Reader Question
“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
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!
— Lori L. Overland, MS, CCC-SLP, C/NDT, CLC, FOMWhat 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.
Why Prerequisites Matter Before Food Exposure
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.
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:
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 →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.