oral control.
Using these approaches together helps to create a specific plan of care that is tailored to each child’s specific needs, ensuring mealtimes become safer, more positive and more successful.
At CHC, we start with reassurance that there is a good and real reason that a child can present as a picky eater and/or have difficulty eating and participating in mealtime, and that it’s not because their child is stubborn, has behavioral issues or is parented poorly. Children with pediatric feeding disorders can have skill deficits, sensory challenges or medical conditions that make it difficult to eat a wide variety of foods. Our team is trauma-informed and aims to meet each family where they are, helping their unique situation.
We aim to provide support to families so that they can work toward improved feeding, leading to less worry and stress.
Located at 5130 N. Highway 89 in Flagstaff, CHC is wheelchair-accessible and serves residents of Coconino, Navajo, Apache, Yavapai and Mohave counties. Contact CHC by calling 928-773-2054.
Thank you to the CHC experts who contributed their expertise to this article:
- Pediatric Dietitian Kirstin Nelson, MS, RDN, CSP
- Speech Language Pathologist JunLi Gallagher, MS, CCC-SLP
- Occupational Therapist Susan Drexler, OTR/L
- Occupational Therapist Kathryn Barrett, OTR/L
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