Diagnosis and Management of Sensory vs. Behaviorally

26 Pages·2010·0.11 MB·English

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Arden Hill, MS, CCC-SLP
Sarah Halloran, MS, CCC-SLP
Children’s Speech & Feeding Therapy, Inc.
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Feeding disorders occur in :
(cid:122)
(Rudolph & Link, 2002)
– 25-35% of developmentally normal children
– 40-70% of children with developmental
disabilities and/or chronic medical conditions
SSeennssoorryy IIssssuueess
Where do they come from?
(cid:122)
– Prematurity
– Chronic illness
– Multiple medical interventions/medications
– Underlying neuro issues
– Diagnosis with SI as a component
SSeennssoorryy IIssssuueess
Where do they come from?
(cid:122)
– Unpleasant oral-tactile experiences
– Delayed introduction of oral feeds
– GI issues
BBeehhaavviioorraall IIssssuueess
Where do they come from?
(cid:122)
– Bad habits/desperation
– Poor limit setting
– Lack of mealtime structure and routine
– Passive eating with distractions
– Inconsistent expectations re: eating
SSeennssoorryy IIssssuueess wwiitthh
BBeehhaavviioorraall OOvveerrrriiddee
Behaviors often stem from somewhere else
(cid:122)
Normal cognition yields behavioral issues
(cid:122)
Children with underlying sensory issues
(cid:122)
rarely just eventually eat
Underlying issues must be addressed
(cid:122)
Similar rules imposed with eating as with
(cid:122)
other behavioral management
SSeennssoorryy IIssssuueess -- PPrreesseennttaattiioonn
Often avoids whole foods or texture groups
(cid:122)
Difficulty tolerating sensory input –
(cid:122)
sight/smell/touch/taste
Eats the same regardless of people/place
(cid:122)
Overstuffs oral cavity/takes tiny bites
(cid:122)
Stores food “for later”
(cid:122)
Gags as a sensory response
(cid:122)
Excessive drooling
(cid:122)
BBeehhaavviioorraall IIssssuueess --
PPrreesseennttaattiioonn
Rarely selective avoidance
(cid:122)
Eats better for certain people/places
(cid:122)
Gags to get attention
(cid:122)
Rarely underlying neuro or medical issue
(cid:122)
AAbbnnoorrmmaall SSeennssoorryy RReessppoonnsseess
Hyposensitivity
(cid:122)
Hypersensitivity
(cid:122)
Assess the child’s comfort level with food
(cid:122)
within the sensory domain and begin your
treatment at that level
HHyyppoosseennssiittiivviittyy
“Reduced awareness of non-nutritive and
nutritive stimuli in the mouth, heightened
sensory threshold to oral input”
Poor suck
(cid:122)
Liquid pooling
(cid:122)
Liquid loss
(cid:122)
Gag (protection vs. rejection)
(cid:122)
Overstuffing/pocketing
(cid:122)