A Sensory Motor Approach to Feeding
Medical issues, delays or disorders in gross motor development, and sensory processing issues may contribute to feeding disorders.
Children with sensory regulation problems may or may not be able to organize themselves for feeding. Those with oral sensory issues may not feel the food in their mouths, or they may be overly sensitive to the feeling of the food in their mouths. In addition, they may not feel the hunger. Sensory processing issues can cause feeding disorders such as food refusal and self-limited diets.
These feeding issues are often viewed as behavioral issues, when they are actually adaptive responses to primary oral phase feeding disorders. The oral phase of feeding includes intake of food into the mouth, chewing of the food, and movement of the food in preparation for swallowing.
Any breakdown in oral sensory-motor development can result in gagging, vomiting, choking, or sub sequential food refusal. The inability to easily chew food, such as meat and vegetables, negatively affects a child’s ability to thrive and gain wait.
Children who have feeding delays due to motor skills may have had negative sensory experiences with food. If behavioral feeding techniques are resisted by a child, a sensory-motor based feeding program could be implemented with oral sensory-motor exercises and activities. This will allow the child to develop the motor plans for safe, nutritive feedings. Once oral-motor skills of the oral phase of feeding have been acquired, sensory techniques and behavioral reinforcements can be used to expand the diet and increase food quantity.
Purely behavioral feeding programs use preferred foods, toys, books, or television to reinforce children for eating challenging foods. They do not account for the sensory and motor challenges children may be experiencing. Purely sensory-based programs encourage children to explore the smell, feel, and taste of food, However, this approach does not help a child with limited motor skills to develop the ability to safely handle food. Because of this, it is essential to incorporate both behavioral, oral-motor, and sensory components into a feeding program.
A pre-feeding program is to develop the motor skills needed for feeding. The clinician then designs a program to help the child develop skills needed to support safe, nutritive eating. The motor planning required for specific feeding tasks, such as spoon feeding and chewing, can be addressed with oral sensory-motor activities and exercises prior to the introduction of solid foods. Appropriate oral massage and motor planning tasks with oral-sensory tools can help facilitate the development of motor movements required for the oral phase of feeding.