How do I Know if My Child has a Feeding Disorder?

young asian girl covering her mouth being a picky eater

Feeding disorders are very common. Though it is hard to quantify, “[a]pproximately 20-50% of normally developing children, and 70-89% of children with developmental disabilities” (1) have a feeding disorder. How does this happen so frequently?!

According to Dr. Kay Toomey’s research and reviews of other studies, of children who have feeding disorders, between 65-95% of cases are caused by both behavioral and natural, organic causes (2017) (2). In other words, more often than not, a feeding disorder is not just behavioral! For example, a child that has undiagnosed reflux or allergies has learned to refuse food, because they have learned that food causes them to have an upset stomach. They may continue to refuse food even after receiving treatment for the initial physiological problem. A child that has choked on some solids because of undiagnosed oral dysphagia will begin to only eat liquid and purees to avoid choking. A child that is refusing crunchy foods could have sensory processing disorder and benefit from desensitization. A child that is having a hard time breathing will refuse food in order to get enough oxygen to survive. The examples could go on and on. Every child is different, and needs to be diagnosed and treated holistically.

Some signs that may indicate your child could have a feeding disorder include:

  • If your child eats less than 20 foods
  • If mealtimes take more than 30 minutes
  • If they refuse all of food of a certain texture or color, or are they having difficulty transitioning to solids
  • If they are choking, coughing, or gagging while eating
  • If they are demonstrating a lot of negative behaviors during meal times
  • If they have difficulty with mealtime routines or have a hard time sitting at the table
  • If they have difficulty chewing or swallowing (example: food left in their mouth after they’ve finished eating)

If you think your child could have a feeding disorder, or you feel that you’ve exhausted your options at home and don’t know where else to go, your child could likely benefit from a feeding evaluation and possibly feeding therapy. A pediatric feeding specialist can help you determine the cause, if a cause is present, make appropriate referrals, and plan the best course of treatment. Slowly, your child will become an adventurous and independent eater!

Sources:

  1. 2013. June 13. Banchaun Benjasuwantep, Suthida Chaithirayanon, and  Monchutha Eiamudomkan. Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices. Published online 2013 Jun 13. doi: 10.4081/pr.2013.e10
  2. Toomey, Kay (2017). Top Ten Myths of Mealtime in America. SOS Approach to Feeding. https://sosapproach-conferences.com/resources/top-ten-myths-of-mealtime-in-america/

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April 25, 2024

How Does Physical Therapy Help Children Who Toe Walk?

April is Autism Awareness Month, a time dedicated to shedding light on autism spectrum disorder (ASD) and promoting understanding and acceptance. Throughout this month, we've been exploring how MetroEHS, a pediatric neighborhood therapy company with locations across Metro Detroit, is making a difference in the lives of children on the autism spectrum through various forms of therapy.

Today, we delve into a common phenomenon observed in children—toe walking—and its potential significance, particularly in relation to autism. Toe walking, the act of walking on the toes, balls of the feet, or tippy toes, is a behavior that may raise concerns, especially when observed in children around the ages of two to three.

According to experts at MetroEHS, including Kelly Johns, the Director of Physical Therapy, toe walking can be an indicator of potential developmental issues, including autism spectrum disorder. Children on the spectrum often exhibit sensory-seeking behaviors, and toe walking can be one manifestation of this sensory-seeking behavior, providing them with additional sensory input.

While occasional toe walking in toddlers who are still learning to walk may not be alarming, persistent toe walking, especially beyond the age of two or three, warrants attention. If a child is consistently toe walking more than 50% of the time, it is advisable for parents to seek evaluation and possible intervention, such as physical or occupational therapy.

Toe walking can have various implications for a child's physical development and overall well-being. It can lead to issues such as pelvic misalignment, muscular imbalances, and even the shortening of the Achilles tendon over time. Addressing toe walking early through therapy and interventions can mitigate potential future problems and promote proper musculoskeletal development.

MetroEHS offers a range of therapies, including physical and occupational therapy, to address toe walking and other developmental concerns in children. Additionally, parents can play an active role in helping their children at home by incorporating simple exercises and activities aimed at stretching the calf muscles and promoting proper walking mechanics.

Simple interventions like stretching exercises and using swim flippers can aid in correcting toe walking tendencies and promoting a more natural gait pattern in children. By combining professional therapy with at-home practices, parents can support their children's physical development and overall well-being.

MetroEHS has 14 locations across Metro Detroit, with three more on the way, ensuring accessibility for families seeking therapy services for various developmental needs, including autism spectrum disorder. Find the nearest MetroEHS location to you on the Locations Page!

As we wrap up Autism Awareness Month, let's continue to spread awareness, understanding, and support for individuals on the autism spectrum and their families, empowering them to thrive and lead fulfilling lives.

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.

October 21, 2024

What Is Pediatric DMI Therapy and How Does It Support Motor Development?

Pediatric Dynamic Movement Intervention (DMI) therapy is a specialized treatment aimed at improving the gross motor skills, movement control, and overall functional mobility of children with developmental delays.  DMI therapy is designed to promote and enhance the natural ability of children to develop motor skills through structured, targeted interventions.

What is Dynamic Movement Intervention (DMI)?

Dynamic Movement Intervention (DMI) is a cutting-edge therapeutic approach focusing on improving strength, coordination, balance, and motor planning in children with developmental delays. DMI therapy is based on neuroplasticity principles—the brain’s ability to reorganize itself by forming new neural connections. This means that with consistent and well-targeted interventions, children with motor impairments could make significant gains in motor function.

Without disruption or intervention, unhealthy habits (the types of learned patterns of movement a child relies on rather than reflexive movements) become engrained in the child’s behavior repertoire. Neuroplasticity is defined as the ability of the brain to form and reorganize synaptic connections, especially in response to learning, experience, or following an injury. Neuroplasticity is at its height in young children. Without novelty and challenge, well-established habits always dominate. Due to this natural neuroplasticity, it is often better to start children young with any kind of therapeutic care.

The primary theory behind DMI is the use of the body's automatic postural responses.  In DMI therapy, we place the child in a position where gravity provides information requiring a response. We then wait for the child to complete the movement, with gradually less assistance over time.

Who Needs DMI Therapy?

DMI is beneficial for children with and without a specific diagnosis. However, those with specific diagnoses include, but are not limited to:

Cerebral Palsy: Children with cerebral palsy often struggle with motor control, muscle tone, and balance, all of which can be targeted by DMI therapy.

Developmental Delays: Children experiencing delays in reaching motor milestones (such as crawling, walking, or standing) may benefit from DMI’s movement-based approach.

Genetic Disorders: Certain genetic conditions that affect motor development, such as Down syndrome or muscular dystrophy, may be candidates for DMI.

Spina Bifida: This congenital condition affecting the spinal cord can cause motor deficits, and DMI can be useful in strengthening movement capabilities.

Brain Injuries: Traumatic or acquired brain injuries in children that result in impaired motor functions can be addressed through DMI therapy.

Other symptoms of a child who could benefit from DMI include:

  • Difficulty with postural control (e.g., sitting, standing, or balancing)
  • Delayed or atypical motor development (not crawling or walking at the expected age)
  • Limited muscle tone or spasticity
  • Challenges in coordination and movement precision
  • Fatigue or weakness during movement activities

This is not an exhaustive list. There are many other conditions that may benefit from Dynamic Movement Intervention. DMI therapy is typically recommended for children who have developmental motor disorders or neuromuscular challenges that affect their ability to move, balance, or coordinate their body movements.

Identifying the Need for DMI

The need for DMI therapy is typically identified by healthcare professionals such as neurologists, rehabilitation specialists or physical therapists, often after a comprehensive evaluation of the child’s motor function. Parents may also notice signs that their child is not reaching developmental motor milestones and seek medical advice.

Any physical therapy diagnosis can result in the use of DMI, and this is often very useful for children under 1 to help with head control, children under 2 to help with standing, walking, and posture control, and children 5 and under with more involved diagnoses. Early identification and intervention are extremely beneficial in maximizing the effectiveness of DMI therapy and improving the child’s functional outcomes.