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Toddlers & Preschoolers Toddlers & Preschoolers

Leo's Feeding Appointment (PIOG)

Posted by on Feb. 13, 2013 at 11:46 AM
  • 6 Replies

Leo's appointment went well.  We almost had to reschedule because he was sick!  And that would have postponed everything until APRIL!  Luckily, he was well enough for the trip.

She was great, she said that we were making great progress with him.  His weight/height are doing much better :).  He grew nearly 3 inches (for a 1-year old, thats insane!!)

We are no longer on survival mode, and we are now in experimental mode :).  She said to wait on sippy cups full time, but to give him 2 oz of formula in a cup with each meal, too :).  We can try new foods too.

But, since he's starting to chipmunk his food (meaning he doesn't know what to do with it) and he's gagging consistently on most higher level foods (Breads, fruits, etc), she referred us to an OT.  

She gave us two options.  We can go through the county or we can go through our insurance.

So, my question for you guys:

1. What is the best route to go?  What are your experiences with county OT's vs. private?

2. What do you I expect them to do with Leo?

3. For county Ot's, how do I get started and what do I expect?


by on Feb. 13, 2013 at 11:46 AM
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Replies (1-6):
.Angelica.
by Angie on Feb. 13, 2013 at 1:55 PM

I don't have any experience here. but glad you are getting some answers. :)

Poisongirl98
by Bronze Member on Feb. 13, 2013 at 10:57 PM
Hmmm, my answer comes more from a professional perspective, although both of my kids are in OT (though not for feeding). I'm an SLP who works in a private pediatric clinic, but we also service the 0-3 population through the state's early intervention program. So, I see both insurance and 0-3 program kiddos. Really,every state is different on how they run their early intervention program, so I couldn't necessarily give you what would be better in your state. With insurance pay, you get to choose where you go as long as they're in network and you may be able to get services more quickly. With the state's program, the providers come to your home, but more than likely you'd have to go to a clinic for insurance-based services. I don't know that providers in state programs vs. Private clinics/hospital settings are necessarily any better, I'd just specify that you want an OT with feeding experience.

The OT will probably look at Leo's sensory-motor profile too see what seems to be the cause of his feeding issues and whether or not it's affecting any other motor skills or behaviors(e.g., lower muscle tone, over or under-sensitive to touch). He/she will probably ask you a lot of questions regarding his history and his everyday functioning, may have you fill out something called the Sensory Profile, and observe and "play" with Leo to elicit certain skills and behaviors he/she would like to assess. As far as therapy, it depends on the training of the therapist and his/her methodologies and philosophies. Some of the more well-known feeding therapy programs/approaches are Food Chaining, S.O.S., oral-motor remediation based approaches and behavioral modification. Food chaining involves taking a child's preferred food, altering it by just one property(shape, color, texture,temperature, taste) and giving it to the child, then altering that food by just one property, etc..SOS' main idea is going through a hierarchy of steps when a new food is introduced to a child, and giving them a food that closely resembles the texture of something they can eat. For example, first it may just be allowing it on his plate, then it would be touching with fingertips, then touching with his palm, etc. Oral motor approaches soften include exercises to help strengthen functioning of oral muscles needed for feeding, presenting foods certain ways to encourage better chewing, etc. Behavioral mod approaches (which I personally am not a fan of) generally view the feeding problem as mainly a behavioral issue, so giving positive reinforcement when a child eats a "challenge food," a child must eat X number of bites of a challenge food before getting a preferred food, etc. Also, the OT should also do more general sensory integration techniques to help get his body ready for eating, check his postural stability in his high chair, etc.

As far as finding a county OT, I'd just Google your county and state and "early intervention" and that hopefully will point you in the right direction.

I'm sorry this was so much info, hopefully it's not too overwhelming!
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Gweneveer
by on Feb. 14, 2013 at 8:52 AM

bump!

corrinacs
by on Feb. 14, 2013 at 12:31 PM

Thank you so much.  No, what you said was not overwhelming at all....the situation itself is though, but I'm sure you are well aware.


Thank you for laying out the methedologies. I agree, I am not a fan of the last one either :/.  That's what the pediatrician recommended for BOTH of my kids and I can tell you from experiece (two different kids with different personalities)...it doesn't work.   BUt the other two do make sense.  I like the SOS methedology, but we will see what the OT suggests.

He's been through PT before and it seems like OT is very similar to that.  I'm just wondering for my area is it worth spending the time through county services or would I be better utilizing private OT's instead.  I just don't want to initiate it on one end and it be unsatisfactory, KWIM?

THank you so much :) :)

Quoting Poisongirl98:

Hmmm, my answer comes more from a professional perspective, although both of my kids are in OT (though not for feeding). I'm an SLP who works in a private pediatric clinic, but we also service the 0-3 population through the state's early intervention program. So, I see both insurance and 0-3 program kiddos. Really,every state is different on how they run their early intervention program, so I couldn't necessarily give you what would be better in your state. With insurance pay, you get to choose where you go as long as they're in network and you may be able to get services more quickly. With the state's program, the providers come to your home, but more than likely you'd have to go to a clinic for insurance-based services. I don't know that providers in state programs vs. Private clinics/hospital settings are necessarily any better, I'd just specify that you want an OT with feeding experience.

The OT will probably look at Leo's sensory-motor profile too see what seems to be the cause of his feeding issues and whether or not it's affecting any other motor skills or behaviors(e.g., lower muscle tone, over or under-sensitive to touch). He/she will probably ask you a lot of questions regarding his history and his everyday functioning, may have you fill out something called the Sensory Profile, and observe and "play" with Leo to elicit certain skills and behaviors he/she would like to assess. As far as therapy, it depends on the training of the therapist and his/her methodologies and philosophies. Some of the more well-known feeding therapy programs/approaches are Food Chaining, S.O.S., oral-motor remediation based approaches and behavioral modification. Food chaining involves taking a child's preferred food, altering it by just one property(shape, color, texture,temperature, taste) and giving it to the child, then altering that food by just one property, etc..SOS' main idea is going through a hierarchy of steps when a new food is introduced to a child, and giving them a food that closely resembles the texture of something they can eat. For example, first it may just be allowing it on his plate, then it would be touching with fingertips, then touching with his palm, etc. Oral motor approaches soften include exercises to help strengthen functioning of oral muscles needed for feeding, presenting foods certain ways to encourage better chewing, etc. Behavioral mod approaches (which I personally am not a fan of) generally view the feeding problem as mainly a behavioral issue, so giving positive reinforcement when a child eats a "challenge food," a child must eat X number of bites of a challenge food before getting a preferred food, etc. Also, the OT should also do more general sensory integration techniques to help get his body ready for eating, check his postural stability in his high chair, etc.

As far as finding a county OT, I'd just Google your county and state and "early intervention" and that hopefully will point you in the right direction.

I'm sorry this was so much info, hopefully it's not too overwhelming!




addiesmommy1109
by Member on Feb. 14, 2013 at 12:34 PM
My dd is in county therapy. We had the option to do county or private and it was cheaper for us to do county. Our DT comes weekly and is awesome. There is only one PT for the whole county so she doesn't have openings right now. We are going to a private clinic and we have only been seen once.... They keep cancellong her appointments and pissing me off.
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addiesmommy1109
by Member on Feb. 14, 2013 at 12:36 PM
Btw the county program is the early intervention for 0-3. Shes only 8 months.


Quoting addiesmommy1109:

My dd is in county therapy. We had the option to do county or private and it was cheaper for us to do county. Our DT comes weekly and is awesome. There is only one PT for the whole county so she doesn't have openings right now. We are going to a private clinic and we have only been seen once.... They keep cancellong her appointments and pissing me off.

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