During a clinical feeding assessment:
the child and caregiver meet with a speech language pathologist who specializes in the area of pediatric feeding and swallowing.
the child is seen in an office type setting and observed during a trial feeding.
food is brought from home and supplied by the clinician.
the child's oral motor skills, developmental feeding skills and swallowing are evaluated.
speech and language skills are screened.
After the assessment is complete, recommendations are given to the family on the safest and most appropriate diet level for their child.
Outpatient Feeding Team
The feeding team serves children with a complex medical history with a variety of medical needs.
The team is a multidisciplinary group consisting of:
- speech language pathologist who specializes in pediatric dysphagia
- developmental pediatrician
- behavioral psychologist
- nutritionist (as needed)
During a feeding team evaluation:
the child and parent are seen with the entire team in an exam room.
an extensive history is taken by the physician.
the child is observed during a trial feeding and evaluated by the physician, speech language pathologist and behavioral psychologist.
After the Visit
The family is given a list of recommendations at the end of the visit. There is also an extensive feedback session with the team as to the feeding diagnosis, strategies to improve feeding, any further testing, medication, and/or referral to other medical specialties.
Recommendations on whether the child is in need of on-going behavioral or feeding therapy and ways to obtain those resources is also discussed.
Inpatient Feeding Team
The Swallowing Disorders Program currently services patients on nearly all units of Boston Children's Hospital including neurology, cardiology, gastroenterology, surgical, neonatal intensive care unit, cardiac intensive care unit and medical intensive care unit, oncology and organ transplant.
The program also provides consultative services to babies at both the Brigham & Women's Hospital and Beth Israel Deaconess Medical Center Neonatal Intensive Care Unit for both videofluoroscopic swallow studies and bedside assessment of feeding skills.
Assessment of Feeding Skills
During a bedside assessment of feeding skills, a child is seen by a speech pathologist with specialized training in infant/pediatric feeding and swallowing disorders.
S/he assesses oral motor function and the child's feeding readiness skills both before and during an actual feeding. Assessments are made regarding:
- the best method of feeding the child (by mouth or by feeding tube)
- appropriate feeding device (specialized nipple, bottle, cup)
- appropriate diet level.
Based on the bedside assessment of feeding the baby/child may also be referred on for a videofluoroscopic swallow study.