Category Archives: Feeding

Would my Infant or Child Benefit from Feeding Therapy?

Feeding Therapy Insight

As a pediatric speech-language pathologist with special interest in feeding and swallowing disorders, I have encountered a wide range of ages of children who present with difficulties surrounding feeding and mealtimes for a variety of underlying reasons. I have also had the unique opportunity to see these children make incredible gains and progress toward enjoying mealtimes.

For most of us, eating is generally an enjoyable, fairly effortless experience that we look forward to; but unfortunately this is not the case for everyone.

Prevalence

Studies have shown that 25% of the pediatric population exhibits moderate to severe food refusal and that number increases to 80% in children with developmental delays.

Infants or Children Who are Tube-Dependent or Have a Complex Medical History that Negatively Impacts Feeding

Feeding disorders can present themselves in a variety of ways, making it important to know when your child would benefit from seeing a speech language pathologist who specializes in feeding.

  • Is your child’s medical history significant for complexities that negatively impact their ability to receive nutrition orally?

  • Is your goal for them to rely less on a feeding tube or to decrease building stress when it is time to eat?

When children require significant medical attention, they can develop negative associations surrounding feedings or even any touch close to the face.

Feeding tubes can be required for a variety of reasons, but a speech-language pathologist is knowledgeable on the anatomy and physiology of the systems that work together for eating and drinking and can help you reach goals you have for your child, whether it be related to behaviors, oral motor difficulties, etc.

 

Enteral feeds can feel unnatural and frustrating for both parents and their children and unfortunately removal can feel like an intimidating and sizable goal. For this reason, feeding specialists also use strategies to make this experience positive, while gaining the child’s trust to allow touch to the face or for foods to enter the mouth without heightened fear that someone is going to hurt them.

The future is always in mind, as we work with families to establish positive feeding behaviors that will decrease stress further down the road. Since caregivers are with their children for the majority of these feedings, it is also critical that the feeding specialist work alongside families as members of the team.

With the help of a feeding specialist, issues surrounding negative mealtime behaviors and oral motor abilities will evaluated and treated.  Feeding therapy will target providing your infant positive oral stimulation and equipping families with tools and knowledge necessary to meet their goals for their infant. This process requires patience, as it takes small steps to achieve this large goal.

If you have questions or are concerned about your child’s feeding abilities, contact us at anytime. We would welcome to provide a complimentary phone consultation.

Written by:

By: Abby Ziegler M.A.,CCC-SLP
Pediatric Speech Pathologist
Feeding Specialist

Read More about Abby at: http://www.teamchatterboxes.com/about/abby

Chatterboxes Private Speech Therapy Services

 

Better Speech Therapy

No, We don’t Accept Insurance Directly for Speech Therapy:

See Why Parents & Kids Love It

Prior to her work at Chatterboxes, our founder, Megan Rozantes., M.S., CCC-SLP used to provide insurance-based speech therapy services.

She knows first hand the differences between Insurance-Based and Out-of-Network Speech Therapy. Based on her previous insurance-based experience as a speech therapist, Megan learned everything she didn’t want in a private speech therapy practice, and everything she did want!

Our practice’s mission is to shine the therapy spotlight directly on each child, every time. We’ve alleviated administrative duties, external challenges, red tape and time constraints for our therapists, so our therapists have the ability to focus intensely on each child’s needs and abilities. This is truly the cornerstone of Chatterboxes. Our support staff ensures that each speech-language-pathologist has the administrative support, time and resources she needs in order to maximize her clinical impact, allowing therapists to work smarter, not harder.

Now, more families are choosing the Out-of-Network and Private Pay model for Speech Therapy. Here’s Why:

Speech Therapy Low Caseloads

Low Caseloads

Speech therapy services are in demand! The average Speech Therapist is helping so many more kids than is reasonable for her schedule. At Chatterboxes, our caseloads are 50% lower than industry average so that we are able to devote more time to each child’s therapy session each and every time.

What do lower caseloads mean? Plan, Prepare, Plan: We can provide twice the planning time and premium resources for rapid progress. It’s not uncommon for a Speech Therapist at Chatterboxes to plan for a 1-2 hours for a single 45 minute therapy session.

The more time our team puts in behind the scenes to prepare for each child’s visit, the better the therapy results. Why? because kids are engaged and it matches their needs. Know a lover of Paw Patrol or Red Matchbox Cars? We guarantee that our kids are super-motivated to participate, as we’ve thoughtfully crafted up a personalized session based on their interests every time.

Speech Therapy Fresh Top Talent

Fresh, Top Talent

We provide speech therapy with a personal connection and friendship, creating trust from which progress is built. We are not a factory. We do not churn out visits. That means, our talented private speech therapists are bright-eyed and are honored to be providing services to each child! Our Speech-Therapists are eager to share their clinical knowledge via in-person conferences, phone talks, countless emails and text messages,  highly customized home programs and family training to make a difference in each child’s abilities! 

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The Child’s Ecosystem & Skill Progression

In order for Speech Therapy to be effective, each child must be able to demonstrate skills outside of the therapy environment. Each child is surrounded by their own ecosystem. If the important adults in each child’s life are not trained in targeting speech therapy goals, progress will be affected. We train parents, teachers, grandparents, nannies, babysitters, etc in our vivid and clear home programs. Each adult has access to specific instructions and understands how to offer support to the child toward speech therapy goals. To keep everyone updated, we offer free speech therapy progress reports and phone conferences.

The Bottom Line

In Conclusion, at Chatterboxes, our team feels that Highly-Individualized speech therapy is not possible in an Insurance-accepted paradigm due to limitations on time and resources driven by financial constraints

Our mission at Chatterboxes is to increase each child’s ability to succeed with better speech therapy services and transform the process of speech therapy to be a highly-customized, delightful and effective experience for kids and parents.

Eager to learn more? Contact Heather for your Complimentary Initial Consultation at 617-969-8255, or visit us at www.TeamChatterboxes.com

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Proudly Serving Massachusetts via our two easy access locations:

35 Bedford Street Lexington MA 02420

 10 Langley Road, Newton Centre 02459

 

 

 

 

Many parents experience the woes of picky eating at some point in their child’s development. A child’s negative eating behavior can adversely affect the mealtime experience and have a detrimental effect on the child’s health and development.

Try these tips:

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  • Let your children ‘help’ you prepare meals when you can! Getting them involved in the process allows kids exposure to new foods without the pressure of consuming them.
  • When introducing a new food, encourage interaction with the food in a less invasive way by gradually progressing through the following levels: tolerating on the table/plate, touching, smelling, kissing, licking, biting, chewing, and swallowing.
  • Introduce an “all done” bowl. Don’t allow your child to leave the table until all of the food on his plate is either ingested or interacted with (pick up, kiss, lick, etc.) and placed into the all done bowl.
  • Use a timer or visual schedule to encourage your child   to stay at the table for the duration of the meal.
  • Ignore any negative mealtime behaviors. This includes verbal protesting, pushing foods away, letting food fall   to the floor, etc. Use timeouts when necessary in the event of disruptive mealtime behaviors.
  • Continue offering new foods many times, even if the foods were refused in the past. Be patient and persistent.

Fostering Feeding Independance

Feeding Indepedance

Children have a natural drive for independence and control from a very young age, especially when it comes to eating. By allowing your child to self-feed and participate as fully as possible in their meal, you create valuable opportunities for children to be exposed to a variety of foods and practice essential skills. Provide your child with the right tools:

  • Get your child involved in mealtime preparation in any way possible. (Helping cook the food, or set the table) this increases their comfort level with a variety of foods, prepares them for what foods they will be presented with during the meal.
  • Allow your child to make choices between foods whenever possible. Make sure that you will be happy with whatever choice your child decides upon (e.g. offer the choice of broccoli vs. green beans but not broccoli vs. cookies).
  • Avoid sippy cups. Use straw cups or open cups instead. Babies as young as six months can begin to use straw cups. Sippy cups can create an open-bite and a tongue thrust swallowing pattern in some children, which adversely affects articulation and dentition.
  • After age 18 months, try to avoid feeding your child as much as possible. Developmentally, children at this age are ready to be fully independent eaters.
  • It’s OK to get messy! The sensory experience of getting messy can foster greater exposure to and acceptance of foods. Allow your child to attempt self-feeding as much as possible, even it means making a mess.

Developmental Milestones for Feeding

Feeding Highchair

The below feeding skills may be a helpful guide as you work through mealtimes with your young child:

Age: Birth to 4-6 Months

  • Nipple Feeding: (breast or bottle
  • Hand on bottle during feeding (4-6 Months)
  • Parent-Infant interaction

Age: 6 – 9 Month

  • Spoon feeding for thin puree
  • Suckle PatternBoth hands hold the bottle
  •  Finger Feeding introduced
  • Vertical munching of dissolvable solids

Age: 9 – 12 Months

  • Cup drinking
  • Eats lumpy & mashed food
  • Finger Feeding for dissolvable solids
  • Chewing & rotary jaw actions

Age: 12 – 18 Months

  • Self –Feeding
  • Grasps spoon
  • Holds cup with 2 hands
  • Drinking with 4-5 consecutive swallows
  • Holds and tips bottle

Age: 18 – 24 Months

  • Swallows with lips together
  • Self-Feeding is predominate
  • Chewing a wide range of foods
  • Tongue movements become more precise

Age: 24 – 36 Months

  • Circulatory jaw rotations
  • Total Self-Feeding using fork
  • Chewing with lips closed
  • One handed cup holding

Picky Eater or Feeding Disorder?

Ruby Mendoza, a student in the Munroe Elementary School gardening club enjoys a meal she helped prepare by growing and chopping vegetables at the school in Denver

Chatterboxes’ therapists work with children and their families to develop age-appropriate feeding skills and promote positive mealtime behaviors so as to foster healthy feeding habits during the critical early stages of a child’s life. Our feeding therapy program employs motor exercises, oral-motor techniques and/or procedures to optimize mealtime structure, as well as to explore and introduce new food types and textures.

The development of feeding skills is essential to a child’s physical, cognitive, and emotional growth. Children begin acquiring feeding skills as infants and gradually progress to have adult-like skills by the age of three. In these critical first three years of life, children learn to manage a variety of textures, starting with liquids and then advancing to purees and solids. They become increasingly skilled at using utensils and eventually become independent self-feeders.

Many children can be described as “picky eaters” in these early years, but when is it more than just being picky? A feeding disorder can manifest in a variety of ways. For instance, some children have an extremely restricted repertoire of ingested foods. Others do not consume enough volume to maintain a healthy weight. Still others may not be able to progress to age-appropriate textures. Whichever the feeding-related issue, the situation can be extremely stressful for both the child and their family.

Common Referral Criteria for A Feeding Evaluation Include:

  • Delay in feeding milestones
  • Weight loss or lack of weight gain for 2-3 months
  • Persistent gagging or coughing while eating
  • Irritability surrounding meals
  • Severe behavior problems related to feeding
  • Food refusal

Click Here to Read More about Feeding Milestones & When To Expect Particular Skills

Private Speech Therapy vs School-Based Speech Therapy: How do they Stack Up? (Part 1 of 2)

 
“Should I Stay with School Therapy or Should I go Private?”  
 
Alot of parents are asking themselves this question at some point during their child’s speech therapy care. Parents may struggle to see progress with school speech therapy,  Yet, going to a Private Practice entails an increased cost when compared with school-based therapy.

 

Training
 
Both a Private Speech-Language Pathologist and a School Based Speech Pathologist who are “CCC-SLP Certified” have the same level of educational training after all, so how can there be a difference in services?

 

Here’s why: The school SLP must work under the confines of her school district’s regulations. Due to the intense need for speech & language services at school, the Speech-Pathologist practicing in a Public School typically faces an ever-increasing set of demands during the school year; thus she’s presented with an expanded scope of practice. School SLP workload responsibilities include:
 
Therapy Timeline
 
By law, in Massachusetts, once the public school has received parental consent, the school has 30 working days to perform an Evaluation. Once the testing is complete, a team meeting must be scheduled within 45 school working days.
 
Time-Out. 75 Days? That’s a substantial period of ‘waiting’ time in a child’s academic school year.
 
In a private setting, an evaluation is typically scheduled within 1 week. The report is then produced in 7-10 days and therapy often begins the week after the evaluation.
 
Eligibility & Qualification
 
Your child needs to meet state issued eligibility standards to qualify for speech/language services in the Public Schools. In Massachusetts, “To be eligible for special education services, a student must first be found to have a  disability which is causal to an inability to make effective progress in school.”
 
In a Private Setting, your child does not need to be ‘eligible’ for our services. A parent calls with concern and we arrange for an Evaluation during a preferred time in your schedule.
 
The Evaluation Process
 
In a school-based testing situation, the SLP is confined to measuring performance solely based on standardized test results.
 
A private evaluation entails standardized testing (like in the schools), yet the Private Therapist has the discretion to include her Clinical Impressions. She has the ability to consider that your child may have had an off-day, or that he can exhibit a particular skill in play, but not during testing. You can also weigh in with your thoughts on your child’s performance, as chances are, you’re in the room.
 
With your parental consent, the private SLP can share her immediate impressions of your child’s evaluation results upon completion of the evaluation.
 
Therapeutic Environment
 
We all know that kids make progress when they are engaged and having fun. In a child- therapy situation one of the keys to success is the clinical environment. Do you know where your child’s school-therapy takes place? A hallway? A noisy classroom? An office? Background noise is distracting.

Interested in learning more about us? Visit: www.TeamChatterboxes.com