Feeding & Swallowing Therapy
Addresses difficulties with eating, drinking, and swallowing, including food refusal, texture sensitivities, oral motor challenges, and aspiration risk.
What Is Feeding Therapy?
Feeding therapy helps children and adults who have difficulty eating safely and effectively. It is provided by SLPs (who specialize in swallowing) and occupational therapists (who address sensory and motor components of feeding).
Feeding difficulties are common in many disabilities and can include trouble sucking, chewing, or swallowing; gagging or choking on foods; extreme food selectivity; texture aversions; and aspiration (food or liquid entering the airway).
Therapy uses a combination of oral motor exercises, food exposure hierarchies, sensory desensitization, positioning strategies, and mealtime routine modifications to improve safe and enjoyable eating.
Who Benefits from Feeding Therapy?
cerebral palsy
Addresses oral motor difficulties that affect chewing and swallowing safety. Modified food textures and positioning strategies reduce aspiration risk.
down syndrome
Supports oral motor development for feeding, addresses low muscle tone affecting chewing and swallowing, and helps with the transition to solid foods.
autism
Helps with extreme food selectivity and sensory-based food refusal. Gradual, pressure-free approaches expand accepted foods and textures.
muscular dystrophy
Manages progressive swallowing difficulties and adapts diet textures as muscle function changes over time.
What to Expect in a Session
First Session
A feeding assessment (45-90 minutes) includes observation of a meal, oral motor examination, and detailed history of feeding challenges. A videofluoroscopic swallowing study may be recommended if aspiration is suspected.
Ongoing Sessions
Sessions involve practising eating skills with therapeutic foods, oral motor exercises, sensory exploration of new textures, and coaching caregivers on mealtime strategies.
Your Child's Role
Your child engages with foods at their comfort level — this might start with just touching or smelling new foods before tasting. The therapist follows your child's pace.
Caregiver's Role
Caregivers learn mealtime strategies including positioning, pacing, food presentation, and how to reduce mealtime stress. Consistency at home is essential for progress.
When to Start
Early Childhood (0-5)
Begin as soon as feeding difficulties are identified. For infants with known conditions (e.g., Down syndrome, cleft palate), feeding support should start at birth.
School Age (6-17)
Continue therapy for ongoing food selectivity or swallowing safety concerns. School-age children may need support with eating in social settings like the school cafeteria.
Adults (18+)
Adults with progressive neurological conditions or acquired brain injuries may need feeding therapy to maintain safe swallowing and adequate nutrition.
General guidance: If your child is losing weight, refusing entire food groups, gagging frequently, or mealtimes are highly stressful, seek a feeding evaluation promptly.
| Item | Range | Details |
|---|---|---|
| Initial Assessment | $250–$500 | Feeding and swallowing evaluation |
| Per Session | $130–$200 | 30-60 minutes |
| Insurance | Typically covered under speech-language pathology or occupational therapy benefits | |
| Tax Credit | Eligible for Medical Expense Tax Credit (METC) when provided by a registered SLP or OT | |
Money-Saving Tips
- Children's hospitals often have feeding clinics with shorter wait times and no direct cost
- Group feeding programs are sometimes offered at community health centres at reduced rates
- Ask your paediatrician for a referral to a publicly funded feeding clinic
| Province | Status | Program | Details |
|---|---|---|---|
| BC | Partially Funded | At Home Program | Covered through child development centres and At Home Program for medically complex children.(Under 19) |
| AB | Partially Funded | FSCD | FSCD covers feeding therapy as part of occupational therapy or speech pathology services.(Under 18) |
| SK | No data | — | — |
| MB | No data | — | — |
| ON | Partially Funded | Children's Treatment Centres | Available through children's treatment centres and hospital programs; often combined with OT and speech therapy.(Under 18) |
| QC | Partially Funded | CISSS/CIUSSS | Available through public rehabilitation centres, typically as part of interdisciplinary pediatric programs.(Under 18) |
| NB | No data | — | — |
| NS | No data | — | — |
| PE | No data | — | — |
| NL | No data | — | — |
| NT | No data | — | — |
| NU | No data | — | — |
| YT | No data | — | — |
Evidence & Research
Feeding therapy has moderate evidence, with strongest support for oral motor interventions in cerebral palsy and systematic desensitization approaches for food selectivity in autism. Research supports multidisciplinary feeding clinics combining SLP, OT, and nutrition expertise.
Red Flags to Watch For
Be cautious of any provider who:
- Forces food into your child's mouth or uses coercive feeding practices
- Ignores signs of distress, gagging, or refusal during feeding sessions
- Promises rapid results for complex feeding issues that typically take months to resolve
- Does not consider medical factors (reflux, allergies, constipation) that may contribute to feeding difficulties
- Uses punishment or withholding preferred foods as a therapeutic strategy
How to Find a Provider
- 1
Ask your paediatrician for a referral to a hospital-based feeding clinic or children's treatment centre
- 2
Search for SLPs or OTs with specialized feeding therapy training through your provincial regulatory college
- 3
Contact your local children's hospital — many have multidisciplinary feeding teams
- 4
Look for therapists trained in SOS Approach to Feeding, Sequential Oral Sensory approach, or responsive feeding methods
- 5
Ask other parents in disability support groups for recommendations of feeding therapists in your area
Conditions That Use Feeding Therapy
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