Major focus area

Feeding Therapy -> Swallowing

Short description

Motor learning approach takes the process of oral motor skill acquisition and considers the applicability of motor learning concepts for advancing swallowing and feeding capabilities in patients (Sheppard, 2008).

Long description

Motor learning approach takes the process of oral motor skill acquisition and considers the applicability of motor learning concepts for advancing swallowing and feeding capabilities in patients.

Method:
1. Improve sensory tolerances for learning to eat. Activities include sitting up in a well-fitting chair at a table and keeping plate, cup, and utensils in front of the patient.
2. Precursors to feeding: Example: licking tastes of milk or something the patient likes from a spoon.
3. Eating from a spoon: Start with small slow bites of puree to practice routines emphasizing upright head alignment with chin down posture. Increase amounts of puree accepted and the rate of intake. Introduce one new food at a time. Viscosity is increased gradually to allow time for the acquisition of motor capabilities for swallowing more viscous foods.
4. Advancing skills for swallowing increased texture and viscosity: Introduce grainy then mashed consistencies. Initially foods can be moist and as ability increases added moisture can be reduced gradually.
5. Self-feeding, biting, and chewing, and drinking from a cup.
6. Advancing skills for biting and chewing: Self-feed or SLP feeds patient to train them to bite off small pieces. Chewing skills are targeted by placing foods on preferred side for chewing. Tactile and verbal cues can be used increase patient awareness of food in mouth.
7. Drinking from an open cup and straw: Teach sequence to sip from cup and to swallow with cup in his mouth. Move to teaching sip and swallow sequentially. Move to teaching how to sip and swallow with a straw.
8. Transition to self feeding.

(Sheppard, 2008)