Feeding & Swallowing Therapy Program

If your child is experiencing feeding and/or swallowing difficulties, an evaluation may be scheduled with a speech-language pathologist to assess your child’s eating and to develop a plan for treatment. Therapy or follow-up visits may be recommended with frequency to be determined based on your child’s needs.

Symptoms of a feeding and swallowing disorder can include:

  • Poor weight gain, weight loss or failure to thrive
  • Choking, gagging or coughing during or after meals
  • Increased respiratory sounds or congestion during or after feedings
  • Ongoing or recurrent respiratory issues
  • Difficulty with transition to next developmental stage of feeding
  • Increased feeding time (greater than 30-40 minutes)
  • Known medical diagnosis associated with oral-motor deficits, oral-sensory deficits or aspiration
  • Difficult mealtimes

Clinical Evaluation

A clinical evaluation is often the first step in diagnosing a feeding disorder. During the evaluation, the speech-language pathologist (SLP) will collect medical and developmental history as well as feeding history and concerns. The SLP will observe you and your child during a mealtime while evaluating the following:

  • Oral motor skills
    • Sucking
    • Chewing
    • Controlling food and liquid
    • Use of age-appropriate utensils
  • Oral sensory skills
    • Aversion
    • Limited variety of foods
    • Extreme picky eating
    • Sensitivity to touch, textures and flavors
    • Excessive gagging
    • Overstuffing
    • Holding food in the mouth for extensive periods of time
  • Swallowing
    • Coughing/choking while eating or drinking
    • Other signs or symptoms that the child may have food or liquid entering the airway (aspiration)
  • Mealtime behaviors
    • Response to mealtime and the feeding environment

Preparing for the Clinical Evaluation

Review the steps below to set up an evaluation. Please note, evaluations are done on a referral-only basis.

  1. Get an order or referral from your child’s physician.
  2. Verify your benefits with your insurance carrier. Contact our Insurance Liaisons at 312.227.6440 with specific questions regarding coverage.
  3. Call 1.800.543.7362 (1.800.KIDS DOC) to schedule a clinical feeding and swallowing evaluation. When possible, schedule the appointment to align with your child’s regular mealtime.
  4. Make sure your child will be hungry when you arrive.
  5. Bring food and drink that your child likes, and foods that are challenging or not preferred.
  6. Bring any bottles, cups or spoons that you use at home.
  7. Bring any other documentation from previous evaluations or treatment.

During the evaluation, the speech-language pathologists will observe your child eating, initiate therapy interventions specific to your child’s needs, make changes to your child’s feeding plan if necessary, and discuss recommendations for therapy or referral to other professionals as needed.

If your child shows signs of aspiration, which occurs when food or liquid enters the airway, your therapist may recommend further evaluation of the swallow via a videofluoroscopic evaluation of swallowing (VFSS) or a fiberoptic endoscopic evaluation of swallowing (FEES).

Videofluoroscopic Swallow Study (VFSS)

A videofluoroscopic swallow study is a procedure used to test children experiencing difficulties with feeding and/or swallowing. The swallow study is performed in the Department of Medical Imaging by a speech-language pathologist and a radiologist. Special equipment is used to provide a moving x-ray of your child's swallow.

During the test, your child is placed in a chair next to the x-ray equipment, which will be running while your child eats and drinks. The parent or speech-language pathologist provides your child with variety of foods and liquids mixed with barium, as well as liquid barium. The barium makes the food and liquid visible during the x-ray. The speech pathologist closely watches the x-ray to see how the food and drink move through the mouth and into the esophagus during drinking, chewing and swallowing and watches for any signs of aspiration. Once the test is complete, you will be given recommendations for feeding strategies and/or changes to your child's diet.

An appointment for a VFSS may be made by calling 1.800.543.7362 (1.800.KIDS DOC®). A physician’s order is required for this evaluation.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

A FEES study is another test of swallowing that may be recommended when there is concern for aspiration. A FEES study is completed with a speech-language pathologist and otolaryngologist (ear-nose-throat doctor). A very small camera is inserted through the nose to directly view your child's throat and larynx when eating. The speech-language pathologist and doctor can see if and when aspiration occurs, and will make recommendations at that time. This test is completed in the otolaryngologist’s office and does not require the use of radiation.

An appointment for FEES may be made through the Otolaryngology Division by calling 312.227.6730.

Contact Us

To learn more about feeding and swallowing services at Lurie Children’s, please call us at 312.227.6320 or e-mail us at speechdepartment@luriechildrens.org and ask to be connected with one of our feeding and swallowing specialists. 

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