- Before selecting tools or strategies for a toddler feeding difficulty, complete a task analysis of the child's feeding-related motor skills to identify what prerequisites are missing.
- A sensory-motor approach to feeding evaluates how sensory processing and oral-motor skill development work together to support safe, effective eating.
- Low oral tone and open-mouth posture at rest suggest motor-based feeding challenges that require targeted pre-feeding work before food exposure.
- Interest in non-edible items (pica-like behavior) alongside food refusal warrants further evaluation of sensory processing and oral-motor function.
- The Navigating the Feeding Journey course and A Sensory-Motor Approach to Feeding book provide the clinical framework for assessment and treatment planning.
Reader Question
From the Community
“Have a little girl 3:0 who has no interest in food. Parents maintain nutrition with PediaSure, bananas, and sometimes bread; that is all she will eat. Mouths often. No noticed difficulty with teeth brushing or oral sensitivity. Has shown interest in non-edible items (i.e., wall, rocks/dirt). Low muscle tone in face and oral cavity; open mouth at rest. Goal of expanding on texture aversions and increasing food interactions. What treatment strategy ideas and/or TalkTools could she benefit from? Hoping to purchase and looking to attend courses.”
Therapist Answer
Answered by Lori L. Overland, MS, CCC-SLP, C/NDT, CLC, FOM
Expert Response
I would ask if this therapist has taken a sensory-motor approach to feeding. It sounds like they need to do a task analysis of this child's motor skills with food as a prerequisite to figuring out what to do!
What Is a Sensory-Motor Approach to Feeding?
A sensory-motor approach to feeding considers how sensory processing and oral-motor skill development work together to support safe, effective, nutritive eating. Rather than jumping straight to food exposure or texture-based goals, this approach first assesses the underlying motor foundations: jaw stability, lip function, tongue movement, and chewing patterns, that the child needs in order to handle food safely and comfortably.
For children like the one described above, with low facial tone, open-mouth posture, and an extremely limited diet, the toddler feeding difficulty may not be purely behavioral or sensory. There are likely motor-based prerequisites that have not yet been developed, and identifying those gaps through a structured feeding assessment is the essential first step.
Interest in non-edible items such as walls, rocks, or dirt (sometimes described as pica-like behavior) alongside food refusal warrants further evaluation. In the context of low oral tone and open-mouth posture, this pattern can reflect a child who is seeking oral sensory input but lacks the motor skills to safely process food textures. A comprehensive pediatric feeding evaluation is strongly recommended in these cases.
What Does “Task Analysis” Mean in Feeding Therapy?
Task analysis means breaking feeding into its component motor skills, for example, the motor requirements for spoon feeding, straw drinking, cup drinking, and eating solids, so the clinician can identify exactly which prerequisites are missing and plan treatment accordingly. Without this step, therapists may select tools or strategies that do not match the child's current motor skill level, leading to frustration for both the child and the family.
Lori Overland's Navigating the Feeding Journey (Feeding Therapy: A Sensory-Motor Approach) course provides detailed task analyses for each of these feeding modalities, along with pre-feeding exercises designed to build the motor skills that support safe, nutritive feeding.
Why Prerequisites Matter Before Food Exposure
When a child has low oral muscle tone and open-mouth posture at rest, the jaw, lips, and tongue have not yet developed the stable base needed to manage varied food textures or utensils. Introducing challenging foods before these motor prerequisites are in place can increase anxiety around mealtimes, reinforce avoidance, and make later intervention more difficult. Pre-feeding work, targeting jaw grading, lip function, and tongue lateralization, creates the foundation that makes food exploration possible and productive.
The following TalkTools® books, courses, and resources directly support the sensory-motor approach to feeding described above:
A Sensory-Motor Approach to Feeding (book)
The companion text by Lori Overland & Robyn Merkel-Walsh, covers assessment, task analysis, report writing, and therapeutic techniques for all ages.
Pre-Feeding Exercises: A Sensory Motor Approach (course)
A focused self-study on developing the motor skills that support spoon feeding, cup drinking, straw drinking, and eating solids. 0.2 ASHA/AOTA CEUs.
Browse all TalkTools® feeding tools, from spoon and cup progressions to jaw and tongue pre-feeding tools, designed to support a sensory-motor approach at every stage.
See upcoming live and self-study course offerings, including Lori Overland's foundational feeding courses available both in-person and online.
Recommended Courses
For clinicians ready to implement a sensory-motor approach to feeding, TalkTools® offers a structured learning pathway starting with Lori Overland's foundational course:
Foundational Course
Navigating the Feeding Journey (Feeding Therapy: A Sensory-Motor Approach)
TalkTools®’ foundational feeding course by Lori Overland, MS, CCC-SLP covers sensory processing, pre-feeding exercises, and therapeutic feeding techniques with detailed task analyses for spoon, straw, cup, and solids. Includes assessment frameworks and treatment planning guidance for toddlers through adults. 1.2 ASHA CEUs | 1.2 AOTA CEUs.
Learn more →Also Recommended
How to Identify Signs of Poor Sensory Processing (Feeding and Mealtimes)
This self-study course by Alisha Grogan, MOT, OTR/L helps clinicians recognize the sensory red flags that influence feeding and develop targeted strategies. Especially relevant for children showing pica-like behaviors, oral seeking, and low oral tone. 0.15 ASHA CEUs.
Browse course →Browse all TalkTools® feeding courses here.
Frequently Asked Questions
Understanding the Sensory-Motor Approach
It considers how sensory processing and oral-motor skill development work together to support safe, effective feeding. Assessment includes a structured task analysis of the motor skills required for each feeding modality, spoon, cup, straw, and solids, before selecting tools or strategies.
Task analysis means breaking feeding into its component motor skills so you can identify which prerequisites are missing and plan treatment accordingly. For example, spoon feeding requires jaw grading, lip closure, and tongue movement, if any of these are underdeveloped, spoon feeding will be difficult regardless of food preference.
Clinical Questions
TalkTools® offers the Navigating the Feeding Journey course, the foundational course by Lori Overland, MS, CCC-SLP, plus the companion book, pre-feeding exercises course, and a full collection of feeding courses from infant feeding to the tube-fed child.
An extremely limited food repertoire in a toddler, especially when paired with low oral tone, open-mouth posture, or nutritional supplementation, warrants a feeding evaluation by a qualified SLP or feeding therapist. Research on self-limited diets in children shows that early assessment and intervention can make a significant difference in long-term outcomes.