Modifying environment | Changing the physical or social setting at mealtimes (eg, reducing distractions such as levels of noise; using distractions to reduce a child’s attention on their food. |
Positioning | Ensuring a child is in the best position to eat and drink food safely and efficiently (eg, a child sitting upright providing support for head control). |
Modifying equipment | Using different spoons, forks, plates, cups, or bottles (eg, doidy cup; plastic spoon). |
Scheduling of meals | Setting the timing of mealtimes to encourage a child’s appetite and establish a mealtime routine (eg, spreading meals/snacks throughout the day; setting a 30 min limit for mealtimes). |
Modifying consistency of food | Changing the consistency of the child’s food or drink (eg, pureeing food; thickening food or drink). |
Modifying other aspects of food | Changing the temperature, taste, amount or presentation of the child’s food or drink (eg, presenting different foods so they do not touch each other; mixing liked foods with disliked foods). |
Modifying placement of food | Changing where food is placed in a child’s mouth to help chewing or swallowing (eg, placing food to the side of the mouth). |
Enhancing communication | Improving communication between a child and the person feeding them during mealtimes (eg, offering choices of food to a child; a child using eye pointing or signs or symbols to ask for specific food or drink). |
Visual supports | Use of pictures, a ‘countdown clock’, or social stories to increase a child’s understanding of what happens during mealtimes (eg, showing a child pictures of what food will be on their plate; showing a child a story to explain what will happen during a mealtime). |
Responding to a child’s cues for feeding | Helping people to recognise the signs that a child is ready to take another mouthful of food or drink (eg, looking for breath alterations or repeated swallows from a child to indicate a lack of readiness). |
Pace of feeding | Changing the speed at which each mouthful of food or drink is taken by a child (eg, slowing pace down to prevent overfilling of a child’s mouth). |
Medication | Any medication (eg, for epilepsy, pain, drooling, tone, gastro-oesophageal reflux). |
Energy supplements | Any energy or calorie supplement given orally or via feeding tube. |
Vitamin or nutritional supplements | Any supplements given or changes to a child’s diet to increase the vitamins or nutrients in their diet. |
Physical support | Giving direct physical support to a child when eating or drinking to improve the movements needed to bite, chew and swallow (eg, placing a thumb underneath the chin to help a child close their mouth). |
Oral and sensory desensitisation | Activities aimed at reducing a child’s adverse reactions to different sensory experiences linked to eating and drinking (eg, face massage; chewing no-food items such as a chewy ‘toothbrush’). |
Oral-motor exercises | Exercises done with a child to improve the control of their mouth, jaw, tongue or lips (eg, a child moving a non-food item with their tongue; a child sucking through a straw). |
Graded exposure to new food | Activities aimed at gradually exposing a child to new or disliked foods and drinks (eg, messy play activities involving a child touching new or disliked foods; using small steps towards a child accepting new or disliked foods such as licking the food or putting it in their mouth with no expectation to swallow). |
Graded exposure to new textures | Activities aimed at gradually introducing a child to more challenging food textures and fluid consistencies (eg, messy play activities involving a child touching new or disliked textures; using small steps to introduce a child to lumpy food or foods that require chewing). |
Changing behaviour at mealtimes | Strategies to encourage a child to behave appropriately at mealtimes (eg, a child sitting down ready to eat; a child staying seated for the meal). |
Modelling | Giving a child the opportunity to learn from others by eating and drinking with them (eg, sitting a child with other children or family members at mealtimes). |
Training to self-feed | Teaching a child to feed themselves (eg, placing a hand over a child’s hand to help guide the food into their mouth). |
Support for parents | Help for parents around their child’s eating and drinking difficulties (eg, counselling; parent support groups). |
Sharing information | Any information shared to help parents and professional understand a child’s difficulties with eating and drinking (eg, professionals teaching parents and school staff about a child’s physical or sensory difficulties; parents helping professionals understand what’s important about mealtimes in their family). |
Psychological support for children | Psychological help for a child (eg, counselling). |