What Does Pediatric Feeding Treatment Look Like?

young asian girl covering her mouth being a picky eater

Once a child has been diagnosed with a Pediatric Feeding Disorder due to oral dysphagia or sensory processing disorder or, if diagnosed by a psychologist, ARFID (Avoidant/Restrictive Food Intake Disorder), they will likely be referred for treatment. Eating is a learned behavior. It is only instinctive for the first 6 months of life. Older children must either teach themselves, or be taught (Toomey). Treatment for a feeding disorder can be completed by a Speech-Language Pathologist (SLP), Occupational Therapist (OT), Board-Certified Behavior Analyst (BCBA), Dietician, or Psychologist. All of these disciplines have overlapping and unique approaches to treatment, so a Pediatric Feeding team that involves more than one specialist may be best for your child. As an SLP who is part of a feeding team that involves an OT and BCBA, some approaches to treatment that I utilize alongside the team include the Food Chaining Approach, The Sequential Oral Sensory approach (SOS), and the Escape Extinction approach.

Food Chaining has become recently popular due to a book written by Fraker and Cox called Food Chaining: The Proven 6 Step Plan To Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet. To summarize this approach, clinicians and parents would “chain” from food that children currently enjoy by changing 1 aspect of the food at a time: either color, texture, flavor, or shape. For example, if a child enjoys cheetos, you might “chain” to orange veggie sticks (changing flavor), then to green veggie sticks (change in color), then to green veggie chips (change in shape), then to zucchini cut in a circle and placed on the chip (change of texture), then remove the chip. The child is now eating zucchini, and it was introduced slowly in a non-threatening manner! In this procedure, food is not forced on children- they are able to touch and explore it themselves, the clinician models eating it, and children are encouraged to take a bite, but they decide if they would like to try it or not. Using food chaining, children will slowly and positively increase their repertoire of acceptable food.

The Sequential Oral Sensory (SOS) approach was developed by Dr. Kay Toomey, a psychologist who specializes in Pediatric Feeding Disorders. This procedure includes another slow process of children having repeat exposures to foods prior to being forced to take a bite. For example, a child would tolerate a new food, let’s say apple slices, on their plate without expectation of eating it. Once that is tolerated, the apple will slowly and systematically move closer to their mouth, again without expectation of eating. They will touch it first with a fork or toy, then their hand, then put it on their arm, then their cheek, then kiss it, then lick it, then take a bite and spit it out, then chew, and finally swallow the apple slice. This could take a couple of days or even weeks. The idea is to allow children to have positive interactions with the food so that eating is enjoyable and they control what is placed in their mouth according to their comfort level. Eventually the child will be able to more quickly and independently follow the above steps with a new food to independently increase their diet. Children will gain confidence and learn that new foods aren’t as scary as they once thought.

The Escape Extinction approach is an effective, evidence based approach used to aid with feeding problems across all ages and is often utilized in ABA therapy by a BCBA or Behavior Technicians under the guidance of a BCBA. Eating novel food items and non-preferred food items is broken down into easier steps to aid your child with succeeding in their feeding journey. Keeping the presentation of bites and the bite sizes predictable decreases anxiety and allows the child to feel more in control during meal times. We never move up in bite size until we are certain your child is able to handle the bite at that size and has the skills needed to properly lateralize the food item, masticate the bite, and take consecutive bites. Furthermore, this approach reinforces appropriate feeding behavior while extinguishing inappropriate or disruptive feeding behaviors by not allowing the child to escape from taking bites by using a non-removal of the spoon. Often times, children will spit out food, swallow food without chewing, pack bites, turn head away from the bite, or engage in aggression. When these behaviors occur, we do not remove the bite from their lips until the bite has been taken, and provide prompts and reinforcement for taking bites and chewing appropriately.

Children enrolled in the feeding program Metro EHS Pediatric Therapy are evaluated and treated as unique individuals, so these approaches, along with others, are often combined to best help your child experience success with eating.

Sources

  1. Tooomey, Kay. SOS Approach To Feeding.
  2. Tarbox, J and Tarbax, C. Training Manual for Behavior Technician Working with Individuals with Autism Spectrum Disorder. Retrieved from Sciencedirect.com.
  3. Fraker, Fishbein, Cox, Walbert. Food Chaining: The Proven 6 Step Plan To Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet. Da Capo Lifelong Books.

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May 28, 2025

The Importance of Reading and Speech Development

Unleashing the Superpower of Words: The Importance of Reading and Speech Development with MetroEHS Pediatric Therapy

Greetings, heroes of child development! At MetroEHS Pediatric Therapy, we believe every child has a SUPER spark waiting to shine, and there’s no greater way to ignite that spark than encouraging a love of reading. Like a trusty cape, developing reading skills empowers children to soar through life with confidence, connection, and success. Let’s dive into why nurturing these abilities is a game-changer for your little hero’s growth, all while embracing the compassionate, play-based approach that defines MetroEHS!

The Superpower of Reading: Building a Foundation for Success

Reading is more than just decoding words on a page—it’s a superpower that unlocks imagination, knowledge, and communication. For young children, reading acts as a catalyst for cognitive and emotional growth, especially during the critical early years when the brain’s neuroplasticity is at its peak. According to our MetroEHS mission, early intervention is key to leveraging this neuroplasticity, helping kids develop essential skills like speech, comprehension, and social interaction.

When children engage with stories, they’re not just following along—they’re building vocabulary, learning sentence structure, and developing critical thinking. Picture your little one giggling at a silly rhyme or pointing excitedly at a colorful picture book. These moments are more than just fun; they’re wiring their brains for language mastery! Reading exposes children to new words and concepts, fostering a love for learning that sets them up for success in the classroom and beyond.

Speech Development: Giving Voice to Their Inner Hero

Speech development is the megaphone that amplifies a child’s thoughts, feelings, and ideas. At MetroEHS, we know that clear communication is vital for connection and engagement, two pillars of life which enhance quality of life. Through play-based therapy, our therapists create a joyful environment where children feel safe to express themselves, whether through words, sounds, or even playful gestures.

Speech isn’t just about pronouncing words correctly—it’s about building confidence and social skills. When children struggle with speech delays, it can impact their ability to connect with peers or express their needs. That’s where MetroEHS swoops in with intensive, evidence-based interventions. By focusing on consistent, tailored support (think five times a week for maximum impact!), we help children overcome challenges and unlock their ability to communicate effectively.

Reading Fuels Speech Development

Reading and speech development are like two sidekicks working together to save the day. When children listen to stories or read aloud, they practice articulation, rhythm, and intonation. Storytime becomes a playground for language, where kids mimic sounds, learn new phrases, and build the confidence to share their own stories. Our play-based approach at MetroEHS harnesses this magic, using activities like storytelling and role-playing to make speech practice feel like an adventure.

For example, a child might act out a scene from their favorite book, practicing words like “roar” or “zoom” with a therapist’s guidance. These playful interactions not only improve speech clarity but also boost emotional well-being by creating a safe space for self-expression. Plus, reading together with parents or caregivers strengthens family bonds, aligning with our collaborative care model to empower families for long-term success.

Here’s the superhero secret: timing is everything.

The earlier we nurture reading and speech development, the greater the impact. MetroEHS emphasizes intensive early intervention because young brains are wired to learn and adapt. Parents swoop in heroically and read to their little superheroes daily. Therapists address any speech delays or reading challenges, mitigate developmental delays and set children on a path to achieve their full potential. Think of it as giving your child a head-start in their heroic journey!

Unleash Your Child’s Superpowers Today!

Ready to help your little hero soar? At MetroEHS Pediatric Therapy, we’re passionate about revealing the SUPER in every child through compassionate, play-based care. Learn how our evidence-based therapies can empower your child’s reading and speech development. Contact us today to schedule a consultation and join our mission to foster connection, engagement, and success!

December 8, 2023

Unlocking the Power of Play: 5 Beneficial Toys for Children Aged 0-10 Years

‘Tis the season of shopping! During all the hustle and bustle, MetroEHS wanted to offer a few tips for how to shop smart for your little superhero! At MetroEHS, we know that play is a crucial aspect of a child’s development. This means choosing the right toys can significantly impact a child’s cognitive, physical, social, and emotional growth. During this season of giving, we thought we could explore five suggestions for beneficial toys that cater to the developmental needs of children, as well as share our Amazon Shopping Idea list that was created by some of our amazing and knowledgeable MetroEHS therapists.

Sensory Toys and Building Blocks for Littles (0-2 years):

In the early stages of life, infants rely heavily on their senses to understand the world and face-to-face time during play time is paramount. Through engaging directly with beloved caregivers and family members by singing simple songs, reading nursery rhymes, and playing silly fingerplays like peekaboo, little ones learn to enjoy level appropriate toys as well as time with caregivers.

Sensory toys with high contrast patterns are the most engaging selection for children aged 0-2 years. This includes toys with different textures and sounds and toys that allow for simple problem solving.  Aim for easy to grasp toys that target multiple senses for the sensorimotor stage of play in order to promote motor skill development and learning.  Ensure toys are free from small parts that could pose a choking hazard. Be sure to engage with your child by narrating what they are feeling and doing with the toy with simple language (e.g., “Big ball!” if playing with a ball). soft, cold, bumpy, hard, etc.).

Children are natural builders and playing with building blocks can enhance their motor skills, spatial awareness, and creativity. Choose colorful blocks that are easy for small hands to manipulate. Building activities also promote problem-solving, social skills, and cognitive development as children experiment with different arrangements and structures. Engage with your child by verbalizing and encouraging them to “put on”, “knock down”, “kick over”, “put in”, “take out”, or use narration of colors and counting to practice those ever-important verbal skills. Make playtime learning time!

-Pretend Play for Toddlers (2-4 years): Preschoolers love to pretend and role play. Toys that simulate real life tasks (cooking, tools, costumes) are great for cognition and development of the imagination. They also foster independence, social and emotional skills, overall language, and critical thinking.

-Games for Early School-Aged Kids (4-6 years): Board games tailored for young children offer a fun way to introduce early learning concepts such as counting, color recognition, and basic literacy. Games like “Memory” or “Chutes and Ladders” encourage social interaction, turn-taking, and strategic thinking. Games like “Sneaky Squirrel” and “Twister” can foster fine and gross motor skills. Ensure the games are age-appropriate and encourage cooperative play, fostering important social skills.

-STEM Toys for School-Aged Children (6-10 years): As children progress through the school years, STEM (science, technology, engineering, and math) toys can play a vital role in developing critical thinking and problem-solving skills. Look for age-appropriate science kits, robotics, or construction sets that engage children in hands-on learning experiences. These toys not only make learning fun but also prepare children for the challenges of a technology-driven future. Consider games like Headbandz, which can allow your child an opportunity to practice vocabulary skills. Card games are a great time to play with your child in which your child can think strategically, for instance Uno, Phase 10, and Old Maid, can be fun for early school age children.

-Art and Craft Supplies for Creative Expression (All Ages): Foster your child’s creativity with art and craft supplies. From coloring books and crayons for younger children to more advanced crafting materials for older kids, these activities help enhance fine motor skills, self-expression, and imaginative thinking. Consider providing a designated space for art projects, allowing children to explore their creativity in a supportive environment.

Choosing the right toys for children aged 0-10 years involves considering their developmental stage and providing opportunities for growth through play. Soft, sensory toys, building blocks, educational board games, STEM toys, and art supplies can all contribute to a well-rounded and enriching playtime experience. By selecting toys that align with a child’s developmental needs, parents and caregivers can actively support their journey of learning and discovery. Parents are a child’s first play partner. The importance of a parent engaging in play with their child cannot be minimized! Enjoy this special time with your child and make playtime beneficial for both of you.

Experienced MetroEHS Clinicians pulled together a great shopping list which includes some of the toys discussed in this blog. You can find that list here.

https://www.amazon.com/hz/wishlist/ls/2GKR4U81VUFCE?ref_=wl_share

May 7, 2025

The One-Stop-Shop for All Things Pediatric Therapy! – WDIV Segment #3

A Collaborative, Child-Centered Approach

At MetroEHS, therapists from various disciplines—speech-language pathology, occupational therapy, physical therapy, and applied behavior analysis (ABA)—collaborate to address the diverse needs of each child. This team-based approach ensures that therapy is cohesive and comprehensive, promoting optimal outcomes.

Dr. Vira Francis, a speech-language pathologist at the West Bloomfield location, emphasizes the importance of this collaboration:

“When we’re using a collaborative and holistic approach with children, it’s like each team member is a puzzle piece. We really make that impact when we all come together to make the big picture, and it really helps to prioritize the child’s needs.”

Services Offered

MetroEHS provides a wide array of pediatric therapy services, including:

  • Speech Therapy: Addressing communication challenges, articulation, language development, and literacy skills.
  • Occupational Therapy: Focusing on daily living skills such as bathing, dressing, grooming, toileting, feeding, play, social participation, and school readiness.
  • Physical Therapy: Enhancing gross motor skills, balance, coordination, and strength to support functional movement and participation in activities.
  • ABA Therapy: Utilizing evidence-based strategies to improve socially significant behaviors in children with autism and other developmental disorders.

Each therapy session is designed to be engaging and child-led, incorporating play-based methods to make therapy enjoyable and effective.

Creating a Stimulating Environment

The West Bloomfield center is intentionally designed to be colorful and kid-friendly, providing a stimulating environment that encourages active participation. Therapists tailor activities to each child’s interests and sensory needs, ensuring that therapy sessions are both fun and beneficial.

Empowering Families

MetroEHS is committed to not only supporting children but also empowering parents and caregivers. By providing education and resources, they enable families to reinforce therapy goals at home and advocate effectively for their children’s needs.