The Sensory-Motor Approach to Feeding…
I have worked as a professional SaLT (Speech and Language Therapist in a number of settings including for the NHS. This training revolutionised how I think about oromotor therapy and the integration of sensation with motoric skills. The core tenet of the approach is considering what work can be done as “pre-feeding” input so as to not just leave children who aren’t currently safe to take anything orally in the same way without working to provide therapeutic benefit – if nothing is being practiced, nothing is going to change. This is where “task analysis” comes into play for parents and therapists to tune into what each child can currently do, and to think through the very next safe step to move in the direction of more oral movement/more sensory exposure.
The link to the training which I attended face to face, now appears to be available online is here: https://talktools.com/pages/feeding-therapy-a-sensory-motor-approach
There’s also an associated book: https://talktools.com/products/feeding-book?variant=28453224841
This is a brilliant article parents could be armed with to explore with their therapist and treating team.
The SOS (Sequential-Oral-Sensory) Approach to Feeding
This is also a brilliant resource in working through increasing children’s exposure to the sensory aspects of food, and the rich learning that comes through food exposure even if it isn’t yet for oral exploration.
More information on this approach is available from https:sosapproachtofeeding.com.
VitalStim programme
This isn’t something I’m trained in, or know much about. What I can say is that there seem to be communities of SaLTs that heavily adopt it as a treatment modality, however as with most aspects of SaLT we are a young profession relative to other areas like physiotherapy or most aspects of Medicine and as such there’s not a great deal of research available to support much of what we do – particularly in feeding. Interestingly, the TalkTools “camp” which deliver the Sensory-Motor Approach to Feeding which I listed above are another aspect of SaLT where there is great resistance/reluctance to adopt similarly due to limited research being available to prove its efficacy. The thing with evidence based practice is, however, that the research is only one facet of making an evidence based decision – parent/patient preference and individual clinician experience also must factor in.
The caveat to all of this is that each individual SaLT, and treating team, for each individual child will have different levels of risk aversion and may sit differently on the balance of safety vs. quality of life continuum. It is critical that parents feel empowered to bring up their thoughts and preferences on this balance with their whole treating team so that everyone is working to the same goal, and that each child is afforded the experiences their family are seeking for them – therapeutically managed to be at the right balance between – as is agreed within the health care team.
Anastasia Hamilton, Speech and Language Therapist
