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Picky Eating or Feeding Disorder?

What is a feeding and/or swallowing disorder?

As defined by the American Speech-Language and Hearing Association (ASHA):

“Feeding and swallowing disorders can lead to health, learning, and social problems. Feeding disorders include problems with sucking, eating from a spoon, chewing, or drinking from a cup. Swallowing disorders, also called dysphagia (dis-FAY-juh), are difficulties with moving food or liquid from the mouth, throat, or esophagus to the stomach. Feeding and swallowing disorders are often related to other medical conditions but may also occur without a known cause.”

Feeding and swallowing are complex processes that are influenced by:

  1. Anatomy and physiology, including oral motor function

  2. Sensory development

  3. Behavior or environmental factors

Speech-language pathologists (SLPs) assess and treat feeding and swallowing delays and/or disorders related to all of the above three issues. However, the SLP often needs to consult with other medical professionals, occupational therapists, and/or behavior therapists. Some feeding disorders caused by a physical change in anatomy, structures, or function of the swallow can only be treated through medical intervention. When a feeding disorder is primarily caused by sensory issues, occupational therapists may take the lead. Similarly, when a feeding disorder is primarily caused by behavior issues, a behavioral therapist or a psychologist would need to be the lead therapist on the team.

Meals are a time for nourishment that can be physical as well as emotional and social. Mealtimes involve communication, socialization, sense of family/community, physical growth and health, sensory exploration, and a break as part of a routine.

Identifying a feeding problem

Feeding concerns can be common in some developmental disorders; however, it can be difficult to tell whether a child’s eating habits are normal or require intervention.

Even though picky eating can be a common problem for many young children, research suggests that it’s usually a temporary and normal part of development. Some children have more chronic feeding problems that go beyond picky eating. For example, a child may refuse to eat an entire category of food such as proteins or vegetables, or extremely limit foods based on texture and/or flavor. This may lead a child to exhibit intense behaviors when offered foods they don’t like.

If mealtime is becoming a dreaded part of your day, or if your toddler's eating habits are negatively affecting family life, it is time to call for a feeding consultation. A speech- language pathologist can help decipher between typical picky-eating habits of young children, and a feeding disorder that is more complex.

In a feeding assessment, the speech-language pathologist will ask questions about your child’s medical history, development, and the problems they are having. Then they will observe how your child moves their mouth and tongue, watch your child eat to see how they pick up food, chew, swallow, and drink, and observe how your child behaves during meals. In more serious cases relating to swallowing where aspiration is a concern, a trained clinician may perform a modified barium swallow study. During this. a child eats and drinks food and liquid with barium in it which is visible on an x-ray. This lets the speech-language pathologist and medical team observe how the food/liquid is moving from the mouth to the esophagus.

If you have questions regarding your child's eating skills, call us today at 404-808-5427 or email

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