Chewing delays can make mealtimes challenging for both you and your child. Chewing requires skilled muscle work! Your child may be demonstrating chewing issues if he is holding food his mouth, pocketing food in his cheeks, gagging, or taking a very long time to complete a meal.

Feeding therapy can provide strategies to improve oral-motor skills and chewing efficiency. As chewing improves, children begin to enjoy mealtimes more and are more willing to accept new foods as they build strength and confidence.

Coughing when eating or drinking is a red flag and should be assessed by a Speech-Language Pathologist or feeding therapist. Coughing can be a sign of food or liquid entering the airway or lungs by accident.  This is called aspiration.

While everyone aspirates from time-to-time ("went down the wrong pipe"), if a child aspirates frequently it can lead to respiratory problems, like pneumonia. Children may aspirate during swallowing or from Gastroespophageal Reflux Disease (GERD). Health problems like prematurity, GERD, anatomic defects, chronic heart disease, and congenital syndromes can cause aspiration.

Picky or selective eating is a common issue during childhood that often causes significant parental anxiety and concern. Picky eating can lead to nutritional issues and poor growth. Food refusal is often related to sensory-based feeding issues, which impact a child’s ability to tolerate food textures, tastes, colors, shapes, and temperatures.

Feeding coaching/therapy will provide a variety of strategies to expand your child’s food repertoire resulting in more balanced nutrition and happier mealtimes for your family.

Feeding therapy can help your child learn to drink from an open cup or with a straw. Some children have difficulty transitioning from a bottle to a cup. Tips and equipment recommendations are available to help your child develop these skills.

Children sometimes demonstrate difficulty learning to feed themselves. Mastering hand-to-mouth and utensils skills can be challenging, especially in children with visual impairment, sensory-processing issues, and/or gross and fine motor skill delays.

Feeding therapy will help to provide strategies to promote self-feeding using a fun, positive, and child-directed approach. Appropriate feeding tools and equipment will be identified for your child to facilitate his journey toward self-feeding and independence at meals. When children become more independent with feeding, they often feel an increased sense of control and therefore demonstrate increased enjoyment and improved intake at mealtimes.

Poor weight gain and growth can be extremely distressing to parents. Trips to the doctor for weight checks can be very anxiety provoking when your child is not growing well. Feeding therapy can support your child's growth and nutrition by identifying issues which may be contributing to poor intake (e.g., food textures, oral-motor issues, aversion, GERD).

S-LPs/Feeding Therapists will work with a Registered Dieitian and/or your child's physician to develop a feeding plan to promote your child's growth.

Vomiting and spitting-up with feedings can be a sign of an underlying medical issue like Gastroesophageal Reflux Disease (GERD). Children may also vomit for other reasons like overfeeding or constipation.

It is important to address the cause of vomiting in order for your child to progress with his/her feeding development. Feeding intervention involves collaboration with your child's physician to address any underlying medical issues that may be impacting feeding.

Children can demonstrate feeding aversion for a variety of reasons. Medical issues, developmental delays, and feeding experiences can impact a child's willingness to eat. Children with severe feeding aversion may receive a diagnosis of ARFID (Avoidant/Restrictive Food Intake Disorder). Others are described as Picky Eaters.

Feeding therapy and parent coaching with a Speech-Language Pathologist can place your child on the path toward positive mealtimes and eating enjoyment.

Children may require tube feedings to support their growth, nutrition, and oral feeding development. If a child is judged to be safe to orally-feed, even in small amounts, it is important to continue to maintain and develop oral feeding skills for children that are tube-fed. Tube feedings do not typically have to completely replace oral feedings, rather they can support a child's growth and nutrition while they learn to eat by mouth.

When children are medically stable and developmentally ready, feeding therapists can work with a child's medical team to gradually reduce and wean tube feedings to allow more appetite for oral intake. 

Children gag for a variety of reasons. The gag reflex helps us to expel food that our bodies feel is unsafe for us to swallow. Due to their medical history or sensory differences, children may have a sensitive gag reflex in response to food textures and mouth stimulation. Sometimes children gag as a way of communicating their needs.

Occasional gagging is normal when children are learning to eat and manipulate new textures in their mouth; however, excessive gagging can be very distressing to children and can contribute to feeding delays, aversion, and refusal.

Feeding therapy can provide strategies to address gagging by working with food textures and mouth tools to help your child reduce gagging.

Speech-Language Pathologists (S-LPs) are regulated healthcare professionals that hold a Master's Degree. Speech-Language Pathologists are sometimes called Speech Therapists. S-LPs are trained to assess and treat a variety of communication and feeding/swallowing disorders. S-LPs in Ontario are regulated under the College of Audiologists and Speech-Language Pathologists (CASLPO).

At this time, FeedingPlus does not offer communication therapy for speech and language issues like articulation or language delays. We specifically focus on children with feeding and swallowing issues.

You can search for an SLP practitioner in your area at OSLA (Ontario Association of Speech-Language Pathologists) www.osla.on.ca or through SAC (Speech-Language & Audiology Canada) www.sac-oac.ca

Yes, some S-LPs are highly trained in the assessment and treatment of pediatric and adult feeding and swallowing disorders. S-LPs take Master's level academic coursework related to swallowing disorders. S-LPs are required to participate in ongoing continuing education in order to maintain their license. S-LPs working with children and adults with feeding and swallowing disorders take continuing education courses and certification to remain up-to-date on best and evidence-based practices.

Speech-Language Pathologists (S-LPs) often work as a member of an interdisciplinary team in order to provide the best quality of care to their patients/clients. This team always includes family members, but could also include an Occupational Therapist (OT), Physiotherapist (PT), Nurse (RPN or RN), Physicians (MD), GI Specialist, Registered Dietitian (RD), Behaviour Therapist (BCBA), or Personal Support Worker (PSW).

Telehealth, telemedicine, virtual care, and online clinic are all terms used to describe the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, education, coaching, and treatment. In a nutshell, Telehealth is healthcare with a medical professional or therapist through your computer or mobile device.

Speech-Language Pathology services offered through FeedingPlus are not covered by OHIP. FeedingPlus offers private therapy. You do not need a referral and can contact us directly to book an appointment.

Many insurance companies offering extended healthcare benefits cover Speech-Language Pathology services. Please check your insurance regarding your specific coverage.

FeedingPlus will provide you with a receipt for any services rendered, which you can submit to your insurance company for reimbursement.

All you will need is internet access and a computer, tablet, or smart phone. Nicola may ask you to do some preparations before a visit (e.g., seating your child for a feeding observation or preparing certain foods).

FeedingPlus' online clinic offers therapy in the comfort, safety, and convenience of your own home. It is very beneficial to observe your child in his/her natural feeding environment versus in an unfamiliar clinic setting. Video-based appointments have become increasingly popular as telemedicine has advanced.

As healthcare providers, S-LPs are responsible for maintenance of the confidentiality of your personal health information (PHI). This includes confidentiality of both electronically transmitted information and records in audio and video format.

As an HIC (Health Information Custodian), FeedingPlus provides a secure PHIPA (Ontario’s Personal Health Information Protection Act) compliant infrastructure for video calls, messaging, and record-keeping.  

FeedingPlus is fully compliant with both PHIPA and HIPA (Health and Information Protection Act) security standards.

Therapy fees vary depending upon the service required (e.g., assessment vs treatment). Fees are based upon guidelines provided in the OSLA Recommended Fee Schedule for S-LPs. Sessions range from 30 - 60 minutes in length.

Please click the Book An Appointment button throughout the FeedingPlus site for a list of service descriptions and fees.