Q. My child only eats three things. Will feeding therapy work?
A. Feeding therapy is ideal for your child. If a child has less than 20 foods in their repertoire they have become stuck and need intervention to help them accept more foods. Children will become bored with food they have repeatedly and may start to refuse it. A child may also stop eating a food when the package changes or the ingredients are altered. If they have lots of items in their repertoire losing one isn’t an issue. If they have three and they lose one it becomes a concern.
Q. I am told to put my child to bed hungry – they won’t starve (implying they will eat later). I am not comfortable with this.
A. Children who have feeding issues (e.g. have less than 20 foods, and/or oral motor issues) will starve themselves. They have become stuck and need intervention. Refer to a feeding therapist.
Well meaning people/friends/relatives can often given wrong advice based on their own experience. The majority of children don’t have feeding issues therefore these techniques work. Research shows these techniques/myths are not successful for children with feeding issues. Here is a great resource to share with them. Look at myth 6 in relation to your question in this link, Top ten myths of mealtime.
Q. Do I need a referral from a medical practitioner?
A. No. You can self refer (by contacting me). During our phone call we will discuss whether feeding therapy will be appropriate at this time.
Q.My partner works full time but they want to be part of therapy.
A. I can do evening visits for the initial assessment and we will discuss therapy techniques and plans. At the end of each clinic session I will have notes to give you for ideas at home. I am happy to take phone calls between sessions. (If these are longer than 15 mins a charge will occur).
Q. Why do you need to see me in my home?
A. It is beneficial for me to see what your child does in their own environment around meal times e.g. the chair they sit in, the utensils you have, the distractions they may need. We will also be spending a lot of time gathering information and discussing next steps. Your child will be happier to play in their own home than in a clinic setting.
Q. Why do I need to come to clinic for the sessions?
A. Behaviours have been practiced at home, and there are lots of distractions that can remove the child from therapy. The clinic setting removes these and new skills can be practiced, become successful and then transferred home.
Q. Do you cater for dietary needs?
A. Yes I can, (mainly gluten/dairy free). If however I am unsure what products I can and can’t use I will discuss a shopping list prior to each session and request you supply the food.
Q. How is the food stored and prepared?
A. The Mess Hall is registered using the Food Control Plan with Wellington Council. This is the standard all restaurants and cafes have to abide by and is reviewed each year. An environmental officer comes out to do inspections and ensures my paperwork is up to date. I buy food from supermarkets, store it in containers, (separate from my own food), label and date items. Any food that is prepared in my home has to be to the standards set out in the Food Plan.
Q.My child is seen by a team at the hospital – where do you fit in?
A. I am happy to work alongside other team members you have, share progress and discuss next steps. It can however be tricky/not best practice if two feeding therapists are working with you and your child at the same time. In this situation, breaks in private therapy have occurred when the other feeding therapist is working directly with you, and restarted when this has stopped. We can discuss this on a case by case basis. I require your permission for this contact, therefore if you do not wish me to make contact, I will respect this and none will be made.
Q. My child is on a wait list. Will seeing you affect this?
A. No. I am completely separate from other organisations. It is up to you whether you discuss our involvement with others.
Q.Is there funding I can access?
A. Check with your GP or paediatrician if your child is eligible for the Child’s disability allowance. They will fill out a form which you take to WINZ (NZ Only).
Check with your medical insurance company (each one is different). If feeding therapy is covered there will be a limit to how much you can claim over a period of time.
I have also had other therapists state WINZ may also be able to help if there is a financial inability to pay and can prove no other speech/feeding therapist is available.
Q. What does the clinic look like?
A. The clinic is in my kitchen. You access the house down a driveway (there is room for parking but it can be a bit tricky to turn).
The gate will be open and you walk down a short path to the glass kitchen doors on your right. You will have access to the toilet.
Q. My child has lots of sensory issues and won’t manage feeding therapy.
A. I take into account sensory issues, (as they are linked with feeding issues). The clinic is very quiet with minimal items to distract. The items required for clinic are contained in a trolley. I use calming techniques and take sensory breaks when required.
I also have SOS trained occupational therapists I can recommend who can assess and put strategies in place around sensory concerns before starting therapy session in clinic. We can discuss ideas to try at home if feeding therapy is not appropriate at this time.
Q. How many sessions will it take before my child is eating?
A. It takes 2 years for a person to learn how to eat. When a child becomes stuck it will be longer, however feeding therapy will give you strategies and skills to target this area of concern. I recommend a block of at least 4 sessions. It can be beneficial to have a break to consolidate skills and then attend for another 4 and repeat if manageable. I have found some families are happy with the strategies learned in one block and they contact me for one off appointments in the future.
Q. I don’t have someone to look after my other child.
A. Depending on the age, stage and ability of the sibling will determine whether they can join in. I have had successful sessions with siblings present. (Children can respond well when learning new skills alongside others). Please note if the sibling attends they will need to be part of the session.
Q. Why are feeding therapists also speech therapist?
A. It is my understanding that historically speech therapists were the ones in hospitals who had detailed anatomical knowledge of the lungs, throat, and mouth (mechanics needed for successful feeding and swallowing) and were working on a frequent basis with the patients. Feeding therapy was focused around safe swallowing and alternative feeding methods. More recently ( the past 10 years in NZ), it has now developed into considering the sensory, behavioural and oral motor aspect of feeding skills. Occupational therapists and psychologists can do the SOS training however assessment of safe swallowing remains with the speech therapist.