Feeding Therapy for SLPs: Where to Start When You're New to Pediatric Feeding

When I faced my first pediatric feeding therapy client, I felt overwhelmed and unsure of where I should even start. My grad program had briefly mentioned food chaining, but I didn’t feel like I had enough training to use it — or even know what goals to set. If you're an SLP stepping into the world of pediatric feeding therapy, you might feel the same way.

The good news? You’re not expected to be an expert in feeding therapy for SLPs from day one. After working with dozens of pediatric feeding clients, here are my go-to strategies for helping SLPs get started with feeding therapy confidently and effectively.

1. Start with the Parent Interview

Don't be afraid to fill a portion of your sessions with questions to the parent. Feeding therapy is different than targeting speech or language.

I ALWAYS bring the parent into the session with me because they are the most important piece of the puzzle. In a 60-minute session, I typically spend at least 10 minutes asking questions every week. I follow up with one recommendation that can help the parent find more success at home.

Instead of jumping straight into food trials or oral motor exercises, take time to understand the mealtime environment, routines, and emotional tone at home. Here are three open-ended questions that give meaningful insight:

• "What does a typical mealtime look like at home? Who’s there, where do you eat, and what’s the overall vibe? Does your child graze throughout the day?"

• "When your child refuses a food, what do you usually do next?"

• "How long does your child usually sit at the table if they finish their food?"

These questions go beyond surface-level info and often uncover environmental or behavioral factors that directly influence feeding progress.

2. Combine Your Approaches

Many kids coming into feeding therapy aren’t just dealing with one challenge. Until you become more confident in feeding, don't be afraid to combine approaches. This will help you feel like you aren't missing things. It will also give you a way to fill your time during the session. Because the session layout is so different from what you're used to, it's completely normal to feel like you don't even know what to do during the session.

If you're doing a 30-minute feeding session, try this combo:

• 5–10 minutes: parent questions and conversation

• 10–15 minutes: oral strength training (This isn’t just for kids with complex diagnoses like Down syndrome or cerebral palsy. Oral motor challenges show up in about 95% of the picky eating cases I see.)

• 10–15 minutes: food chaining and actually practicing eating food

This creates variety in the session and gives you two angles to make progress.

3. Know the Most Common Red Flags

You don’t have to be a feeding expert to start identifying patterns that need more support. Three of the most common red flags you can start watching for:

• Gagging on certain textures

• Food refusal (especially entire categories)

• Overly messy OR overly neat eating — both can signal underlying challenges

These observations help guide your goals and can also validate the parent’s concerns with language they understand. Just remember — these are not the actual goals. Gagging, refusal, and messy eating are symptoms of deeper issues. For now, make note of them, and stay tuned — I’ll be diving into how to write meaningful goals for these kinds of challenges in future posts.

4. You’re Not Alone

Feeding therapy is a specialized skillset — and no one masters it overnight. The important thing is to stay curious, keep asking questions, and lean on others in the field.

If you’re just starting out and feel unsure, that’s okay. You don’t have to figure it all out on your own. If you have questions or want to connect with others who are learning, drop a comment below — I’d love to hear what you’re working on and help however I can.

Want more?

Be sure to follow along for future posts where I’ll dive deeper into pediatric feeding therapy for SLPs — from writing goals to choosing oral motor tools to navigating sensory challenges with confidence.