Feeding

Feeding work addresses participation in meals, food exploration, oral feeding skills, and functional communication within the person’s medical, sensory, cultural, and family context. Food refusal, discomfort, hunger, fullness, and preference are meaningful communication. The SLP considers feeding and swallowing separately and coordinates with caregivers and the appropriate medical or nutrition professionals.

What to consider in assessment

Ask about family food practices, medical and nutrition concerns, sensory preferences, mealtime routines, hunger and fullness cues, and the person’s preferred way to communicate. Observe acceptance, exploration, oral feeding skills, and participation without making refusal a character judgment. Screen for swallowing concerns and coordinate when needed.

What the SLP can address

The SLP may support oral feeding skills, mealtime communication, and responsive participation with caregivers and the appropriate interdisciplinary team. The goal is individualized participation and safety, not a universal list of foods or forced bites.

Offer a familiar and a novel food in a predictable routine. Let the person choose whether to look, touch, smell, taste, or decline, and model language for preference and “all done.” Record each step of exploration and the support used.

• Use responsive food exploration and document acceptance, refusal, and sensory responses without judgment.
• Record the food, presentation, number of opportunities, supports, and the person’s choices.
• Select goals around participation and autonomy as well as relevant oral feeding skills.

Choose strategies using assessment findings, the person’s preferences, and the treatment context.

Specify the functional context, observable response, criterion, support level, and how progress will be checked.

Describe food, texture, presentation, exploration, acceptance, refusal, and signs of discomfort objectively. Include the person’s communicated preference and caregiver report when available; avoid “noncompliant” or “failed.”

• S: Record the caregiver’s or client’s mealtime report and preferences.
• O: Name foods, presentations, exploration, accepted trials, and supports without describing refusal as noncompliance.
• A and P: Interpret participation and plan the next responsive mealtime opportunity.

Continue with resources currently available on Culturally Speaking SLPs.