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What is Feeding Therapy? A complete guide for parents of autistic children

Feeding therapy for autism: What parents should know

Updated: August 29, 2023 · 9 Minute Read

Rashelle Berry, MPH, MS, RDN, LD

Reviewed by:

Rashelle Berry, MPH, MS, RDN, LD

Highlights

  • Autistic children with food selectivity often struggle to improve their eating patterns without intervention or therapy
  • The feeding therapy team can include a pediatrician, pediatric gastroenterologist, speech-language pathologist, occupational therapist, nutritionist, and behavioral therapist
  • Before starting any feeding therapy, your pediatrician should screen your child for any underlying medical issues
  • Feeding therapy is designed to help your child develop a positive relationship with food by combining different treatment strategies together like behavioral, physical, and nutritional interventions

 

What exactly is feeding therapy?

 

Feeding therapy sounds great! But where do I start?

What happens during a feeding assessment?

  • Perform lab work (blood draw, stool sample, etc.) and/or imaging (X-rays, ultrasounds, etc.)
  • Refer to a pediatric gastroenterologist, speech-language pathologist, nutritionist, pediatric allergist or other specialist if needed
  1. A barium swallow study, also called esophagram or video fluoroscopy swallow study, uses a special type of X-ray imaging (called fluoroscopy) that looks at the back of your child’s mouth to their esophagus (the tube that connects the mouth to the stomach). Fluoroscopy is a kind of X-ray “movie” that shows real-time movements inside the body. Your child will drink a liquid with barium in it. The liquid is usually flavored strawberry (Quick tip! If your child is extra picky, ask if the liquid can also be mixed with chocolate syrup!). Barium shows up on X-ray and shows where the liquid goes when your child swallows. Check out the Children’s Hospital of Philadelphia’s website to learn more about what to expect during your child’s barium swallow study.

 

Normal Barium Swallow Animation, 2011

 

  • Developing strategies to increase the acceptance of food textures
  • Advance your child’s feeding skills by improving their posture, hand-to-mouth coordination, fine motor skills needed for using utensils, etc.

Don’t most kids go through a picky-eating stage? Will my autistic child outgrow it too?

So we know most autistic children have eating difficulties and most will need feeding therapy to improve their eating habits…. Why is this so common?

  • Gastrointestinal issues (constipation, reflux, etc.)
  • Food allergies
  • Oral motor (or chewing issues)
  • Swallowing disorders (difficulties with moving food or liquid from the mouth, throat, or esophagus to the stomach)

Dive Deeper

Article References

  1. Postorino, V., Sanges, V., Giovagnoli, G., Fatta, L. M., De Peppo, L., Armando, M., et al. (2015). Clinical differences in children with autism spectrum disorder with and without food selectivity. Appetite, 92, 126–132.
  2. Mayes SD, Zickgraf H: Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development. Res Autism Spectr Disord 2019, 64:76–83.
  3. Barnhill K, Tami A, Schutte C, Hewitson L, Olive ML. Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder. Case Rep Psychiatry. 2016;2016:1420549. doi:10.1155/2016/1420549
  4. Baraskewich, J., von Ranson, K., McCrimmon, A. and McMorris, C., 2021. Feeding and eating problems in children and adolescents with autism: A scoping review. Autism, 25(6), pp.1505–1519.
  5. American Speech-Language-Hearing Association. 2022. Feeding and Swallowing Disorders in Children. [online] Available at: <https://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-in-Children/#signs> [Accessed 21 April 2022].
  6. 2011. Normal Barium Swallow Animation. [video] Available at: <https://commons.wikimedia.org/wiki/File:Normal_barium_swallow_animation.gif> [Accessed 21 April 2022].
  7. 2015. Upper endoscopy: Guide for children. [video] Available at: <https://www.youtube.com/watch?v=1PrlgWWiJGc> [Accessed 21 April 2022].