Pam Modugno, OTR/L, works with problem feeders in her feeding skills program.

Being a “picky” eater is a rite of passage for many children. But for families with children on the autism spectrum, problem feeding can be particularly challenging. Pam Modugno, a pediatric occupational therapist at Bacharach, offers a special program to help children on the spectrum overcome or improve their feeding disorder.

Bacharach’s Pediatric Feeding Skills Program utilizes the Sequential Oral Sensory (SOS) approach, introduced at Bacharach six years ago. This trans-disciplinary program assesses and treats children with feeding issues. Patients are assessed for posture, hand and oral skills, and how they respond to preferred and non-preferred food. Patients in the program participate in outpatient therapy once a week where they are introduced to 10-14 foods per session.

“It’s all about getting children comfortable with foods with the end result of eating and swallowing,” says Pam.
Children on the spectrum may have oral sensitivity to textures and have trouble transitioning to solid foods or may find the texture of meats, certain fruits and vegetables to be repulsive.

SOS is a Step by Step Process

It’s a step-by-step process. First, for children who can’t tolerate food visually, Pam tries to get children comfortable placing food items on a plate, for starters.
“We try to make the sessions fun by playing games with the younger kids and conducting food science with older kids,” adds Pam. “As children become more comfortable with food, they are gaining skills such as learning how to drink from straws, open cups, and use utensils.”

Pam recalls a 10-year-old boy whose diet was gluten and casein (protein present in milk and cheese) free. He was very limited in what he would eat and he became very anxious around family gatherings that involved food. As a result of the SOS program, he went from a diet of only chicken nuggets, rice, one vegetable, gluten free bread and peanut butter, to a whole variety of foods including hamburgers, any vegetable in rice, scrambled eggs and oatmeal.

“Everyone was completely thrilled,” says Pam who notes the child’s mother wasn’t sure if he could ever change.” The young patient also showed improvement in oral motor skills and chewing and is able to drink and eat items he would have refused in the past.

“Helping children overcome feeding issues is very rewarding to me – that’s why I do what I do.”

Coping With Problem Feeders

Pam offers these feeding tips for children:
• Keep trying to get your child to learn about food – even touching it she is learning.
• Don’t force your child to eat certain foods – let her go at her own pace.
• Your child has to try something at least 10 times in order to decide if she likes it.
• Try to change up her food and give her variety.
• Change the brand and the shape of foods. These subtle changes – like adding a little salt or pepper, changing the shape of sandwich or the color of cheese – will help avoid a food jag – where your child wants to eliminate a certain food from her diet.

For more information about Bacharach’s SOS program, contact Pamela Modugno at
609-652-7000 X5468.


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