Nemours Children's pediatric speech-language pathologists (also sometimes called "speech and language therapists”) evaluate, treat and provide consultations for children with feeding and swallowing challenges. We look at kids’ oral feeding skills, provide family education, and offer strategies to promote safe eating and drinking.

Our speech and language therapists are trained in managing kids’ communication and swallowing problems. Children might be candidates for feeding evaluation and therapy if they: 

• Actively refuse foods
• Misbehave at mealtime
• Won't eat many types of foods 
• Gag, cough or vomit when eating 
• Gain weight slowly or have trouble gaining weight
• Have trouble chewing, swallowing food and/or eating foods of different textures 
• Mostly take a bottle when sleeping
• Need tube feedings for nutrition

We see a full spectrum of conditions — far too many to list here. The conditions we treat vary depending upon the location and providers selected. Don’t see a condition listed? Call us.

• Airway disorders 
• Autism spectrum disorder (ASD)
• Cerebral palsy 
• Complex medical diagnoses 
• Craniofacial anomalies (birth defects of the face and head, like cleft lip and palate)
• Failure to thrive (when kids don’t gain weight or grow as expected)
• Gastrointestinal (digestive) problems 
• Oral-motor delays and deficits (when there’s a problem in the areas of the brain responsible for speech and feeding, making it hard to coordinate the lips, tongue and jaw)
• Swallowing disorders (like dysphagia)

Speech and language therapists are the first line of specialists to see children for problems with feeding and/or swallowing. Sometimes, occupational therapists (OTs) can help too. Depending on what we find, we may be able to diagnose and treat the condition. Services for diagnosis and treatment may include: 

• Clinical evaluation, including a review of your child’s medical, developmental and feeding history
• Family education and training 
• Treatment planning specifically for your child  
• Meal observation  
• Referral for additional assessment, if needed

Depending on each child’s condition, care may include specific studies and treatments such as: 

• Fiberoptic endoscopic evaluation of swallowing (FEES) (when kids eat and drink while their feeding and swallowing skills are viewed through a flexible laryngoscope — a thin, flexible instrument that lights and magnifies images for a better view of the larynx/voice box and vocal cords)
• Modified barium swallow studies (MBSS) (when kids swallow a small amount of a chalky liquid, which appears on a special X-ray and shows the swallowing process as they eat and drink) 
• Neuromuscular electrical stimulation (NMES) (using electrical stimulation with traditional swallowing therapy to strengthen muscles for swallowing)

Depending upon the location you visit, our programs and services may include:

Delaware Valley/Greater Philadelphia

Our speech and language therapists offer feeding and swallowing therapy at Nemours Children’s Hospital, Delaware (Wilmington) and select Nemours Children's Health satellite locations.

• Only pediatric rehabilitation program in the greater Philadelphia region accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)
• New state-of-the-art Rehabilitation and Inpatient Therapy Center, with Activities of Daily Living (ADL) suite

Central Florida

Our occupational therapists (OTs) and speech and language therapists offer feeding and swallowing therapy at Nemours Children’s Hospital, Florida (Orlando).

• One of only four multispecialty pediatric inpatient rehabilitation programs in all of Florida — and the only one in Central Florida
• Unique treatment settings, like our outdoor Discovery Garden that integrates therapy with healing, nature and sensory exploration
• Only pediatric rehabilitation program in the state of Florida located in a freestanding children’s hospital  
• Integration with world-class programs (brain and spinal cord injuries, diseases of the nervous system, cerebral palsy, spina bifida and muscular dystrophy)

Northeast Florida

Our speech and language therapists offer feeding and swallowing therapy at Nemours Children's Health, Jacksonville and select satellite locations. Our services are provided through the Division of Otolaryngology (Ear, Nose & Throat/ENT) — a recognized leader in providing state-of-the-art ENT programs for kids.

• Vital Stim® therapy (noninvasive stimulation therapy for swallowing disorders)
• VPI (Velopharyngeal Insufficiency) Clinic (bringing together physicians and speech therapists to help kids with soft palate muscle problems)