What Should I Expect during a Feeding Evaluation?

Who will I see?

Depending on the type of clinic, you will likely see a Speech-Language Pathologist (SLP) or an Occupational Therapist (OT). Other professionals who may be present or part of the team include a Gastroenterologist (belly doctor), a Dietition, or a Psychologist. In my clinic, a feeding evaluation usually involves an SLP and sometimes an OT.

Should I bring anything?

I usually recommend that parents bring familiar foods for the child. Bring foods you know your child prefers, or may be more likely to eat. Don’t be concerned if the foods are “snack foods” or “treats.” Some children with feeding disorders are more likely to accept certain easy to eat foods, and the team would rather see how the child eats than worry about what they’re eating at that time. I also recommend bringing preferred cups or dishes so that we can see how the child drinks and uses familiar utensils. I would also recommend a change of clothes for the child. Feeding therapy can get messy, and some children become upset if they are in wet or messy clothes.

Should I bring my child hungry?

I usually recommend bringing the child hungry but not starving. You may also consider scheduling the evaluation at a time the child usually eats to make this easier.

What will the evaluation look like?

During my evaluations, I usually start with allowing the child to become comfortable in the clinic. My clinic is peaceful and fun, and purposefully does not look like a medical facility. I speak with the caregiver to get a brief history, and a general idea of main concerns. When the child is more comfortable, I ask the caregiver to prepare and feed the child the way they normally do, while I observe. Remember, we can help the best if we know the reality. It is helpful to see the full story of how hard a caregiver has to work and change to try to get the child to eat. I always tell my caregivers that they wouldn’t be here if the feeding was going well. I am not judging your parenting, I am looking for places where I can help. After quietly observing some of the feeding, I may ask some questions, or make some suggestions to try. I am watching how the child reacts to different textures, how they bite and chew, and what their lips, cheeks, and tongue do. I’m also looking for concerning reactions or behaviors that could indicate the need for further testing. After the feeding, I will talk with the parent and make recommendations.

What if my child won’t eat?

Don’t worry if your child completely refuses to eat, or becomes very upset. During my evaluations, this happens sometimes. I usually ask the parent if this is common surrounding food and eating. Some children with Pediatric Feeding Disorder (PFD) are unable to eat in different settings, or when there are changes in their routine, or become extremely upset around eating. Children may also take emotional cues from their caregiver for feeding, if you are feeling anxious about the session, they may feel that way as well. If the child won’t eat at all I use caregiver report to develop my treatment plan. This can always be altered when the child is more comfortable and able to take some tastes in future sessions. You may also want to take some videos of the child eating prior to your appointment. This could be very helpful in showing the evaluator what your child looks like when they are eating in their home environment. Finally, some children will only eat at home. In those cases, I sometimes opt to do a home visit or zoom visit to observe the child when they are more comfortable.

What if my child makes a mess, or throws up?

These are both common concerns of caregivers of children with PFD when coming into the clinic. Little eaters are MESSY, and that is expected. Many children with PFD gag during eating, which could sometimes lead to vomiting. This has happened more times than I can count over the years, and is really not a big deal. Any feeding professional knows that this can happen in a session. In my clinic, I will be ready to help with towels and a warm washcloth, as well as a reassuring word. My clinic has stacks of towels and washcloths, sheets to put under the chair, a washable rug, and plastic bags for messy clothes changes.

Final thoughts

It is really important to be completely open with the therapist/team evaluating your child. I always tell my parents “Tell me all the things!” My clinic is a safe space for your family. This is your chance to share all of your concerns, no matter how small. This is also your chance to share your own stress and emotions about your child’s eating. 18 years ago I began treating feeding because my own child had PFD. It is one of the most stressful and emotionally upsetting situations you can confront as a parent, when your child is having difficulty eating. It is a totally helpless feeling which often comes with feelings of guilt, and affects your parenting confidence, I understand this well! Sharing the entire situation with your feeding team can help us to best help your family.

If your child is showing signs of Pediatric Feeding Disorder, or you have concerns with their eating, speak with your family doctor about scheduling a Pediatric Feeding Evaluation. If you’re in Northwest Ohio, you can make an appointment with Dr. Hayward-Sneider by calling (419)-577-1057 or emailing brightideas.speechtherapy@gmail.com