Feeding Therapy -> Behavior


Common behavioral concerns faced by parents include: solid or liquid refusal, physical and verbal protest, refusal to self-feed, throwing food, expelling food, gagging or coughing, selectivity by texture, type or color, as well as vomiting. Research on this subject has determined that there are three common consequences that maintain the problematic behaviors surrounding feeding disorders. They include providing escape (e.g. ending the meal, or removing the non-preferred food), attention (can be in the form of coaxing, comforting, or reprimands) or access to preferred items or food, with escape being the most common consequence following problematic mealtime behavior.

Reference links

  • Feeding Therapy (and Picky Eating) 1
    Author: Sensory Kids - There are many reasons why a child can have difficulty with feeding. At Sensory Kids we look at the whole picture, taking in your child’s unique needs and strengths and your family routines and priorities to help develop a comprehensive approach to mealtime and eating. What is Feeding Therapy? Feeding and the act of eating … Continue reading Feeding Therapy (and Picky Eating)
  • A Little PEP Goes a Long Way In the Treatment of Pediatric Feeding Disorders 2
    Author: Teresa Boggs and Neina Ferguson - Feeding disorder in young children is a growing concern, particularly feeding challenges with sensory and/or behavioral underpinning. These feeding disorders are characterized by food refusal, anxiety when presented with novel foods, failure to advance to textured foods, and inappropriate mealtime behaviors. The Positive Eating Program (PEP) was developed to remediate feeding disorders by providing rich experiences in food vocabulary, positive sensory nonfood and food activities, and structured and predictable through trials
  • Therapy Co-Treatment Scenarios and Documentation - Harmony Healthcare International (HHI) Blog 1
    Author: Kris Mastrangelo, OTR/L, LNHA, MBA - PT and OT appear to be a natural pairing because of the treatment crossover in neuromuscular and orthopedic deficit remediation. However, patients also benefit from co-treatments with SLP and OT, for interventions such as self feeding. During these types of therapeutic collaborations, OT can address postural alignment, positioning, adaptive equipment, and the motor sequence of self feeding, while the SLP addresses bolus size, rate of presentation, and any specific strategies identified to reduce the risk of aspiration; such as chin tuck swallow, or multiple swallows per bolus. Examples of appropriate goals in support of co-treatment follow: Patient will demonstrate self feeding skills with setup assistance x 4/5 consecutive sessions x 14 days, while applying swallow safety strategies with minimal verbal cueing. Patient will demonstrate lower body dressing skills with minimum assist while maintaining standing balance in order to complete the task safely in preparation for return to ALF.
  • Self-Determination Theory As a Theoretical Framework For a Responsive Approach to Child Feeding 0
    Author: Johanna Cormack, Katja Rowell, Gianina-Ioana Postavaru - Cormack et al. propose using self-determination theory (SDT) to support the advancement of feeding skills. SDT says that people want to improve their skills, but their ability to improve depends on their social environment. SDT in feeding focuses on cultivating: Autonomy: The ability to control your actions–so, letting kids regulate their own energy intake Competence: Feeling effective–so, choosing foods and feeding methods that provide a ‘just right’ challenge given the child’s developmental level), and Relatedness: A feeling of belonging that allows you to feel connected with others–so, focusing on social connectedness and engagement during mealtimes. On the other hand, SDT suggests that restrictions or pressure to eat will interrupt self-regulation, and might even contribute to adverse outcomes (e.g., food refusals, atypical weight gain, or eating disorders). https://www.theinformedslp.com/review/disbanding-the-clean-plate-club
  • A Behavioral Approach to Feeding Therapy 0
    Author: Verbal Beginnings - Parents of young children more than likely have experienced various levels of pickiness when it comes to getting their children to eat or experience new or different foods. And if you are wondering: “is it just me?” studies have found that this is a rather common problem. About 25% of typically developing children display some forms of picky eating. If you are a parent of a child with developmental disabilities, chances are you have encountered this more often, as it is estimated that 33% of children with disabilities present with feeding difficulties. And if you are a parent of a child with autism, well, you more than likely have a breadth of experience with feeding difficulties as some estimates place the rates of prevalence at about 70% for this population.
  • Milestone Moments 1
    Author: Centers For Disease Control and Prevention - These developmental milestones show what most children (75% or more) can do by each age. Subject matter experts selected these milestones based on available data and expert consensus.

Activity List(s)

Visual Schedule Cards

Related Disorder(s)

  • Feeding disorders - A feeding disorder, in infancy or early childhood, is a child's refusal to eat certain food groups, textures, solids or liquids for a period of at least one month, which causes the child to not gain enough weight, grow naturally or cause any developmental delays.
  • Eating disorders - Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological and social function. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder.

Goal Bank

  • Laura will tolerate the least restrictive diet without signs/ symptoms of aspiration, dehydration, or malnutrition typical for developmental peers in 3 of 4 attempts as measured by clinician observation and data collection over 5 therapy sessions to improve overall feeding and nutrition skills. 2
  • Bryson will participate in structured food tries to increase novel food acceptance to include a variety of textures and consistencies when presented in new locations across a 3 month period. 1
  • Within a 12 month period, Scott will consume 5 or more IDDSI level 7 (regular ) foods from each food group with moderate cueing in order to maintain adequate nutrition as measured through observation during mealtime food trials. 0
  • Marley will increase food awareness of food types through participating in food related activities across a 3 month period. 1
  • Jane will make gains on the food hierarchy to increase food-inventory over a 3 -month period. 0
  • Sarah will participate in easy-moderate food sensory activities with minimal resistance given minimal support over a 1 period. 0
  • Jane will increase food inventory by 2 foods to improve nutrition over a 6 week therapy period. 0
  • Erica will participate in moderate-challenging non-food sensory activities with minimal resistance given minimal support over a 1 period. 0
  • Bryan will increase food acceptance to include a variety of textures and consistencies through participation in food tries across a 3 month period. 1


Therapists who selected this major focus area as their top area of expertise.

  • Alexa Perry

    Alexa Perry

    Full-time Therapist CF-SLP

    New CF finding her way!