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Early Intervention Speech Therapy

Feeding Children with CAS

Published February 26, 2010 8:38 AM by Stephanie Bruno-Dowling
For today's post I will continue to address reader questions regarding feeding. The following question was submitted by the parent of a child diagnosed with CAS (Childhood Apraxia of Speech):

My son is 2.2 years old and has been diagnosed with suspected apraxia. He has rec'd speech therapy and some feeding therapy through a SLP.  We are currently trying to get our son help through a feeding clinic, but our insurance is denying coverage.

We are overwhelmed and very stressed. Our son refuses most solids, and if left on his own ...would not eat at all.  We definitely fall into the category of making a few mistakes you mention. We give in and offer him more milk (mixed with Carnation Instant Breakfast) to boost his caloric intake...and we also give in to offering up videos.  Often times, we find ourselves giving in and feeding him ourselves. He is perfectly capable of feeding himself, but will not.  We are at our wits end.  Since we may be on our own in teaching feeding therapy, can you offer any tips to children who may be apraxic and have feeding issues as well?

I have several questions to ask before making suggestions. One of my first questions is why does your son not want to feed himself if he is capable? Is it a behavior issue or a sensory issue or both? Also, you mentioned that your son has received "some feeding therapy through an SLP" but now feeding therapy "may be on our own". Have you pursued early intervention services and if not, why?

The little girl I wrote about over the last two weeks is also apraxic although I did not make mention of it specifically because I chose to focus mainly on her feeding issues. Many of the techniques I shared in the last 3 posts, particularly the post Problem Solving the "Picky" Eater, have been very successful with this little girl and may be helpful for you and your son as well.

Also at the end of January, I wrote a post entitled, Checking in with Sharon Gretz, MEd, the founder and current executive director of the Childhood Apraxia of Speech Association of North America (CASANA). In that post, I interviewed Sharon and we discussed the correlation between apraxia and feeding issues, which you may find both interesting and helpful. Good luck to you and your family and please keep us posted on your son's progress.


Perhaps a GI consult to rule out reflux might also be helpful.

Feeding can be a complex issue and the problem pieces need to be fully exaimined before starting a treatment program.

Breaking down behavior issues is a good start and starting with a simple behavior program of reinforcing sitting and not making meals last too long can start to elevate some of the issues.

Good luck with this complex issue.

Suzanne Wiley, MA CCC-SLP

March 4, 2010 6:53 PM

Hi Stephanie,

Just wanted to make a quick comment to share that where I work in California, our regional center now has a policy that they will no longer cover any feeding therapy.  Families who's medical insurance will not cover feeding therapy are completely on their own at this point.  Not sure if that is the case with the family who's letter you are answering, but it is happening in some places unfortunately.

February 27, 2010 12:53 PM

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About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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