Collaborating to Support Students With Feeding Difficulties School-based SLPs can offer essential information and support to clinical SLPs treating students with feeding issues. School Matters
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School Matters  |   May 01, 2018
Collaborating to Support Students With Feeding Difficulties
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Swallowing, Dysphagia & Feeding Disorders / School-Based Settings / School Matters
School Matters   |   May 01, 2018
Collaborating to Support Students With Feeding Difficulties
The ASHA Leader, May 2018, Vol. 23, 30-31. doi:10.1044/leader.SCM.23052018.30
The ASHA Leader, May 2018, Vol. 23, 30-31. doi:10.1044/leader.SCM.23052018.30
Like parents cheering on a first-time bike-rider, speech-language pathologists frequently encourage children to reach their goals without training wheels.
The bicycle analogy works especially well with children receiving treatment for feeding issues. Many factors can affect how long it takes the student to “ride the bicycle” of independent and healthy eating patterns, but there’s one particular factor that would likely help to speed up the process: collaboration between an SLP treating a child’s feeding issues in a private clinic and the SLP working with that same child in school.

When a student experiences trouble eating, it can affect many parts of their day.

Food and school
As an SLP working with clients in a private clinic, my main focus is treating feeding disorders—characterized by any difficulties eating or drinking, including chewing, sucking or swallowing. Students may have a genetic, developmental or behavioral disorder causing difficulty during mealtimes. Feeding disorders may manifest in a variety of ways: Students may fail to develop age-appropriate feeding skills, refuse most foods, or accept only a small variety of foods and liquids.
  • Picky/selective eaters decline most foods, but eventually eat enough of a variety of foods to sustain healthful nutrition. These students may pack the same few items for lunch every day but overall maintain their health and development.

  • Resistant eaters seriously and consistently avoid food and/or have medical impairments, such as oral motor or developmental delays causing them to eat 15 or fewer foods. They also often refuse entire food groups and demonstrate severe anxiety or tantrums when presented with a new food. This category can include students with autism spectrum disorder and others with a variety of behavioral impairments.

When a student experiences trouble eating, it can affect them throughout their day. They can feel left out of classroom parties or food-related field trips. They might struggle to engage with others during lunch or aren’t able to eat a well-balanced meal that provides them with energy for the remainder of the day. School cafeterias often serve as the epicenter of school life for all grade levels, with conversations ranging from classes, sports teams and TV shows to what everyone is eating for lunch.
Given the importance of lunch to students’ physical health and social-emotional well-being, students receiving feeding treatment would likely benefit from their private-practice SLP and school-based SLP working together. The school SLP can acquire valuable information to help improve the student’s success in private or clinic-based sessions.

Talking about food outside of direct meal time allows students to discuss their feelings toward foods and explore them in a low-pressure environment.

Simple collaboration strategies
Though finding time is never easy, a school-based SLP’s observation of a student’s daily feeding challenges can be very valuable. Many students behave differently at school, at home and during clinical sessions. Observing a student during lunch or in any setting involving food can reveal valuable details to help the private-practice SLP determine the best strategies for private sessions. I often ask my clients’ school-based SLPs for their observations about:
  • Positioning and location of the student in the cafeteria. Does the student always sit with the same students who might eat similar items? Do they avoid walking past or looking at the hot lunch line and bring their lunch every day? How does the student react to peers eating a variety of food at the table?

  • Behaviors observed during classroom activities. Does the student avoid getting messy or touching items with their hands? Does the child not like tight-fitting clothing or have sensitivity toward certain materials? Does the student’s mood drastically change when prompted to complete sensory-based activities?

As I work with school-based colleagues on treating students with feeding issues, I find the following helpful:
  • Engage students in food-related speech activities. Target articulation goals, for example, by naming foods. Set up a “lunch bunch” or go on a “picnic” to focus on pragmatics. Describe food and drink properties with students working on descriptive language goals. Talking about food outside of direct meal time allows students to discuss their feelings toward foods and explore them in a low-pressure environment.

  • Monitor students’ progress. Due to the high interaction rate between school-based SLPs and their students, small milestones are more easily recognized. A student may become more open to new items on their lunch tray, show less discomfort around others eating various foods, or become less messy when they eat. Parents might not notice these changes at home. The progress made at school—a potentially less-stressful environment for the student—factors significantly in a student’s overall success.

Students with feeding issues can face many difficulties at school. Collaboration improves outcomes for any student receiving services from an SLP, but is especially important for students in feeding treatment. Working together, the school-based and private-practice SLP can move students closer to their ultimate goal of getting on a bike and riding without training wheels!
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May 2018
Volume 23, Issue 5