How Speech Therapy Supports Feeding and Swallowing in Children

Feeding should be a natural and enjoyable part of a child’s day. But for some children, eating and swallowing can be difficult, stressful, or even unsafe. They may gag on certain textures, cough frequently while eating, avoid food altogether, or take a very long time to finish meals. 

For parents and carers, this can be worrying and frustrating.

1. Why is my child having trouble swallowing?
2. How can a speech therapist help with feeding?
3. Are there techniques to make mealtimes easier?
4. Should we also see an occupational therapist? 

Speech therapists, also known as speech pathologists, play a key role in supporting children with feeding and swallowing challenges. They look at the child’s oral motor skills, sensory responses, and swallowing safety, then create a plan to make eating safer, easier, and less stressful. 

In this guide, we’ll explain how speech therapy helps children with feeding and swallowing, outline common techniques, and discuss how occupational therapy works alongside speech therapy to support mealtime success.

Understanding Feeding and Swallowing Difficulties in Children 

Feeding and swallowing difficulties in children are known as paediatric dysphagia. They can have many causes, including: 

• Premature birth or low muscle tone 
• Neurological conditions such as cerebral palsy 
• Structural differences like a cleft palate 
• Sensory processing challenges that affect tolerance of textures and tastes 
• Medical conditions that affect breathing, reflux, or digestion 

When feeding is difficult, it can affect more than just nutrition. Children may: 

• Refuse certain textures or foods entirely 
• Take a very long time to finish meals 
• Gag, cough, or choke while eating 
• Show distress or anxiety during mealtimes 
• Lose interest in food, affecting growth and energy levels 

Speech therapists specialise in assessing the different parts of feeding and swallowing. They look at: 

• Oral motor skills – how the lips, tongue, cheeks, and jaw move during eating 
• Swallowing safety – whether food or liquid is entering the airway (aspiration) 
• Positioning and posture – whether the child’s seating or head position supports safe swallowing 
• Sensory responses – whether certain textures, temperatures, or smells trigger aversion 

Early support is vital. The longer feeding difficulties go untreated, the more they can impact nutrition, development, and family stress. 

For more information on feeding challenges, the Raising Children Network has helpful resources for Australian families.

How Speech Therapists Help With Feeding and Swallowing 

Speech therapy for feeding and swallowing focuses on making mealtimes safer, easier, and more positive. Here are some of the ways therapists support children. 

Comprehensive Feeding Assessment 

The therapist begins with a detailed assessment of: 

• Oral motor strength and coordination 
• Sensory preferences and aversions 
• Current diet and feeding routines 
• Posture and seating during meals 
• Any signs of aspiration, such as coughing or wet-sounding breathing after swallowing 

They may work alongside your child’s paediatrician, dietitian, or occupational therapist to create a complete picture of the feeding difficulty. 

Oral Motor Exercises 

Some children have weak or uncoordinated oral muscles, making it hard to chew or move food around the mouth. Speech therapists may use: 

• Chewing exercises with safe, chewy foods or tools 
• Tongue movement activities to improve lateralisation (moving side to side) 
• Lip closure and suction practice with straws or blowing games 

These exercises are always introduced in a fun and playful way to keep children engaged. 

Texture and Flow Modifications 

Sometimes adjusting the food or drink consistency makes swallowing safer. 

• Pureeing solid foods can reduce the risk of choking. 
• Thickening liquids slows the flow, making them easier to control. 
• Introducing new textures gradually helps children build tolerance and confidence. 

The therapist teaches parents how to safely prepare and offer modified foods. 

Safe Swallowing Strategies 

Speech therapists also teach practical techniques to make swallowing safer, such as: 

• Adjusting seating or head positioning during meals 
• Using pacing strategies, like offering smaller spoonful's and taking breaks 
• Encouraging specific chewing or swallowing patterns to improve efficiency 

Making Mealtimes Positive 

Children with feeding difficulties often develop anxiety around food. Therapists use play-based approaches and positive reinforcement to help children feel relaxed and successful at mealtimes. 

For more detail on these techniques, visit our Speech Pathology services.

Techniques That Promote Swallowing in Children 

Speech therapy uses a combination of oral motor training, sensory desensitisation, and behavioural strategies. Here are some techniques commonly used to promote safe swallowing and better feeding skills. 

Oral Stimulation 

Before meals, gentle oral stimulation can “wake up” the muscles and prepare them for eating. This might include: 

• Massaging the cheeks and lips with a soft brush 
• Using vibration tools or chewy tubes to improve oral awareness 
• Offering cold or textured foods to provide sensory input 

Gradual Texture Introduction 

If a child is very sensitive to textures, therapists often start with familiar foods and gradually introduce slightly different textures. For example, moving from smooth purees to slightly lumpy mashed foods. 

Pacing and Bite-Sizing 

Some children eat too quickly or try to swallow large amounts at once. Therapists teach parents to pace the meal with small spoonful's, sips, and pauses between bites. 

Positioning and Posture 

Good posture can make a huge difference in swallowing safety. Simple changes like ensuring feet are supported and the head is in a neutral position can help a child swallow more effectively. 

Sensory Integration 

For children who gag or refuse certain foods due to sensory sensitivities, therapists combine feeding therapy with sensory play. This might include exploring food with hands first, smelling it, or touching it to the lips without pressure to eat. 

For more insight on sensory support during feeding, see our blog on sensory regulation strategies.

How Occupational Therapy Supports Feeding and Swallowing 

While speech therapists focus on the oral motor and swallowing aspects, occupational therapists (OTs) play a complementary role. They look at the broader sensory, motor, and environmental factors that influence mealtime success. 

Sensory Processing 

Many feeding difficulties are linked to sensory challenges. OTs help children tolerate different textures, smells, and temperatures by gradually introducing sensory experiences through play and structured exposure. 

Mealtime Environment 

OTs assess the child’s seating, table setup, and routine. They may suggest adaptive seating, better positioning, or changes to lighting and noise levels to create a calmer eating space. 

Fine Motor Skills 

For children who struggle to self-feed, OTs work on hand strength, coordination, and utensil use so they can eat more independently. 

Behavioural Support 

If mealtimes have become stressful, OTs can help families develop calm, predictable routines and reduce anxiety around eating. 

Together, speech and occupational therapy create a holistic feeding plan that addresses the child’s physical, sensory, and emotional needs. 

For more on OT’s role, visit our Occupational Therapy services.

Frequently Asked Questions (FAQs) 

How do speech therapists help with feeding? 

They assess oral motor skills, swallowing safety, and sensory responses, then use exercises, texture modifications, and safe swallowing strategies to make eating easier. 

How does a speech therapist help with swallowing? 

They teach oral motor exercises, recommend safe food textures, and introduce techniques like pacing and positioning to support swallowing safety. 

Which technique promotes swallowing in children? 

Techniques include oral stimulation, gradual texture introduction, proper positioning, and pacing meals with small, manageable bites. 

What is the role of occupational therapy in managing feeding and swallowing disorders? 

OTs focus on sensory processing, mealtime routines, environmental setup, and self-feeding skills to complement speech therapy.

Feeding and swallowing difficulties can impact a child’s nutrition, growth, and confidence, but with the right support, mealtimes can become safer and more enjoyable. Speech therapy focuses on improving oral motor skills, swallowing safety, and food acceptance, while occupational therapy addresses sensory and environmental factors. Together, these therapies provide a complete approach to helping children thrive. 

Next Step

If you’re a parent or guardian of a child with feeding or swallowing challenges, you can refer them for a tailored therapy plan with our team. 

Refer someone for an appointment 

Our therapists will assess your child’s needs, create a personalised feeding plan, and support your family every step of the way.

Date Published: Tuesday, August 19, 2025