At Bloom we can provide intensive and non-intensive outpatient feeding therapy. Our feeding department is led and managed by Bloom’s co-founder Genevieve Covington, M.A., BCBA/Feeding Intervention Specialist. She has extensive education/training and knowledge in a variety of pediatric feeding disorders (PFD) and intervention methodologies. Genevieve has a nutrition forward and multidisciplinary approach to feeding intervention. She combines methodologies from various practices with a foundation in behavioral approaches (*ABA, CBT, EE, etc.). Genevieve is trained in the following therapeutic and evidence based practices:
- Responsive Feeding Method
- Baby-Led Weaning
- BITES (Behavioral InTEgrated with Speech Approach to Feeding Therapy)
- SOS (Sequential-Oral Sensory) Approach
- Food Chaining/Shaping
- Oral-Motor Approach (Beckman Model)
- TR-eat (Transdisciplinary Effective Assessment and Treatment)
We can address those diagnosed or qualify for ARFID (avoidant restrictive feeding intake disorder), or individuals that exhibit inappropriate mealtime behavior. Approximately more than 40% of individuals with ASD (autism spectrum disorder) also exhibit PE (picky eating). The following symptoms may be indicative that an individual can benefit from behavior therapy to address their behaviors/deficits.
- Selective eating habits (e.g. only eats certain textures, colors, etc.)
- Elopement during mealtimes
- Tantrums during mealtimes
- Unhealthy weight (BMI <18.5 or BMI>25.0)
- Difficulty transitioning to solids
- Prior history of Nasogastric (NG) tube feeding
- Prior history of gastronomy tubes (PEG)
- Unhealthy dental history due to diet and restrictive oral access
What does feeding intervention look like at Bloom?
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Intake process & assessment: a thorough medical history review and caregiver interview is conducted prior to scheduling an assessment to determine if intervention is appropriate for the child.
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A formal in-clinic assessment is conducted to assess healthy vitals (i.e., weight, height, BMI, growth charts), oral-motor skills, chewing repertoires, sensory defensiveness (i.e., visual, tactile, texture, etc.), positional placement and preference for mealtimes (MT), tasting profile (if applicable), texture repertoire, current diet, responsiveness to utensil feeding, etc.
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Following the initial assessment, a consult with a dietitian may take place. Please note this is ONLY for children with nutritionally based feeding goals (i.e. children still being bottle-fed may not have the foundational skills for table food).
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Once nutritional goals are part of the plan of care, nutritional consult and collaboration takes place throughout the duration of treatment until discharge.
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Feeding appointments typically are 60 to 90 minutes in length. All clients are encouraged to be a part of the food preparation process. This may range from beginner level (simply touching or playing with food using utensils, or tactile exposure) to a full “top chef”. These tend to be our older clients that may take a recipe of their choosing that coincides with their nutritional goals and cooks their meal in our full-size kitchen.
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The length of treatment varies tremendously, and is based on medical necessity and length of reinforced behaviors.
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Feeding intervention is an “all hands on deck” type of therapy. Parents and caregivers play an integral role with the outcome of treatment and maintenance of skills. Thus, in-person and/or virtual caregiver training is a MUST. Upon commencement of therapy, caregivers must agree to the minimum recommended amount of training/support (typically 1-4 hours per month).
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Once a client meets discharge criteria they and their caregivers are sent home with tips and recommendations for continued success outside of the clinic.
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Patients do not meet discharge criteria until they are consuming 90% of dietary goals, volume intake, have a healthy BMI/growth trajectory, and are able to consume their targeted diet for most caregivers and in multiple settings (e.g. clinic, home, school, community).
If you are interested in receiving feeding intervention for your child please complete the intake form below. Thank you, I look forward to helping your family achieve happier and healthier mealtimes!
*ABA (applied behavior analysis), CBT (cognitive behavioral therapy), EE (escape extinction)
Resources for Parent/Caregivers
Feeding Matters Resources for Parents/Caregivers
International Association for Pediatric Feeding and Swallowing