• About Me
    • Disclosure and Disclaimer Policy
  • Blog
  • Shop Ebooks
  • Recommended Products

Pediatric Feeding News

Dedicated to up to date pediatric feeding and dysphagia information

Welcome!

Hi, I'm Krisi Brackett, PhD, CCC-SLP,C/NDT. This blog is dedicated to current information on pediatric feeding and swallowing issues. Email me at feedingnewsletter@gmail.com with questions.

Read More About Me Here...
  • Feeding Flock
    Research
  • For Parents
    & Caregivers
  • View The
    Resources
  • Pediatric Feeding
    & Dysphagia Newsletter
    • Volume 1
    • Volume 2
    • Volume 3
    • Volume 4
    • Volume 5
    • Volume 6
    • Volume 7
    • Volume 8
    • Volume 9
    • Volume 10
  • Workshops &
    Presentations
  • Work
    With Me
  • Links
    We Like

Hypersensitive Gag Reflex and Pediatric Feeding Delays By Donna Scarborough Ph.D., CCC-SLP, BCS-S Miami University, Oxford, OH scarbod@muohio.edu

April 3, 2014 by Krisi Brackett 4 Comments

Introduction

Historically, two clinical areas in speech pathology have tested the gag reflex response as part of a standard oral mechanism examination including:

a) assessment of maximum velopharyngeal excursion (Mason & Simon, 1977; Pannbacker, 1985)

 

b) bedside evaluations of swallowing (Daniels, McAdam & Brailey, 1997). However, due to the complexity of velar movement and the inability to view the posterior pharyngeal region adequately, the gag reflex is not a good indicator of velopharyngeal movement. Testing of the gag reflex response during bedside evaluations should only be part of a complete cranial nerve battery, not as an independent criterion, because individual variance is so great. More importantly, research has shown that the presence or absence of the gag reflex response does not correlate to dysphagia or the ability of an individual to adequately protect the airway (Davies, 1995; Leder, 1996; Irwin, 1999).

 

So why does the gag reflex continue to require attention?

In the pediatric feeding arena, a hypersensitive gag reflex is a relatively common phenomenon which frequently interferes with the ability to complete a thorough oral assessment, limits food advancement, and restricts treatment options. Yet, a hypersensitive gag reflex is an abnormal clinical sign which should alert the feeding specialist to pursue a complete medical history and provide medical referrals when appropriate. Children may present with a hypersensitive gag reflex for a number of reasons including: 1) bilateral lesions of the corticobulbar tracts (observed in TBI populations, etc.), 2) interruption of autonomic nervous system development (e.g. NICU babies and other full-term medically fragile populations), 3) conditioned responses (behavioral food aversions, etc), 4) surgical alterations of the gastrointestinal system (e.g. complications resulting from fundoplications and NES), and 5) other gastrointestinal diseases (e.g. eosinophilic esophagitis). In complex cases, more than one pathogenesis may be involved.

 

Back to basics, defining a gag reflex

For most individuals, tactile stimulation within five ‘trigger zones’ will elicit the gag reflex, including: the anterior and posterior faucil pillars, base of tongue, palate, uvula and posterior pharyngeal wall (Bassi, Humphris, and Longman, 2004). Upon closer inspection these “trigger zones” are all located within the posterior 1/3 of the mouth, thus from a neurologic perspective these “trigger zones” are not surprising. The posterior 1/3 of the oral cavity is innervated by the glossopharyngeal nerve (CN IX) or ninth cranial nerve which has been clearly documented as the afferent limb of this complex reflex (Martin, 1996; Zemlin, 1998). The glossopharyngeal nerve sends projection fibers or sensory information to the nucleus tractus solitarius (NTS) of the medulla. Information from the NTS then sends signals to the nucleus ambiguus (NA) (also in the medulla) which in turn activates the vagal (CN X) efferent fibers to produce the specific motor response (Logemann, 1983; Nolte, 1993: Martin and Jessell, 1996).

 

Variability of the trigger of the gag reflex has been reported in neurologically intact adults to include the trigeminal nerve in as many as 17% of the population tested (Scarborough, Bailey Van Kuren, Hughes, 2008). To date the underlying neurologic pathway to include the trigeminal nerve for some individuals is unknown.

 

Wide degree of variability in general population

Despite this rudimentary pathway description of the gag reflex, the specific neurologic underpinnings are poorly understood and the pathway does not explain the large variability, both sensory and motor, observed across individuals. For some, tactile stimuli presented more anterior to the ‘trigger zones’, visual stimuli (such as spoons, etc.), auditory stimuli, olfactory stimuli, and ‘psychic’ stimuli can also trigger a gag reflex (Landa, 1947; Kramer and Braham, 1977; Murphy, 1979; Scarborough, Bailey-Van Kuren, Hughes, 2008). In addition to varied sensory input, a range of motor responses can be observed. The most rigorous description of the motor response of the gag reflex is characterized as constriction of the pharynx (Martin and Jessell, 1996; Miller, 2002). However, a more traditional view of the gag reflex involves lowering of the mandible in a forward and downward trajectory, with velar and pharyngeal constriction (Leder, 1996). Another description adds a vocalization component to the traditional view; thus blurring the separation between a gag re- flex and a ‘retch’ (Faigenblum, 1968). Concomitant responses such as vomiting, nausea and autonomic signs and symptoms (diaphoresis, lacrimation, etc.) have also been included when defining the motor component of the gag reflex (Bassi, et al., 2004). In addition to reports of different degrees of motor responses, the strength of the gag reflex is quite variable across individuals, from absent to ‘hyperactive’ (Chaffee, Zabara, and Tansy, 1970; Pannbacker, 1985; Perlman et al., 1989; Leder, 1996).

 

What exactly does a ‘hypersensitive’ gag reflex mean?

Surprisingly, a clear definition of a hypersensitive gag reflex does not exist. Instead, descriptions of a ‘hyper’ gag reflex may be divided into two categories: a) the force/type of the motor response, and b) the place of sensory stimulation. The most common descriptions involve the strength or type of observed motor response. Such descriptions include: “severe” pulling away to tactile stimulation (Leder, 1986), spasms of the pharynx (Bassi et al., 2004), or a combination of reflex responses with both gagging and some aspect of the emetic or vomit response (Kramer and Braham, 1977, Miller, 2002, Bassi et al., 2004). A less common means of describing a hypersensitive gag reflex pertains to the place that the gag reflex is triggered. Historical reports of ‘stubborn’ gaggers described individuals who trigger a gag reflex in the anterior or middle portions of the oral cavity (Landa, 1946). Similar reports have been noted in individuals who present with a hypersensitive gag reflex during tooth brushing and an inability to shave as a result of gagging to touch to the face (Murphy, 1979). Recently, gag reflex responses to non-oral body parts and regions within the anterior oral cavity have also been documented in a group of children 3-18 months of age who presented with persistent feeding delays (Scarborough et al., 2006). To date, a correlation between the strength of the response and place of response has not been established.

 

Causes of hypersensitive gag reflex

The specific neurologic cause of a hypersensitive gag reflex response is not known and is likely to be due to more than one basic neurologic mechanism. One way to evaluate the cause is through inspection of the population who exhibit the problem. Children who have a history of traumatic brain injury, specifically bilateral cotrico-bulbar tracts demonstrate a ‘hypersensitive’ gag reflex due to the loss of upper motor neuron inhibition (Schulze-Delrieu & Miller, 1997). In contrast, the hypersensitive gag reflex ob- served in NICU and full-term medically fragile infants who have a history of tube feedings has been pro- posed to be a result of abnormal autonomic nervous system development (Scarborough & Isaacson, 2006). Based on this theory, ‘transient’ tactile connections between the touch sensory fiber tracts and the nucleus tractus solitarius (NTS) are present at birth via an inhibitory interneuron. Further, the activity of the transient fibers diminishes shortly after birth as a result of swallowing during oral feedings. In the ab- errant or hypergag situation these transient fibers fail to retract and consequently result in continued stimulation of the NTS with touch to areas other than the posterior 1/3 of the oral cavity (Scarborough & Isaacson, 2006).

 

Other children are reported to have conditioned responses to oral feedings which may lead to feed- ing aversions (including hypersensitive gag reflexes). Typically, for children with feeding aversions, a hypersensitive gag reflex has been reported to be a result of maladaptive parent-child interactions (Byars, Burlow, Ferguson, O’Flaherty, Santoro & Kaul, 2003). For children with this type of feeding presentation, a hypersensitive gag reflex is a conditioned negative behavior. The exact neurologic mediation of a hyper- sensitive gag reflex that is the result of a conditioned response is not yet known.

 

In adults, a heightened motor response of the gag has been linked to metabolic disturbances such as carbohydrate starvation and dehydration with ketosis (Bassi, 2004); however, in children no such data has been reported. Another report on severe gagging within the geriatric population found an increase in gastrointestinal disorders, 36%, compared to 20% of an elderly ‘non-gagging’ population. Children with gastrointestinal disorders (e.g. reflux, chronic constipation, eosinphilic esophagitis) have also clinically been found to present with a hypergag reflex, although the specific pathophysiology is unknown. Similar clinical reports have been made in children who have undergone surgical procedures such as a fundoplication. One of the reported side effects is “gagging/retching” syndrome. Although the exact neurologic mechanism is not known at this time, the gut has direct connections with the NTS of the medulla and vagus nerve, both of which are involved with basic afferent/efferent loop of the gag reflex.

 

Clinical Implications

Like many other areas of pediatric treatment one of the challenges for the professional is making clinical judgments based on observed behaviors. A ‘hypersensitive’ gag reflex is one observed behavior which has major implications for our pediatric feeding population. By obtaining a thorough history of the child with a hypersensitive gag reflex, the clinician may better determine a potential cause of the abnormal response. Treatment techniques to remediate the hypersensitive gag reflex have been plentiful; but rarely does one technique work for all populations.

 

Interventions of a Hypersensitive Gag Reflex

A number of attempts over time have been made to remediate the hypersensitive gag reflex, particularly in the adult populations. Some early attempts noted in the dental literature included swabbing the mouth with diluted cocaine, using distraction by ‘disengaging the patient’s mind from its tangle of gagging stimuli’ and redirecting it towards some other interest, exercising maximum will power, and altering the dental appliance to minimize the amount of area stimulated when placed in the oral cavity (Landa, 1947). Early reports also found surgical resection of the uvula as successful for individuals with a stubborn gag (Kramer, 1977). Other less invasive approaches have suggested voluntarily increasing the respiratory rate (Chaffee, et al 1970), having the patient hold their breath (Kramer, 1977), hypnosis (Bartlett, 1973), re- laxation in conjunction with hypnosis (Murphy, 1979), behavior modification, suggestion, systematic de- sensitization, sensory flooding, and medications (Kramer, 1977; Bassi et al., 2004). Acupuncture to the upper part of the ear between the concha and triangular fossa has been found to normalize the gag reflex (Fiske & Dickinson, 2001). More recently, combinations of acupuncture and hypnosis have been recommended to treat a hypersensitive gag reflex in long-term therapy needs (Eitner, Wichmann and Holst, 2005a, b). One acupressure point on the chin (Cheng Jiang REN-24) has also been reported to success- fully control the gag reflex during maxillary impression procedures as noted in a brief clinical report (Vachiramon and Wang, 2002). A small region on the palm of the hand has been found to move the afferent limb of the gag reflex posteriorly in neurologically intact adults if at least 2 pounds of pressure are applied (Scarborough, Bailey-Van Kuren, and Hughes, 2008; unpublished data, Scarborough). At this time, individual variability is being explored to determine if the variability is related to the natural curvature of the hand using 3-D technology. None of these techniques have been reported with children although our lab will begin trials in pediatrics in the upcoming months.

 

Behavioral psychologists in the pediatric feeding arena have developed successful behavioral feed- ing programs which address feeding aversions (including a hypersensitive gag reflex) as a result of conditioning or a breakdown of the child-caregiver interactions. Specific behavior management techniques including reinforcement patterns (both positive and negative), shaping, discrimination training and extinction to name a few, are used to remediate feeding aversions (Burklow, McGrath & Kaul, 2002; Patel, Piazza, Martinez, Volkert & Santana, 2002). Professionals who run these programs have done an exceptional job in documenting the specifics related to their success. And although these programs have been successful with remediating a hypersensitive gag reflex in some children, not all children respond to this type of treatment.

 

Finally, in an attempt to begin to unravel the neurologic conundrum of the hypersensitive gag re- flex, animal research is currently underway in our lab. We have begun the process of utilizing c-fos immunohistochemistry and immunofluorescence to begin to map the gag reflex including the specific neuro- transmitters involved (Scarborough & Isaacson, 2007), in hopes that some day future feeding specialists might have answers to a complex and frustrating clinical problem. A research reporting our animal model findings are now available (Scarborough and Isaacson, 2014, in press).

References

Bartlett, KA (1973). Gagging. A case report. Am J Clinical Hypn, 14 (1):54-56.

Bassi, G.S., Humphris, G.M., & Longman, L.P. (2004). The etiology and management of gagging: A review of the literature. J Prosthet Dent, 91(5), 459-467.

Burklow, K.A., McGrath, A.M. & Kaul, A. (2002). Management and prevention of feeding problems in young children with prematurity and very low birth weight. Inf Young Children, 14(4): 19-30.

Byars, K.C., Burlow, K.A., Ferguson, K., O’Flaherty, T., Santoro, K. & Kaul, A. (2003). A multicomponent behavioral program for oral aversion in children dependent upon gastrostomy feedings. J Pediatr Gastroenterol Nutr, 37: 473- 480.

Chaffee, R.B., Zabara, J., & Tansy, M.F. (1970). Suppression of the gag reflex by exaggerated respiratory movements. J Dent Res, 49 (3), 572-575.

Daniels, S.K., McAdam, C.P., Brailey, K., & Foundas, A.L. (1997). Clinical assessment of swallowing and prediction of dysphagia severity. American Journal of Speech-Language Pathology, 6, 17-24.

Davies, A.E., Kidd, D., & MacMahon, J. (1995). Pharyngeal sensation and gag reflex in healthy subjects. Lancet, 345, 487-488.

Eitner, S., Wichmann, M. & Holst, S. (2005a) A long-term therapeutic treatment for patients with a severe gag reflex. J Clin ExpHypn, 53(1), 74-86.

Eitner, S., Wichmann, M. & Holst, S. (2005a) “Hypnopuncture”-A dental emergency treatment concept for patients with a distinctive gag reflex. J Clin ExpHypn, 53(1), 60-73.

Fiske, J. & Dickinson,C. (2001). The role of acupuncture to control the gagging reflex using a review of ten cases. Br Dent J, 190 (11), 611-613.

Faigenblum, M.J. (1968). Retching, its causes and management in prosthetic practice. Br Dent J, 125, 485-490.

Kramer, R.B. & Braham, R.L. (1977). The management of the chronic or hysterical gagger. ASDC, 44(2), 111-16.

Krol, A.J. (1963). A new approach to the gagging problem. Journal of Prosthedontic Dentistry, 13, 611-616. Irwin, R.S. (1999). Clinical significance of cough as a defense mechanism or a symptom in elderly patients with

aspiration and diffuse aspiration bronchiolitis- a response. Chest, 115, 602-603.

Landa, J.S. (1947). Practical full denture prosthesis. New York: Dental Items of Interest Publishing Co., Inc.

Leder, S.B. (1996). Gag reflex and dysphagia. Head Neck, 18(2), 138-141. Logemann, J. (1983) Evaluation and treatment of swallowing disorders. Austin: Proed. Lu, D.P., Lu, G.P, & Reed, J.F. (2000). Acupuncture/acupressure to treat gagging dental patients: A clinical study of

anti-gagging effects. Gen Dent, July/August, pp.446-452. Martin, J.H. (1996). Neuroanatomy Text and Atlas. Stamford, Conneticut: Appleton & Lange. Mason, R.M. & Simon, C. (1977). An orofacial checklist. Language, Speech, and Hearing Services in the Schools, 8,

140-154. Miller, A.J. (2002). Oral and pharyngeal reflexes in the mammalian nervous system: their diverse range in complexity and the pivotal role of the tongue. Crit Rev Oral Biol Med, 13 (5), 409-425.

Murphy, W.M. (1979). A clinical survey of gagging patients. J Prosthet Dent, 42(2), 145-148.

Neumann, J.K. (2001) Behavioral approaches to reduce hypersensitive gag response. The J Prosthet Dent, 85, 305.

Pannbacker, M. (1985). Common misconceptions about oral pharyngeal structure and function. LSHSS, 16, 29-33. Patel, M.R., Piazza, C.C., Martinez, C.J., Volkert, V.M., & Santana, C.M. (2002) An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal. J Applied Beh Analysis, 35, 363-374.

Perlman, A.L. & Schulze-Delrieu, K. (1997) Deglutition and its Disorders: Anatomy, Physiology, Clinical Diagnoses, and Management. San Diego: Singular Publishing Group, Inc.

Scarborough D.R. & Isaacson, LG. (2014) Activation of Neurons in the Rat Medulla Following a Gag Reflex Stimulus, IJSLPA, in press.

Scarborough, D.R., Bailey-Van Kuren, & Hughes (2008). Altering the gag reflex via a palm pressure point. Journal of the American Dental Association, 139(10), 1365-1372.

Scarborough, D.R. & Isaacson, L.J. (2007) Activation of neurons in the rat nucleus tractus solitarius following a gag reflex stimulus. 15th annual Scientific Poster Session of the Dysphagia Research Society. March 8-10, Vancouver, British Columbia.

Scarborough, D.R., Boyce, S., McCain, G., Oppenheimer, S., August, A., & Neils- Strinjas, J. (2006). Abnormal physio logical responses among children with persistent feeding difficulties. Dev Med Child Neurol, 48, 460-464.

Scarborough, D.R. & Isaacson, L.G. (2006). Hypothetical anatomical model to describe the aberrant gag reflex ob served in a clinical population of orally deprived children. Clin Anat, 19: 640-644.

Scarborough, D.R., Boyce, S., McCain, G., Oppenheimer, S., August, A., & Neils- Strinjas, J. (2002) Consequences of interrupting normal neurophysiologic development: Impact on pre-swallowing skills. (Doctoral Dissertation, University of Cincinnati, 2002) University of Cincinnati Allied Health Sciences : Communication Sciences and Disorders.

Schulze-Delrieu, K. & Miller,R.M. (1997) Clinical Assessment of Dysphagia. In Perlman, A.L. & Schulze-Delrieu,

K.(Eds) Deglutition and its Disorders: Anatomy, Physiology, Clinical Diagnoses, and Management. (pp. 144-145).

San Diego: Singular Publishing Group, Inc. Vachiramon, A. and Wang, W.C. (2002) Acupressure technique to control gag reflex during maxillary impression procedures. J Prosthet Dent, 88(2), p. 236. Zemlin, W.R. (1998). Speech and Hearing Science Anatomy and Physiology (4th edition). Needham Heights, MA: Al

lyn & Bacon.

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)

Related

Filed Under: Oral-motor and Sensory Tagged With: feeding problem, gag reflex, gagging, oral hypersensitivity, oral motor

Comments

    Leave a Reply Cancel reply

    Your email address will not be published. Required fields are marked *

  1. Nadine Methner says

    February 6, 2018 at 2:47 am

    HI, I am an SLP working in a pediatric rehab department. Recently, I have come across two cases where parents with infant’s and a hyperactive gag have been instructed to desensitize the gag with “sensory overload” accomplished by touching the infant’s palate to the point of purposefully gagging. They were advised to allow recovery and to repeat. If vommitting occurs, they are to allow infant to rest and try again later. Each time stimulation is to go further back on the palate. These are former preemies, with history of GERD and NG feeding tubes present. Are you familiar with this process of desensitizing an infant/newborn? Looking for good information regarding the technique. Thank you for your time! Nadine

    Reply
    • Krisi Brackett says

      February 6, 2018 at 8:05 pm

      Nadine, Thank you for reading the blog and taking the time to comment. Some therapists use desensitization techniques to reduce a hypersensitive gag. I do not. I work on a feeding team and we use medical and nutritional strategies to reduce gagging, GERD, and hypersensitivity. I’ve always believed that a hypersensitive gag is giving us information about a child’s GI tract. We have a lot of success using medical and specialized formulas to promote GI or gut comfort which reduces the hypersensitivity and gagging. Hope that helps, Krisi

      Reply
      • Kelsey says

        January 27, 2023 at 4:12 pm

        Hi Krisi,

        Can you please provide further reading on the interventions you and your team are using to reduce hypersensitivity and gagging? I am also seeing many SLPs promote desensitization techniques but would be interested in trying other, less invasive methods (i.e. approaching it from gut perspective) for my 2.5 month-old son with a complex medical history (surgery at birth, NICU stay, NG tube).

        Reply

Trackbacks

  1. Website says:
    April 19, 2019 at 11:23 am

    website

    Hypersensitive Gag Reflex and Pediatric Feeding Delays By Donna Scarborough Ph.D., CCC-SLP, BCS-S Miami University, Oxford, OH scarbod@muohio.edu

    Reply

Work with Krisi

Professional Consulting
Individualized Professional Training
Caregiver/Family Coaching

Girl Image
Click here for more infomation

Cart

Products

  • When Your Child Can't Or Won't Eat When Your Child Can't Or Won't Eat $10.00

Recent Posts

  • Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • A Gold Standard for Meals with Children Using NG Tubes
  • Feeding Matters – Get Curious!
  • Universal Aspects in Feeding Intervention
  • Handout Info- Feeding and Syndrome Info

Recent Comments

  • Taralee Morgan on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Debbie Frierson on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • NEYTZA RODRIGUEZ on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Tara Wiley on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Gloria Macias-DeFrance on Feeding Flock – Feeding Assessment Tools

Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar

Hello! I wanted to let you know about a free talk I am giving tomorrow with my colleagues Dr. Carmen Caruthers and Janet Martin. We are going to talk about our collaboration between the UNC TEACCH program and the feeding team and how we are working with some of our kiddos. Sorry for the late notice. It's 9-11:30 (not recorded)- please come if you are free! - Krisi Keep Reading >>

Feeding Treatment

Universal Aspects in Feeding Intervention

Let's talk about universal aspects in feeding interventionThis is any idea I have been playing around with for awhile now. We all know that there are different strategies and philosophies in feeding treatment. This is a good thing- we need many Keep Reading >>

Understanding Parenting Styles in Feeding Therapy

As feeding therapists, we work closely with caregivers and parents. Perhaps our biggest success in feeding intervention is helping a parent be able to feed their child. One way we do this is to help caregivers understand their child's cues and how to Keep Reading >>

Involving Caregivers in Feeding Therapy

Feeding children is a dyad between the child and their caregiver who is responsible to buying, preparing, and presenting food. In all of my classes whether it be for professionals or graduate students, I talk about the importance and benefits of Keep Reading >>

Adapted Baby Led Weaning

Information from Jill Rabin CCC-SLP/L, IBCLCI wanted to share some resources for adapted baby led weaning from Jill Rabin. I was lucky enough to catch a free seminar last month from Jill which inspired me to add in some of these techniques to my Keep Reading >>

More This Way

Swallowing

Implementing FEES for Infants in CVICU & NICU

BackTable / ENT / Podcast / Episode #165Implementing FEES for Infants in CVICU & NICU with Olivia Brooks, SLPIn this episode, pediatric speech language pathologist (SLP) Olivia Brooks (University of Florida Shands Hospital) shares her experience Keep Reading >>

What is a MBSS- video for kids

I wanted to share a video we made to help children coming to UNC for a modified barium swallow study. Please share with your clients if you think it is helpful. It's also on our feeding team page Keep Reading >>

Swallowing Difficulties May Be Caused by Misfiring Neurons

in Genetic Engineering & Biotechnology News (GEN)Pediatric dysphagia (swallowing difficulties) is a frequent and serious clinical complication in a large number of clinically defined neurodevelopmental disorders including the genetic childhood Keep Reading >>

Swallow: A Documentary- Dysphagia

Nice Documentary on Dysphagia from the National Foundation of Swallowing Disorders. Keep Up the Good Work Everyone! Keep Reading >>

Oral-Motor and Sensory

Impact of Oral Motor Impairment in Infants with Poor Feeding Webinar

Impact of Oral Motor Impairment in Infants with Poor Feeding Presented by Debra Beckman, MS, CCC-SLP, https://www.beckmanoralmotor.com/A few weeks ago I had the pleasure of attending a wonderful free webinar presented by Debra Beckman, MS, Keep Reading >>

Musculus masseter pars coronidea

Scientists Just Identified a Brand New Muscle Layer in The Human Jaw DAVID NIELD23 DECEMBER 2021 It turns out there are still exciting new discoveries to be made in a field as well-studied as human anatomy: researchers have confirmed the existence of Keep Reading >>

Poster: Child Cain’t Chew

This poster from 2018 was shared with me by Sally Asquith who gave permission to post here. The objective of this study: REVIEW CURRENT LITERATURE PERTINENT TO THE ROLE OF ORAL-MOTOR DEVELOPMENT IN DX AND TX OF PFD. COMPLETE A RETROSPECTIVE CHART Keep Reading >>

The Sensory-Motor Approach to Modified Baby-Led Weaning for Babies with Feeding Challenges

by Jill Rabin & Lori Overland Baby-Led Weaning has become “all the rage” with many parents choosing this method of transitioning their little ones to solid foods. Everyone is jumping in, with speech pathologists, dietitians, occupational Keep Reading >>

More This Way

Case Studies

Challenging case with advice from Suzanne Evans Morris, PhD

In this post, I have described a challenging case  and solicited advice from Suzanne Evans Morris, PhD, one of the experts in our field. Suzanne graciously provided commentary and advice and challenged me to look differently at the feeding Keep Reading >>

Complex Case – Changing Therapy Strategies When Needed

Complex Case - Changing Therapy Strategies When Needed*I shared this case with Suzanne Evans Morris and she provided some   guidance and analysis at the end. Hope you enjoy John is a 6 year old male with a complex medical history:Downs Keep Reading >>

Feeding Harley

I am excited to share Harley’s story, written by his Mother about her journey to help her son wean from his g-tube and become an oral feeder. Thank you Liz for sharing and inspiring us all to continue looking for answers! I feel I do need post a Keep Reading >>

Cases From Clinic

Cases From Clinic This is my second post highlighting some of our kids and how we provide multidisciplinary intervention using a medical/nutritional/behavioral approach. I post this hoping it might give some treatment ideas to clinicians. There Keep Reading >>

More This Way

search

Categories

Recent Posts

  • Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • A Gold Standard for Meals with Children Using NG Tubes
  • Feeding Matters – Get Curious!
  • Universal Aspects in Feeding Intervention
  • Handout Info- Feeding and Syndrome Info

Recent Comments

  • Taralee Morgan on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Debbie Frierson on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • NEYTZA RODRIGUEZ on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Tara Wiley on Special Considerations in the Treatment of Pediatric Feeding Disorders in Autistic Patients (2.5 Hours)- Free webinar
  • Gloria Macias-DeFrance on Feeding Flock – Feeding Assessment Tools

Archives

search

Categories

Archives

My Account | Shop | Shopping Cart
Copyright ©2025, Pediatric Feeding News. All Rights Reserved. Custom design by Pixel Me Designs