ICCD Services

Feeding Therapy

Feeding Therapy begins with an evaluation of feeding skills, in which the therapist gathers background information, history of feeding difficulties, and medical history. The therapist will evaluate your child’s feeding skills and profile, including progression from purees to solids, chewing skills, food preferences, avoidance and refusal behaviors, sensory profile, drinking skills, and variety and volume of food intake.  The therapists will collaborate with your family in order to provide feeding strategies that make mealtimes successful and positive for everyone.

Would my child benefit from feeding therapy?

Is your child…

  • Not eating a good variety of foods from all different food groups or avoiding entire food groups?
  • Not eating an appropriate volume within a reasonable timeframe?
  • Refusing foods and engaging in avoidance behaviors (e.g., tantruming, throwing food, screaming, won’t sit at the table)?
  • Not growing well?
  • Gagging or vomiting while eating?
  • Only eating certain textures of food (e.g., purees, crunchy solids, fluids)?
  • Eating less than 20 foods consistently?
  • Eliminating foods previously eaten consistently and not replacing them?
  • Having difficulty transitioning from tube to oral feeding?
  • Aspirating, coughing or choking while eating or shortly after eating?
  • Having difficulty weaning from a bottle to solid foods?
  • Having trouble breastfeeding? Are you a mother who is thinking about/currently breastfeeding and have questions or need support?

The more questions you answered yes to, the more likely your child is to benefit from feeding therapy

Feeding therapy performed by a speech-language pathologist or an occupational therapist can address a variety of issues, including:

  • Improving sensory tolerance to various food textures
  • Developing chewing skills
  • Increasing variety and volume of nutritional intake to include all food groups and textures
  • Reducing avoidance behaviors during mealtimes
  • Teaching self-feeding skills including drinking from a cup and using utensils
  • Providing lactation counseling and management support to families who are thinking about breastfeeding or who have questions or problems during breastfeeding/lactation
  • Increasing oral feeding to wean from reliance on gastrostomy and nasogastric tubes


How does a therapist help a child eat?

At ICCD, therapists use a hybrid of approaches, techniques, and methodologies to develop a treatment plan individually suited to your child’s needs.   Our feeding therapists at ICCD work with families to promote home generalization of skills by including parents in therapy sessions, modeling strategies to use in the home environment, and making recommendations specific to each child’s skills and goals.


Methodology used may include:

The SOS (sequential-oral-sensory) Approach to Feeding developed by Dr. Kay Toomey uses play, steps to eating and research to guide therapy.  The SOS Approach focuses on increasing a child’s comfort level with food by exploring and learning about the different properties of food.  It allows a child to interact with food in a playful, non-stressful way that is comfortable for them.

The TReat (Transdisciplinary Effective Assessment and Treatment) method was created by Elizabeth Clawson, PhD and Carol Elliott, OTR/L as a model for a transdisciplinary and holistic approach for treating children with complex feeding problems. The TR-eat® model combines therapeutic skills and behavioral concepts to address even the most difficult feeding and eating issues. The child-led approach considers the environment, as well as social and medical aspects of every family’s life.


Abigael Collins, M.S. CCC-SLP, Speech-Language Pathologist, Feeding Specialist
Abigael Collins has six years of experience in feeding therapy and has provided evaluations and treatment to infants and children with a wide variety of feeding and swallowing difficulties (dysphagia). She works with families to make mealtimes easier and more enjoyable. Abigael has experience and interest in working with infants transitioning to solid foods, as well as children who are tube fed transitioning to oral eating. She uses a systematic desensitization approach to increase sensory comfort with foods. Abigael is currently completing training to become a Certified Lactation Counselor (CLC).  This certification allows her to assess the latching and feeding process, provide corrective interventions, counsel mothers, and understand and apply knowledge of milk production.


Lauren Zeitler – Occupational Therapist, Feeding Specialist
Lauren Zeitler has over four years of experience in feeding therapy with children ranging in ages from birth to teen years. Previously working in early intervention, Lauren has experience working with a variety of diagnosis’ including cleft palate, children who are tube fed, and GERD. She enjoys helping school aged children – especially teenagers – expand their diets by considering social, environmental, and sensory concerns surrounding their eating experiences. Lauren is trained and certified in the TR-eat (Transdisciplinary Effective Assessment and Treatment) method through the Pediatric Feeding Institute. Taking a transdisciplinary approach, this model integrates oral motor and sensory techniques along with medical and behavioral management for the treatment of complex feeding problems.


Nicole Zwiep – Occupational Therapist, Feeding Specialist
Nicole Zwiep has completed extensive training in the SOS Approach including advanced workshops in reflux, infants and toddlers, children on the autism spectrum, food scientist for older children, and children with severe developmental impairments.  In addition, she has completed the advanced-level SOS Mentorship course.  With the SOS Approach, eating does not begin at the mouth, first a child must tolerate the physical presence of food, next interacting without touching the food, then managing the smell, touching with hands, body and mouth.  Finally, tasting and then chewing and swallowing.

For more information or to discuss your child, please complete the Feeding Questionnaire and email to  Caroline Brinkert – Director of Speech-Language and Occupational Therapies at cbrinkert@iccdpartners.org