Advanced Therapy Solutions

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Articulation and Social Skills Groups

• After School Therapy Sessions!

Articulation Groups: Practice sound production, social practice and real life conversational situations, intensive instruction on sound production, reduced cost but the with low group numbers, peer accountability, and a master’s level therapist expertise.
Social Skills Groups: Designed for students who have high level verbal skills but need assistance with social interaction skills.

Horseback Therapy! Known as Hippo Therapy, this therapy engages the child in learning speech and language goals as well as increasing OT areas of sensory and motor skills. Provided in Queen Creek, Arizona

Feeding Therapy Weekly therapy sessions available to work with children between the ages of newborn to 5 years of age with feeding difficulties. We use a combination approach of sensory and behavioral feeding therapy, depending on the needs of the child.

What is Feeding therapy?
This document has been reviewed by the medical team at www.HealthCentral.com

Feeding therapy helps infants and children with a wide array of feeding difficulties which may include one or more of the following:

Reduced or limited intake
Food refusal
Food selectivity by type and/or texture
Dysphasia (swallowing difficulty)
Oral motor deficits
Delayed feeding development
Food or swallowing phobias
Mealtime tantrums

Addressing feeding problems may be important for preventing or eliminating nutritional concerns, growth concerns including failure to thrive, unsafe swallowing which may lead to aspiration pneumonia and future poor eating habits/attitudes.

Feeding therapy may be conducted in an outpatient clinic or hospital. Staff involved in conducting the initial feeding evaluation and any subsequent therapy will depend on the location of the evaluation and the infant or child’s current concerns. The feeding team may include one or more of the following: a speech/language pathologist, occupational therapist, physical therapist, nutritionist, social worker or other medical professionals.

Initially the evaluator will gather information about the infant or child’s medical, feeding and developmental history. Measurements of weight, height, weight to height ratio, frame size and fat stores may be taken. An observation of a typical feeding then takes place. The evaluator may then change some aspects of the feeding and note the outcomes in order to develop a plan to address the current concerns.

The evaluation itself is looking at a number of feeding skills and behaviors
Most importantly the evaluator is assessing oral-motor and swallowing skills to determine if the infant or child has a physical problem or lack of oral-motor skill that is interfering with the child's ability to eat an appropriate diet safely. Many infants and children with GERD have delayed feeding skills because the pain they associate with feeding caused them to refuse feeding altogether or refuse certain types or textures of foods and they don't gain the needed oral-motor experience to develop the physical skills needed to safely consume the type of diet they should be consuming. These associations can also lead them to attempt to get the feeding process over quickly as possible so they do not take to the time to use the physical skills needed to eat safely. Some children with GERD may also require tube feedings again reducing their exposure to oral-motor experiences and effecting their feeding skill development.

Observation alone may not give the evaluator all the information they need in assessing the infant or child’s physical skills for feeding. They may need to schedule a swallow study to gain more information. The swallow study will allow the evaluators to look for structural abnormalities in the swallowing mechanism and assess risk factors for aspiration (penetration in to the lungs) of foods and liquids.

What foods does the child eat? Which are refused?

The infant or child’s diet is an important factor to evaluate in terms of what food and liquid types are being offered and accepted, amounts consumed and whether there are any nutritional deficits or growth concerns.

Observing mealtime behaviors

Finally the evaluator also notes any mealtime behaviors that may be interfering with adequate intake. In noting behaviors the evaluator will look at how the feeder and the infant or child communicate with each other during the feeding, manipulative or maladaptive behaviors on part of the feeder or child and the child’s self-feeding development. Many problems can occur in this area. The child may be clearly communicating that he finished eating by turning his head yet the feeder pushes the child to eat more. The feeder may offer an endless array of choices at meals allowing the child to manipulate what he will and will not eat. The child may not be allowed to self –feed because of the feeder’s desire to control the amount of intake or cleanliness of the feeding.

The role of reflux in developing unusual eating patterns

It is clear that many infants and children with GERD develop negative associations with feeding due to the reflux pain that feeding has caused them. If their pain is not managed adequately, the infant or child may develop secondary behavioral symptoms of food refusal, selectivity and oral sensitivity which can negatively impact growth and maturation and can lead to delayed acquisition of feeding skills. Infants and children with GERD may be hypersensitive to tactile sensations therefore do not explore objects with their mouths, which can lead to a lag in the development of the oral sensori-motor skills required for feeding. Introduction of spoon feeding may be delayed due to lack of readiness skills or noted increase of symptoms with introduction of solid foods. Young children also may have difficulty advancing to textured foods and may gag or choke while feeding. These symptoms (i.e., food refusal, selectivity and oral sensitivity) put stress on the feeding relationship between the young child and caregivers and may lead to counter-productive feeding practices.

The associations that infants and children make between the pain of GERD and feeding can remain even long after the pain of GERD has subsided. Young children may also be taken off medication when the obvious symptoms of reflux disappear yet their reflux may continue silently (meaning that stomach contents go into the esophagus but does not result in vomiting) and cause continued feeding problems. Therefore it is vital that the young child receive proper medical diagnosis and treatment of reflux, especially pain relief, before attempting a feeding intervention program. Although feeding therapy can be effective in addressing many types of feeding difficulties, without effective pain management, oral-motor, sensory and behavioral feeding interventions may yield disappointing, ineffective results. By Pamela Tyler, M.S., CCC-SLP