Down syndrome feeding therapy was essential for Colter, an 18-month-old little boy who could not chew food. In April of 2015, I received an email from his mother. She was desperate for help because he couldn't chew his food, and mealtimes had become overwhelming for the whole family.
Although this was technically speech therapy, his speech was not the main concern at that point. First, he needed to eat safely. I also knew that if we improved his feeding skills, his speech might begin to develop more easily too.
I love feeding therapy because progress changes everyday life. When children meet feeding goals, they gain safer nutrition and hydration. As a result, the entire family benefits.
Down Syndrome Feeding Therapy Challenges
Many people take for granted how easy it is to feed a baby or toddler. However, some families face a struggle at every meal and snack. That was true for Colter.
There are few things more stressful for a parent than watching a child who cannot eat safely. Colter was both unable to chew well and at risk during feeding.
At 18 months old, Colter swallowed almost every solid he put in his mouth without chewing. He wanted to eat, but he could not organize the motor plan to do it correctly. This is a common concern addressed in Down syndrome feeding therapy, especially when oral motor coordination is delayed.
He also could not move his tongue side to side, which is called lateralization. If food was placed in the front of his mouth, he would suckle it and swallow it. That pattern is concerning because children who do this repeatedly may lose their protective choking response over time.
Clearly, we had a lot of work to do. I taught his mother how to place meltable solids on the side of his lateral molars. This positioning gave him a better chance to keep the food in place and begin chewing.
How Down Syndrome Feeding Therapy Improved Chewing
For practice, we used the TalkTools Pre-Feeding Hierarchy, as described in Lori Overland and Robyn Merkel-Walsh's book A Sensory Motor Approach to Feeding. This approach reduced choking risk and let us focus on chewing and tongue lateralization before moving into harder foods.
This structured Down syndrome feeding therapy plan began to make a real difference. We also used a Z-Vibe along with pre-feeding exercises from Lori Overland's TalkTools course, Feeding Therapy: A Sensory-Motor Approach, before starting more advanced feeding work.
Most importantly, Colter's mom followed through at home. Her consistency was a major reason he made such strong progress. Within six months, Colter was eating more solid food, and he was doing it much more safely.
Why practice at home mattered
Therapy sessions were important, but home carryover made the difference. Because his mother practiced consistently, Colter had many chances to repeat the new oral motor patterns. Therefore, the skills became more natural and more reliable over time.
Results of Down Syndrome Feeding Therapy
A few months later, his verbal speech exploded. He had always understood more than he could say. Once his feeding skills improved, his expressive language started to blossom too.
When I explained to his mother that his increase in talking was likely connected to oral motor therapy, she said, "I know you said that him talking more could be a possibility when we first started therapy, but I didn't think it could happen!"
At that point, Colter was 2 years and 9 months old and eating everything. One of his first words was "eat." That felt especially meaningful because feeding had once been such a challenge.
Remarkably, he loved beef jerky, hummus with veggies, fruit snacks, watermelon, and grapes. He was also beginning to speak in two-word utterances and had great intelligibility when doing so.
Next steps after chewing improved
After chewing improved, our next goal was straw drinking. Colter still used a bottle and was not excited about drinking from anything else. So our focus shifted to the Honey Bear.
We actually had to put the Honey Bear away for about a month because he resisted it so strongly. Then one day during therapy, I used some lip-rounding pre-feeding exercises with him. He did well, so we brought the Honey Bear back out on a whim. Suddenly, it clicked.
We were still working on consistency, but his family and I were thrilled with how far he had come. His case became a textbook example of what targeted Down syndrome feeding therapy can do for a child who needs support with chewing and oral motor control.
"You cannot separate speech and feeding." Colter's story is a strong example of how closely those two systems are connected.
In Lori Overland and Robyn Merkel-Walsh's book A Sensory Motor Approach to Feeding, that connection is discussed clearly. Colter is proof of it.
Vanessa Anderson-Smith is a Speech-Language Pathologist born and raised in South Dakota. She received her Bachelor's Degree at Augustana University and her Master's Degree from The University of South Dakota. In 2013, she began Anderson-Smith Speech Therapy, LLC.
Her practice focuses on assessment and treatment of motor-based speech and feeding disorders in children and adults. She lives in Canton, South Dakota, with her extremely supportive husband, Ryan.