Objective: Conduct a comprehensive assessment and create individualized feeding goals.

Activities:

• Review child’s medical and feeding history

• Assess oral motor skills, sensory preferences, and food tolerance

• Family consultation to understand concerns and set clear goals

• Establish a baseline for food textures, types, and volumes the child tolerates

Objective: Begin desensitizing the child to different food textures and sensory stimuli.

Activities:

• Engage in sensory play activities with food (touch, smell, visual exploration)

• Introduce oral motor toys (chewy tubes, Z-vibes) for sensory input

• Use non-food sensory activities (play-dough, rice bins) to support food exploration

• Introduce visual and social stories about eating to build comfort

Objective: Start building oral motor strength and coordination for chewing and swallowing.

Activities:

• Practice jaw, tongue, and lip exercises through fun, structured activities

• Introduce chewing tools (e.g., chewy tubes) and straw sipping games

• Practice with easy-to-chew foods (soft solids) under supervision

• Caregiver education on reinforcing oral motor practice at home

Objective: Establish a consistent feeding routine to reduce anxiety and resistance during meals.

Activities:

• Create a feeding schedule with predictable mealtime routines

• Introduce a visual schedule or social story about the mealtime process

• Practice structured mealtimes in the clinic with caregiver involvement

• Teach positive reinforcement strategies to manage refusals

Objective: Begin the process of introducing new foods using the least-to-most preferred method.

Activities:

• Present familiar and slightly unfamiliar foods in small, manageable steps

• Encourage touching and smelling unfamiliar foods without pressure to eat

• Utilize motivational techniques (stickers, praise) to encourage exploration

• Caregiver training on how to present new foods at home

Objective: Strengthen the child’s chewing and swallowing skills for a broader range of foods.

Activities:

• Practice chewing with firmer textures, using bite-sized foods

• Use tools like vibrating oral stimulators to enhance oral awareness

• Continue straw drinking for liquid control and introduce new cups/spoons for variety

• Data tracking on oral motor progress and adapting strategies

Objective: Increase acceptance of new textures and flavors by progressing through the food hierarchy.

Activities:

• Present a wider variety of textures and flavors, gradually moving towards more challenging foods

• Encourage tasting and eventually chewing new foods (with no pressure to swallow)

• Use games, rewards, and fun challenges to keep the child engaged

• Document progress and adjust food hierarchy for home practice

Objective: Safely introduce new textures and liquids for children with swallowing difficulties.

Activities:

• Swallowing exercises, such as sucking on different straws or working with thickened liquids

• Gradual advancement of food textures, with ongoing monitoring for signs of aspiration

• Use of vital stimulation or other swallowing aids as appropriate

• Collaboration with parents on safe feeding at home

Objective: Help the child generalize feeding skills to different environments and social settings.

Activities:

• Conduct feeding practice in a variety of settings (e.g., home-like environment, group settings)

• Introduce more complex meals that mimic family mealtimes

• Practice generalizing oral motor exercises to everyday situations

• Prepare caregivers for mealtime challenges outside of the clinic

Objective: Equip parents with the skills needed to maintain progress at home.

Activities:

• Detailed home program with food hierarchies, oral motor exercises, and sensory strategies

• Training on handling food refusals and promoting positive mealtime behavior

• Support on creating family mealtime routines that encourage participation

• Ongoing communication and guidance for future feeding challenges

Objective: Reassess feeding progress and adjust the program based on the child’s needs.

Activities:

• Reassess food tolerance, oral motor skills, and swallowing safety

• Update the feeding plan based on progress made so far

• Discuss any challenges faced during home practice and adapt strategies

• Set goals for continued progress beyond the intensive program

Objective: Ensure the child and family are ready to maintain feeding progress independently.

Activities:

• Review all progress and reinforce critical strategies for maintaining success

• Create a long-term feeding plan for home and school environments

• Schedule follow-up sessions to monitor sustained progress

• Provide resources for ongoing support and collaboration with medical professionals