Pam Modugno, OTR/L Founded the Feeding Skills Program at Bacharach in 2013

Occupational therapist Pam Modugno, OTR/L, initiated the feeding skills program at Bacharach in 2013. She has helped countless children learn to accept and tolerate food they once rejected.

“Right now, there is no in-person feeding skills program,” says Pam, “but we can and do still offer the services virtually so that you and your child can remain safely at home and still get the help you need.”

Who is the feeding skills program for?

“The program is for children who are very limited in their diet, for example kids who eliminate whole food groups like all vegetables or all fruit. Or it may be a child who can’t transition off the bottle to table food.”

How do you enroll your child in the feeding skills program?

“The parent needs a prescription from a pediatrician for a feeding evaluation. During the evaluation, I have the parent offer the child a few of the child’s preferred foods and a few non-preferred foods and a drink. I evaluate how the child is positioned while eating. Some children have low muscle tone, poor core strength, or may slouch in the chair. We start at the concept of 90 degrees at the hip and 90 degrees at the knees, with feet planted firmly on the ground and child’s body up to the table. Sometimes I may adapt the highchair, adding towels on the side to position, and duct tape a more secure footrest to the chair. This gets the child in a better position so they will have a secure posture making it easier to use oral motor skills and hand skills necessary to eat.”

What is the parent’s role in remote therapy?

After the evaluation, I discuss the goals with the parents. Each week we discuss a menu to have for our next remote session. During the session I work with the parent and child to improve the skills for eating. During the session I have the parent do sensory activities (such as: jumping, animal walks, bouncing on a therapy ball, etc.) prior to sitting at the table to prepare the child for eating. When the child is seated at the table, they will do more preparatory activities such as blowing bubbles and washing hands with warm water.

Thirty-two Steps to Eating

“There are 32 steps to eating and the goal is for the child to move up the steps each session. The steps at the bottom include just tolerating food in the room and touching. The child is getting closer to eating the food if he or she has the ability to get it close to mouth to smell, kiss, and bite.”

“I have the parent present the food and we both model and encourage the child. I will guide and instruct the child and give recommendations for home carry-over throughout the session. Usually eating is the hardest skill for these children. I am there to support, educate, and progress the children and their families. I want to significantly improve the quality of mealtime and eating and feeding.
It usually takes a typically developing child two years to be fully ready to use a fork and eat a variety of foods. The feeding program generally starts with 12 sessions once per week, and then a re-evaluation follows.


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