60. 3 Signs Your Child Might Need Feeding Therapy

Written By Brittyn Coleman, MS, RDN/LD

In this episode of the Nourishing Autism Podcast, join Brittyn as she addresses concerns from parents whose children have increasingly limited diets. She emphasizes the importance of early intervention through feeding therapy and stresses the importance of selecting qualified, certified practitioners through specific therapist finder tools. Listen in to get practical steps for advocating for your child’s feeding needs.

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TRANSCRIPT

Hi, I'm Brittyn, a Registered Dietitian and autism sibling. I have a passion for helping parents of neurodivergent kids navigate nutrition and wellness for their child, one small step at a time. Here we'll explore practical nutrition tips, learn from top autism experts, break down the newest research, and share inspirational stories that will empower you to utilize nutrition to help your child feel their best and thrive.

Listen in while picking kids up from school, sitting in a therapy waiting room, taking a quick walk or wherever you find yourself, looking for some inspiration and a friend to guide you along this journey. This is Nourishing Autism.

Brittyn: Hey everybody, welcome back to the Nourishing Autism Podcast. I am so excited that you're here. I am also really excited because this is the first time that we have taken a request from our Instagram page and turned it into an episode. So, thanks everyone who submitted your ideas on @nourishingautismpodcast on Instagram, we submitted a little box for you to drop in your answers and we will be choosing, one topic from that and that is how to know if your child needs feeding therapy, which is a fantastic question. Now, I'm so excited to talk about this because I think that there really needs to be some more education around feeding therapy and what it is and how it can really help an individual that has a really limited diet, [00:02:00] but how we also need to be really careful about who is providing this type of therapy, what kind of credentials they have, and all of the pieces that fit together that are going to help your child get the right service that they need for their sensory needs or whatever reason it might be that they need feeding therapy.

So I'm excited to dive into that today. I get questions all the time about this so I'm excited to have a dedicated episode to it. So let's dive into three signs that your child may need feeding therapy and how they might benefit. So the sign number one would be that they're having persistent picky eating, that you're not having success with resolving at home.

Now typically what we utilize as the number cutoff for a number of foods to really start to designate that, hey there's a nutritional problem here, is fewer than 20 unique foods. Now that number, you know, has been chosen across the board. However, if you are feeling really [00:03:00] concerned that your child's diet keeps getting smaller and smaller, you're not having success with expanding it or getting more foods into the mix, and you've been working at this for a while, follow your gut.

I would rather you ask for feeding therapy sooner than later because we all know that wait lists can take a while to get on, or to get off of it perhaps. So I would rather you be asking this from your doctor sooner than later. Now, especially if your child has fewer than 10 foods or let's say that they are missing out on one or more food groups, that would also be kind of a red flag for me that perhaps this is something that we should get ahead of

or start treating now. Now, when a child has a limited food intake and they're only eating the same foods over and over and over again, you really restrict your variety when it comes to the nutrition of the food. And so you're only getting [00:04:00] that same nutrition from those 10 foods over and over again. So it's really easy to develop a nutrient deficiency, which doesn't show up, you know, In the first month or two, but after months and months of a limited diet, we start to see some pretty significant nutritional deficiencies and the signs of those as well.

So we want to be sure that we are getting ahead of that when we're starting to see some of those red flags. I have had many, many families that I've worked with that have done feeding therapy, have gotten the right support, and it has just made a drastic impact on their child's eating.

Now, some people will say, well, I've been in feeding therapy for a very long time. I haven't seen success. And so there are certain things that I want us to be able to recognize. It's important that you realize who feeding therapy is typically provided by, and that's typically a speech therapist or an occupational therapist.

 There are other members of the feeding team, but that hands on, [00:05:00] one on one feeding therapy is typically speech or OT. Now, as a dietitian, I kind of fill in the gap between the parent and the therapist to making sure that we're getting in the right nutrition. I'm also often teaching families how to bring this home, how to bring in foods into the mix that are meeting both sensory and nutritional needs.

And other important members of the feeding team include a child psychologist, a pediatrician, sometimes PT. There are lots of people that can make up a child's feeding team, including a gastroenterologist, especially if the child is tube fed. Now, not every speech and occupational therapist is going to have the training to become a feeding therapist.

Now, they can say, sure, we can work in food, you know, for 10 minutes every session. First of all, that's not nearly long enough to make any kind of lasting impact. But also, if they don't have the right training for feeding, especially for [00:06:00] kids with some major sensory based food aversions, we are not going to see the right success.

Or for kids who maybe have ARFID or Pediatric Feeding Disorder, if you want to learn more about ARFID, we actually have an entire episode all about ARFID, episode number 54.

And then last week, I talked with Christina Van Ditto, whose daughter has ARFID and their personal experience with it as well. So if you want more resources on ARFID and learning more about what that actually is, those are two really great podcast episodes to listen in on.

So if I am trying to help a family find a feeding therapist, I want them trained in the SOS Approach to Feeding. There is an amazing training put on by the STAR Institute for Sensory Processing and they have trainings all across the globe. I went to the one in 2017 in Seattle and it changed my entire life and career.

[00:07:00] It was absolutely incredible. The SOS Approach to Feeding website has a Therapist Finder that you can go type in your zip code or your country or your city and it will help you find somebody that's certified in your area. These can be a variety of healthcare practitioners, but if you're wanting that one on one feeding therapy, you would want to look for a speech or occupational therapist that is in your area and get on their waitlist and ask your pediatrician for a referral.

Next, I also look at the Therapist Finder from Feeding Matters, which is an organization raising awareness on Pediatric Feeding Disorder and ARFID, and they have a great Therapist Finder as well, and so I would recommend using one or both of those resources to help you find a credentialed feeding therapist that is going to be well versed in sensory based food aversions and other pediatric feeding disorders. We don't just want anyone practicing feeding therapy. I want to make sure that you're [00:08:00] getting the right support, because if we don't have the right support, we could be making backwards progress or no progress at all. Now, the number two reason as to why your child might need feeding therapy is that they do have some big sensory based food aversions.

Now, sensory processing disorder is very common in autism. Up to 90 percent of kids on the autism spectrum also have sensory processing challenges, which affects how they interpret the sensory information from the world around them, but also especially from their diet. And so, when we are eating, we have all of our sensory experiences that are coming together, we smell the food, we taste it, we hear it, we see it, all of this happens.

And so, sensory processing disorder can really affect a child's eating. And so, if your child, you notice that they're having big sensory aversions to foods, or they have sensory processing disorder and their feeding is affected, it's really something to take into account here, and they may really benefit [00:09:00] from feeding therapy.

And then number three would be physical difficulties with eating. So if your child is having a hard time with chewing or swallowing or coordinating eating movements, maybe that means like feeding themselves, all of these issues are a problem for their physical ability to eat, and in that case we do want to make sure that we bring in a speech therapist and or occupational therapist that is going to help us evaluate for low muscle tone, evaluate for issues with like fine motor skills, perhaps like coordinating swallows or coordinating tongue movements, there's a lot of things that really need to be evaluated by a speech or OT. So it's really important that we're having the right person evaluate for these. Now, I do get questions often asking, well, can my ABA therapist provide feeding therapy? And while I know a lot do, my personal experience is that I [00:10:00] haven't seen there to be a lot of success with feeding therapy using a BCBA because they're not evaluating for these things that a speech or occupational therapist would like oral muscle tone or coordination of movements.

They don't have that kind of training and we often see that in these kiddos, but also typically I see that they're taking a behavioral approach rather than a sensory oriented approach. Now I don't mean to put a blanket over all BCBAs. I have some clients who have just had incredible experiences there, but I do want to say if you're just getting started in feeding therapy or you're not having success with your feeding therapy, these are some things I would be looking into and going more of the speech therapist, occupational therapist route.

 It's really common that these physical difficulties with eating are overlooked, especially if you don't know what to look for. If you're not a speech or occupational therapist, it makes a lot of sense that you would not necessarily see this. Now, [00:11:00] you could notice that your child is constantly choking on foods or beverages or they're not really bringing, you know, the utensil to their mouth and using a coordinated movement to eat like you would expect them to, or maybe that your other children or their peers are doing.

So we want to make sure that we get that evaluated. Now there's a mom in my membership and they have been working on feeding therapy and been utilizing the Nourishing Autism Collective, which is my program. I have many people who do both feeding therapy and my program at the same time. It's a really great resource to have while you're working through feeding therapy.

 But her occupational therapist and speech therapist are helping with chewing because she has low oral muscle tone and working on chewing and then what we're doing is making sure that we have the right sensory oriented approach to eating, we have the right foods that we're putting in front of her and also prioritizing her nutrition needs.

I also have some other clients that, didn't realize [00:12:00] that feeding skill was an issue, or their oral muscle tone was an issue, until finally they saw a speech therapist who did an evaluation and said, oh yeah, this is going to be a major thing that we need to be working on. And so they started using something called the Myo Munchee to help with that muscle coordination.

Even just doing that alone with the work that we're doing together inside of the Collective, their food list has exploded, which is really, really exciting. So what I want you to take away from this episode is if you've been considering feeding therapy for a while and you just haven't known like who to see, who's qualified, if it's even worth it, I hope that this clarifies some for you and you also have some action items to help you find a feeding therapist that is qualified, to advocate for yourself and your child, for feeding therapy, I do want to really just remind you that your child's weight [00:13:00] percentiles should not be a reason that your pediatrician denies you a referral for feeding therapy.

Your child could be in the 99th percentile, but still have some major feeding problems. Just note that how we grow, is really based in calories. So your child could be meeting their calorie needs, but missing out on most of their vitamins and minerals, and still be pretty deficient in lots of nutrients.

So if you get that kind of pushback, know that I am here cheering you on. If you have the gut feeling that your child needs feeding therapy, and you resonated with these three reasons, or one of these three reasons, your child could likely benefit. And my approach is that it's better to get an evaluation and be told that your child doesn't need it rather than just putting it off and never getting the evaluation until your child really, really needs it and you're in a sticky situation with food.

So this is my bit of encouragement [00:14:00] for you today if you are looking for additional support. We will also throw some of those resources that I talked about inside of the show notes today, and if you are looking for additional support with feeding, this is what I do for a living inside of the Nourishing Autism Collective.

 We only open our enrollment a few times a year, so right now it's currently closed as of the time that I'm recording this episode, but you can get on our waitlist.

We plan on opening to just the waitlist later this summer, so be sure to get on that so that you can be notified when we open the doors again. I hope that this podcast was beneficial for you. Be sure to follow us on Instagram @Nourishing Autism Podcast or at Autism Dietitian and you can find more information about feeding and free picky eating tips all there, but I hope you join me for the next episode of Nourishing Autism.

Next week, we're going to be talking about sensory diets, which are actually not a diet at all, with the crew over at All Things Sensory and the All Things Sensory podcast. I'm [00:15:00] super excited. Can't wait. I will see you next Wednesday.

Transcribed by Descript

About Brittyn Coleman, MS, RDN/LD

Brittyn Coleman, MS, RDN/LD, is a distinguished Registered Dietitian and Autism Nutrition Expert, known for her innovative, sensory-friendly feeding approach to nutrition for children on the autism spectrum. As the founder of the Nourishing Autism Collective, and as an autism sibling herself, Brittyn brings both professional expertise and personal understanding to her work. She empowers families with her expert guidance, helping children receive essential nutrients for optimal health and development. Her strategies are tailored to the unique dietary needs and sensory preferences of each child.

Brittyn's influence extends beyond her membership site through her active social media presence and her popular podcast, 'Nourishing Autism'. Her educational content on Instagram, YouTube, and other platforms has established her as a leading voice in autism nutrition, providing valuable resources, practical advice, and a supportive community for parents and professionals. 

Brittyn Coleman, MS, RDN/LD https://www.autismdietitian.com
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