Originally published on Dec. 6, 2017.
The world of complex developmental and feeding needs can be a confusing one. Just why do I need this many people involved? What do they all do?
Here's a quick guide to some of the people who might well be the main players on your team. You may well find variations in different countries, and in different parts of the country as to exactly who does which things, because roles in feeding tend to have a degree of overlap (which can be brilliant, or a pain, depending on how well this is managed).
- Dietitian. It's your dietitian's job to monitor your child's nutrition, and optimise growth and nutrition in the light of any developmental and medical needs, and any recommendations made by your Speech and Language Therapist, such as texture modifications or supporting your tube-fed child to experience hunger.
- Speech and Language Therapist (aka SLT or SALT) in the UK/Speech Language Pathologist (SLP) in the US. SLTs usually have additional training to work with children with feeding difficulties. We assess your child's oral skills (sucking, chewing etc) and the safety of their swallow. We may also do work with their sensory systems in as much as they impact on eating and communication. In this role we can overlap with OTs.
- Occupational Therapists (OTs), support children with their ADLs (Activities of Daily Living). Luckily for us, eating is one of these! Our OTs help us with sensory processing assessments and therapy, adaptations (such as seating and adapted eating equipment) and with fine motor skills (so important for self-feeding skills). In some countries, OTs take on more of the feeding therapy roles that SLTs tend to take on in the UK.
- Physiotherapists. Not always remembered as being part of the feeding team, but Physiotherapists often do the work on which many of our feeding skills are grounded. We've talked previously about the need for both stability and mobility in our motor structures in order for feeding skills to progress. Without Physiotherapists doing this work, we wouldn't be able to progress feeding. Physios also support your SLT to understand how to handle and position your child to optimise their feeding development.
- Nursing Teams. Supporting your and your child with issues around tube-feeding (and so much more).
- Paediatricians and other Consultants. Your child may be involved with many consulstants. They may not have a direct day-to-day role in your feeding team, but us therapists need their direction on your child's medical conditions to know how to proceed safely and effectively.
- Play Therapists and Portage Workers. If you're lucky, you will have access to one or more of these services, to help your team and you make therapy playful and fun for your child, and help you break big targets down into smaller, play-based ones
- And most importantly..........
YOU and YOUR CHILD
The reason we all come to work every day, we love to celebrate your child's successes with you.
Have you got anyone on your feeding team that I've forgotten? Sing their praises in the comments.