Feeding challenges are a common yet often overlooked aspect of parenting children with disabilities. From sensory issues to physical conditions like low tone, these hurdles can make mealtime challenging for both the child and their caregivers. However, with understanding, patience, practical strategies and oftentimes a therapy team, parents can transform mealtime into a more positive experience. 

As the mother to four girls, including Rhea, my daughter with Down syndrome, we faced many of these potential challenges to feeding. With some help and guidance, Rhea is currently a fairly well rounded eater who enjoys mealtime with our family. 

Understanding Feeding Challenges

Children with disabilities may face a range of feeding challenges due to various factors such as:

1. Oral-Motor Difficulties: Conditions like cerebral palsy or Down syndrome can affect muscle tone and coordination, making it hard for children to chew and swallow food properly. 
2. Sensory Processing Issues: Children with autism spectrum disorder (ASD) or sensory processing differences may have heightened sensitivity to textures, tastes, or smells, leading to food aversions.
3. Gastrointestinal Problems: Issues like reflux, constipation, or motility disorders are common in children with certain disabilities, causing discomfort during and after eating.These conditions can also be caused or exacerbated by medications that children may need to take related to their disabilities. 
4. Other Challenges: Difficulty with communication, behavioral rigidity, attention span and anxiety can also play a role in feeding problems.

Strategies to Address Feeding Challenges

1. Create a Routine: Establishing a consistent mealtime routine can provide a sense of security and predictability. Our routine includes sitting together as a family (as often as possible), listening to music and generally eating at the same time of day. 
2. Utilize Tools and Accommodations: To address my daughter’s low tone, we utilized some tools our speech therapist recommended to strengthen her oral-motor skills. We also found utensils and bowls that supported independent eating, when she was ready. We bought a high chair that supported a more upright feeding position, sturdy foot support and that would grow with her. 
3. Adapt Food Textures and Consistencies: We offered Rhea a lot of ways to explore food. We modified foods to make them easier to chew and swallow by pureeing, cutting into small pieces and offering softer alternatives. We also used some of the self-feeders that you can put fruits and veggies into to allow them to try these fresh items without a choking hazard. Now, as a Little Spoon family, we love how most of the Plates have several options that are easy for her to eat.
4. Involve Your Child: Engage your child in the process of meal preparation. Let them touch, smell, and even play with the food. Consider giving them small choices that don’t fundamentally change the meal. If you use Little Spoon, consider letting them choose their Plate, Smoothie or other! This can promote independence, reduce anxiety and increase their interest in trying new foods.
5. Use Positive Language & Reinforcement: Encourage and praise your child for trying new foods or eating independently. Model proper mealtime behaviors through yourself or siblings. As soon as my daughter was old enough, I had her sitting at the table with her older sisters. I think watching them try everything on their plates helped her be more adventurous. Avoid negative comments or pressure, as this can increase stress and resistance. Additionally, use positive language when talking about food. Try to avoid using “bad food” or “good food” and consider phrases like “sometimes foods” with food that is less nutritious, and words like yummy, nutritious, colorful and wholesome when talking about more nutrient-dense foods. 
6. Consult Professionals: Occupational therapists, speech-language pathologists, and dietitians specializing in pediatric feeding can provide tailored strategies and support. They can help address specific oral-motor issues, sensory sensitivities, and nutritional needs. Check out a list of Little Spoon’s advisors here! If therapy is not accessible to you at the moment, many of these professionals provide a lot of free resources on their websites, YouTube channels and social media (but do your research to make sure the professional is legit!). 
7. Introduce New Foods Gradually: Start with small, manageable portions of new foods alongside familiar favorites. Repeated exposure without pressure can help children become more comfortable with new tastes and textures. Rhea LOVES pasta, so sometimes I would include a new fruit, vegetable or protein alongside a favorite, and often she would try it without thinking about it too much!
8. Avoid Distractions & Tricks: While we all lean on technology when we need it (no judgment here!), try to avoid using things like the iPad to distract your child into trying a new food. Additionally, try to avoid sneaking new foods into things your child already likes, which could lead to them refusing one of their favorites. 
9. Accommodate Sensory Preferences: Respect your child’s sensory preferences by offering foods that match their comfort level. If they prefer crunchy textures, try offering crunchy fruits and vegetables. Gradually introduce different textures as they become more comfortable. My daughter loves the Little Spoon Snacks and the assortment means that she gets to try crunchy, soft, salty and sweet foods! 
10. Monitor and Manage Gastrointestinal Issues: Work with your child’s healthcare provider to address any underlying gastrointestinal problems. This may involve a bit of trial and error, but proper management of these issues can significantly improve their comfort and willingness to eat. 

Emotional and Social Considerations

Mealtime is not just about nutrition; it’s also a social and emotional experience. As a busy family of six, it’s not always possible for us all to be eating together, but we try to make the most of it when we can. We use this time to talk about our days, share funny anecdotes or sometimes play games. I want my kids to remember these times and feel positively about mealtime. 

It’s also important for caregivers to practice self-care and seek support when needed. Feeding challenges can be exhausting and emotionally draining. It’s certainly ok if every day isn’t perfect and if you need to lean on favorite foods more than you want. Your mental health matters and is an important component of mealtime being positive for everyone, YOU included. Joining support groups or connecting with other parents facing similar challenges can provide valuable encouragement and shared strategies. Other parents often have the best ideas or can at least help you feel seen and heard!

In short, feeding challenges in children with disabilities are multifaceted and require a compassionate, patient approach. By understanding the underlying issues and implementing practical strategies, parents can help their children develop healthier, more enjoyable mealtime experiences. Remember, progress may be slow, but every small step forward is a victory worth celebrating. With dedication and support, families can navigate these challenges and foster a positive relationship with food for their children.

The ELM brand was founded in 2021 by Taryn Lagonigro & Jess Quarello to provide an inclusive space in the disability community. The ELM community represents countless common and rare disabilities. Taryn and Jess are established speakers in the disability community, having been frequent guests on podcasts, interviews and for several corporate diversity & inclusion speaking engagements, including many large financial institutions. Their work has been featured on The Today Show, multiple CBS affiliates and many print articles. In 2024, they launched The Extra Lucky Podcast and were named with the 2024 National Social Media Award by the National Down Syndrome Congress. 

Collectively, their personal and professional experience is vast and they share a mission of supporting caregivers in the disability community, and shouting the worth of individuals with disabilities.