My daughter is 6 and she has a limited variety of foods she will eat. She was adopted from China at 15 months old and refused all solid food for more than a year. She was developmentally delayed and extremely orally defensive. She is now in feeding therapy with a speech therapist and is making some progress. She is working on strengthening her jaw muscles and tongue mobility. She has a hard time moving her tongue up and forward. She has no difficulty with swallowing. She has 50% of her nutrition from a bottle which contains a jar of baby food and milk. Although she can use a cup and a straw, she is very rigid in her thinking and won’t drink the bottle contents out of anything else. It’s hard to condense her history. What is the best way to help her eat more and get off the bottle? I also need to add that she was physically abused in the orphanage and is very fearful of new things.

My 12-year old daughter was 2 years old when we adopted her from an orphanage in Bulgaria.  She was always challenged with eating fruits/vegetables, but we always managed to get her to eat a fairly balanced diet and she has improved.  Over the years we have found evidence of sneaking food - candy wrappers, dirty spoons, empty containers, etc. hidden away (under furniture, in drawers, planters . . . .  We have never restricted her access to treats since we didn’t want them to seem more appealing, and we allow her snacks if it won’t interfere with meals.  She has an athletic build, so she hasn’t had to worry about her weight, which of course, could change. She claims she sneaks when she’s hungry (usually after a meal she doesn’t want).  I don’t want to turn into a short-order cook and prepare a separate meal for her, and we don’t want to eat pasta & carbs every day.  We encourage her to eat in the kitchen whenever she gets hungry since we don’t want her eating elsewhere, but we continue to find evidence around the house.  We even got her the yogurts with the stir-in crunchies to make that a more appealing snack.  I found the yogurt containers (untouched) behind my microwave oven when I was cleaning.  Of course, the stir-ins were gone.  We recently brought home 2 sisters for her and they are not challenged at all.  We’re at our wit’s end.

My daughter was only 1.6 kilograms at birth. She weighed 15 pounds @15 months when we adopted her. Lately, we have been trying to introduce some new foods. We run into big problems if she gets hungry because she will start raging. We are trying to get her to eat before filling her up with her bottle(same child as first question above), but we run the risk of her getting too hungry and her thinking we are not going to give her food. Where do we find a balance?

Is the approach to feeding therapy different when a child is orally defensive because of abuse, and is there a way to determine if a child has been force fed ?

I have a six-year-old client who was adopted at fifteen months of age. The parents believe that there was some sort of oral punishment at an early age.  She still consumes three seven ounce bottles of milk with baby foods everyday for nutrition.  She eats a limited amount of foods ranging in texture.

She showed varying strength and sensory concerns at the initial visit, however I was unsure if the jaw strength was a matter of fear than strength. At the first session she was resistant to oral motor exercises, but is now tolerating all oral motor exercises without protest.  She continues to show hesitancy when she bites on chewy tubes, but is doing better.  She will now allow the spoon to touch her tongue and lips.  She tends to inspect her food visually and by smell.  During therapy she will trial new foods and agree to try varying foods/utensils/spoons at home, but then isn’t willing to follow through with her parents.  We are afraid to push her too much and completely turn her off, but unless she is willing to work at home for mom and dad success won’t come quickly or at all.  The goal at this point is to get her off the bottle feeds.
We have tried special cups, straws, rewards etc.  What should my next step look like?  Also, should we consider talking with her about why she feels afraid?  She typically will give an “I don’t know” answer when questioned as to why she doesn’t want to eat something.