Feeding and Swallowing Services

Feeding and Swallowing Services

Feeding and Swallowing Services at Rady Children’s involves clinical evaluations and therapy provided by occupational therapists or speech therapists. Children with complex feeding and swallowing problems may be seen by our multidisciplinary Feeding Team.

Various studies may be performed to assess medical issues, and treatment may include individualized or group therapy.

Evaluations

The clinical evaluation is the first visit with a feeding therapist. At this time, the specific type and severity of problem with feeding is identified and a treatment plan is created. Your child’s feeding evaluation can be completed by an occupational therapist or speech-language pathologist.

Occupational Therapy

For patients with strong food preferences, feeding tube placement, oral motor or sensory issues, an OT evaluation and treatment is often indicated. OT specializes in feeding problems in patients from birth through 18 years, including patients who need help with swallowing problems, self-feeding and transition to oral feedings.

A doctor’s order/prescription is required and may be entered in EPIC or faxed to 858-966-5859. You may reach an Intake Patient Access Representative at 858-966-5829.

Learn more about Occupational Therapy.

Speech-Language Pathology

Speech-language pathologists, also known as speech therapists, address voice and swallowing issues related to laryngeal pathology. This includes vocal fold paralysis, velopharyngeal inadequacy (VPI), vocal nodules, cleft palate, oral/laryngeal tumors and craniofacial disorders.

Please enter orders in EPIC or fax to 858-278-6627. You may reach an Intake Patient Access Representative at 858-966-5838. Please specify the feeding disorder.

Learn more about Speech-Language Pathology.

Feeding Team

This multidisciplinary team helps patients with the most complex feeding and swallowing problems. The team consists of  an occupational therapist, speech-language pathologist, developmental psychologist, registered dietitian and gastroenterology nurse practitioner. We serve children ages 12 months and older with complex feeding problems who would benefit from input from at least three of our five disciplines.

A doctor’s prescription is required and may be entered in EPIC or faxed to 858-966-8140. For phone triage and intake, please call 858-576-1700, ext. 226101.

Learn more about our Feeding Team.

Instrumental Swallow Evaluations (Dysphagia Study and FEES)

Dysphagia studies are conducted in Radiology with an occupational therapist and/or speech-language pathologist. Videofluoroscopy is utilized to assess the patient’s swallow at the pharyngeal level as they consume foods and liquids containing barium.

Patients who are suspected of aspirating foods/liquids, who have a history of chronic upper respiratory infections/pneumonia, or who cough/choke with oral intake are appropriate referrals. In addition, patients with vocal fold paralysis, tracheostomy, cerebral palsy or failure to thrive might benefit from this type of instrumental assessment.

PLEASE DO NOT REFER PATIENTS WHO DO NOT ACCEPT FOOD OR LIQUIDS BY MOUTH FOR A DYSPHAGIA STUDY. THESE PATIENTS SHOULD HAVE A CLINICAL FEEDING EVALUATION FIRST.

FEES (flexible endoscopic evaluation of swallow) takes place in the Otolaryngology clinic with a physician passing the nasoendoscope and the feeding therapist completing the swallowing evaluation with the scope in place. This study is appropriate for patients with concerns about laryngeal function or who cannot be positioned in Radiology. Additionally, this study can be done with breastfeeding patients.

Prescriptions/orders for instrumental swallowing evaluation should be entered in EPIC or faxed to 858-966-8140. You can reach the Intake Patient Access Representative at 858-576-1700, ext. 225522.

Treatment Options

Once a clinical evaluation has been completed by OT, Speech or the Feeding Team, we offer both individual and group treatment programs for patients with feeding and swallowing disorders from birth to 18 years of age. Individual therapy is offered through the Occupational Therapy and Speech-Language Pathology departments and varies in frequency and duration.

Group therapy programs for feeding disorders include:

  • Little Steps for Little Feeders (OT Department)
  • Picnic Group Preschool Group Treatment Program (Feeding Team)
  • Food Explorers School-Age Group Treatment Program (Feeding Team)

For more information on these programs, please contact the therapist who completed your patient’s feeding evaluation or the Feeding Team Coordinator at 858-576-1700, ext. 226101.