Using a Sequential Skills Training Model to Increase Oral-Motor Skills for Consuming Table-Textured Foods.

Children are expected to advance their oral-motor skills through experiences with different types and textures of foods that are gradually changed over time. However, children with pediatric feeding disorder may not go through the same developmental progression of eating, which interrupts the emergence of oral-motor skills that are necessary to transition to higher textured foods without direct instruction. Few published studies have evaluated systematic methods to teach oral-motor skills like tongue lateralization and mastication to children with feeding disorder. Therefore, the purpose of this study was to develop a sequential skills training program that focused on chewing, mastication, tongue lateralization, and mouth clean for a child with pediatric feeding disorder. This training included chewing on a chew tube, mashing crumbles of dissolvable foods, chewing in tulle netting starting with dissolvable foods and progressively moving to table-textured foods, and side placement chewing. At baseline, chewing, mastication, tongue lateralization, and mouth clean did not occur, and all of these behaviors increased after the sequential skills training package. Furthermore, the child successfully consumed table-textured foods at discharge.