5 Tips for Completing a Feeding Evaluation

feeding evaluation

An integral part of an occupational therapy feeding evaluation is the food questionnaire or checklist. This is the foundation for building your learner’s food repertoire based on their likes and dislikes. When discussing preferences with the parent and child, the more details they are able to provide, the smoother the sessions will go.

Feeding evaluation tips

How to Do a Feeding Evaluation

The first step to a feeding evaluation is often a comprehensive Food Inventory Questionnaire. By understanding what a child is and is not eating helps the therapist to better understand food preferences in the way of food texture issues, flavors, colors, tec. The food inventory is a great tool for consistent data collection. Accurate data collection will helpful be able to provide a just right challenge. Before beginning any feeding program, it is important to become educated on feeding therapy, treatment, and problem areas in a thorough feeding assessment. This guide will provide a basic understanding of sensory versus oral motor feeding concerns.

Check out the tips below to help guide your discussion.

Tip #1: When Planning a Feeding Evaluation, Provide Questionnaires Ahead of Time 

If at all possible, try to provide a feeding assessment checklist or questionnaire ahead of time, or ask the parent to come prepared with a list of foods that their child does or does not like. This is SUPER important, because asking a parent during the feeding evaluation, does not typically go well.

It is likely that you will not get a complete picture, or the parent will forget some key pieces of information–such as what brand of cereal their child eats or be so overwhelmed they claim their child eats “nothing”.

Not all of the problems presented will be sensory food issue related. There are times when they stem from an oral motor deficiency. It is important to be able to spot the difference before beginning treatment.

Tip #2 During a Feeding Evaluation: Ask About Food Jags 

What is a Food Jag?

The term “food jag” is fairly new term referring to a preference toward a couple of foods, eating them all of the time; suddenly stopping eating a once highly preferred food, refusing to add it back into their repertoire. A food jag refers to the case of children only eating one type of food or a small number of food items. Some common food jags include:

  • The child that only eats chicken nuggets, crackers, and French fries (all foods are consistent in taste and texture.
  • The child that only eats Goldfish crackers, dry cereal, and crackers (all foods are bland, have some crunch, but are thin in width
  • The child only eats yogurt tubes or yogurt smoothie drinks (the consistency and sweetness of the yogurt flavors are satisfying)

Food jags include any small group of limited food selections. These food limitations can change over time.

You’re looking to see if this has happened over the course of the child’s feeding history as it may be indicative of trauma (i.e.-choking), emergence of sensory processing difficulties, and feeding developmental milestones that occur in leaps and stages.

This is also common in people who do not eat a variety of foods. They get tired of eating the same three foods over and over. Food jags can happen to people who eat a variety of foods also, but generally people have other foods to put in its place.

For instance, I may eat peanut butter and jelly sandwich every day for three weeks, then get tired of it. That is fine because I can switch to yogurt, or ham, or turkey. A person with limited food choices loses a preferred food and does not have anything to replace it with.

If you notice a trend of food jags in the child’s history, make sure that you provide education on how food jags occur and how to prevent food them, before they leave the evaluation. 

Tip #3: Complete a Sensory Evaluation of Food- Review Each Food Category 

Even if the parent fills out a feeding assessment checklist/questionnaire and hits all the food categories, fruits, vegetables, starches, dairy, protein (meat, eggs, nuts) and other (snack foods), make sure that you go through the list with the family.

When you review each category, even briefly, it may spark the parent to remember something regarding the child’s eating patterns. 

Consider the sensory evaluation of food including differences in types of food categories, and how there can be minute or vast sensory differences in foods based on preparation (cooked in the oven or cooked in the microwave, different brands (drier consistency vs. saltier flavor), or types of foods (spaghetti pasta vs. smaller elbow noodles).

A food evaluation should take the sensory evaluation of foods into consideration for each meal.

Questions to ask regarding food preferences:

For example, if the parent reports that their child eats noodles, you might want to ask what kind of noodles.

  • Do they eat only elbow noodles?
  • All types of noodles?
  • And all varieties of noodles-egg noodles, veggie noodles, rice noodles? 

Another example of food variables is seen in fruit.

  • Fruit can be whole, peeled, fresh or comes in a container.
  • Apples can be peeled, sliced, or presented whole.
  • How does the child eat them?
  • Mandarin oranges come in syrup or can be freshly peeled. Which does your learner prefer?

If the parent reports that their child is very specific or limited on how they will eat their food, this is a starting place for pushing their food limits and boundaries in the first couple of sessions.

Tip #4: Ask About Brands 

This tip ties into Tip #3 when discussing the categories of foods. You want to know if the child will only eat a specific brand of food. This is common with cereal, snack foods, pizza, and pastas such as macaroni and cheese. It can happen with all foods, so it’s good to ask.

This may indicate that the child has challenges with processing novel experiences and may be easily distressed by change, from a sensory perspective. It also indicates that the child is very rigid in their thinking and expectations for mealtimes.

You will need to build confidence and trust, as something as small as changing brand of cereal might be a big leap.

Tip #5 during feeding evaluation: Ask About Temperature 

Another aspect to the sensory evaluation of food is the temperature of preferred foods. Ask how the child likes their food served–hot, cold or room temperature. While this may not seem like a big deal, but it can be for a child who is already struggling with introducing new foods and experiences into mealtimes.

It’s also a very personal preference, and by knowing that preference, you have an increased understanding of the child which leads to trust, and eventually a broadened food repertoire.

Sometimes the issue at hand is not the food at all. It is the learner’s difficulty getting it into the mouth. There are many choices when it comes to spoons, bowls, plates, cups, and serving ideas.

Check out some of these ideas to see if these may help your learner with self feeding or trying new food challenges.

Feeding therapy is complicated

Feeding therapy is complicated. Without the right knowledge and tools, therapist/parents can make the problems worse. Take time to get educated on correct feeding therapy techniques. In the meantime, feel free to engage your learner in messy play. This is a great first step to understanding and tolerating new foods.

Other areas to consider in a feeding assessment include:

  • Anatomical considerations of the mouth and tongue
  • Mobility of the jaw, tongue, lips, and cheeks
  • Positioning and body posture
  • Body awareness
  • Developmental progression of oral motor skills
  • Muscle considerations and issues that impact musculature (digit sucking, extended use of bottle or pacifier, reverse swallow/tongue trust, tongue, chewing habits, lip closure, vertical chewing during food prep stage,
  • Structural abnormalities (teeth alignment, tongue tie, palate, tonsils, lip symmetry, etc.)
  • Movements and range of motion in mouth, cheeks, lips, jaw: Jaw Thrust, Exaggerated Jaw Movements, Jaw Instability, Jaw Clenching, Tonic Bite, Jaw Retraction, Tongue Retraction, Tongue Protrusion, Stability Bite
  • Alignment of teeth
  • Presence of gagging or choking on foods
  • Speech skills
  • Sleep habits (sleeping through the night, snoring, light sleeper/heavy sleeper)
  • Tooth Grinding
  • Phases of food swallow- Oral preparation, Oral Propulsion, Pharyngeal phase, Esophageal phase
  • Vision and Visual motor skills
  • Tone and musculature of the body-impacting range of motion, posture, etc.
  • Fine motor skills

You’ll want to contact a pediatric occupational therapist who is experienced in feeding evaluations, including the oral motor aspect of food assessments.

Use the Food Inventory Tool- A Parent Report Screening Tool to incorporate into feeding evaluations to ensure successful feeding therapy.

This tool provides the therapist with a data sheet for a child’s repertoire allowing for consistent data collection over the course of feeding treatment. It also provides the therapist with a professional looking tool and talking point during the initial feeding evaluation to ensure that a comprehensive list of foods the child eats is gathered to support successful feeding therapy.

Click here to get a copy of the Food Inventory Tool- A Parent Report Screening Tool.

Contributor: Kaylee is a pediatric occupational therapist with a bachelors in Health Science from Syracuse University at Utica College, and a Masters in Occupational Therapy from Utica College. Kaylee has been working with children with special needs for 8 years, and practicing occupational therapy for 4 years, primarily in a private clinic, but has home health experience as well. Kaylee has a passion for working with the areas of feeding, visual development, and motor integration.

*The term, “learner” is used throughout this post for readability, however this information is relevant for students, patients, clients, children of all ages and stages or whomever could benefit from these resources. The term “they” is used instead of he/she to be inclusive.

 

pool noodle Games and activities

pool noodle activities

If you are looking for fun gross motor coordination activities, then these pool noodle games and activities are a great therapy tool to support skill-building. The pool noodle games are great activities to add to therapy sessions, use in home programs, or to add to Field Day or summer therapy camps. Check out these pool noodle games that support development, learning, and sensory motor skills.

Use these pool noodle activities and games to build skills.

Pool Noodle Games

A pool noodle is a swim toy that can be used to build swim skills or have pool-time fun. It can also be used as an OT tool to help build hand/finger skills, overall body strength/coordination, as well as balance, and motor planning skills.

Because they are readily available in stores during the Spring and Summer months, pool noodles are a great addition to your Summer occupational therapy activities.

Pool noodles are a versatile toy that can be cut, divided, and shaped into many tools to benefit children in their skill development, and overall needs. These toys are colorful, inexpensive, and attractive to children, which make them motivating, and facilitates engagement in pool noodle activities created with them.

This is a gross motor toy you’ll want to add to your therapy toolbox, and we’ll cover why that is below.

In addition, imagine all of the equipment needs that can be addressed to help with daily living skills using these noodles.  

Add pool noodles to a few other ideas here on the website for a Summer of fun:

pool noodle activities

pool noodles Activities and Games

Pool noodles can be used by a variety of children, for many needs, and for several purposes.  They can easily be used indoors or outdoors, in the home, the classroom, and therapy room. Pool noodle activities can be used with all ages, and in all environments. That’s right all ages. Maybe not in the conventional manner, but there are many imaginative and thoughtful activities that are fun and safe for anyone!  

The best part? Pool noodles are cheap, cheap, cheap. They can be more challenging to find, if you look for them off season. My helpful tip to you is to buy them in bulk when they go on clearance at the end of the summer season, and you’ll have them whenever you need them. Sometimes you can even find them on clearance for just a few cents, that’s right, A FEW CENTS! 

Let’s take a look at some fun, creative pool noodle activity ideas to get kids up, moving, active and a little ‘noodley’ this season! If you do not need them for pool noodle activities, but want some creative tool ideas instead, I’ve got you covered there too. Just scroll down to the bottom of the page, and you’ll find some innovative ideas for equipment and tools. 

Gross Motor pool noodle activities:

These gross motor pool noodle ideas offer strategies to support motor planning and body awareness. It is by adding a simple pool noodle to play activities that can offer challenging motor tasks, while encouraging coordination, balance, body awareness, and motor planning skills.  

make a pool noodle tunnel for obstacle courses and gross motor skills.
  • Pool Noodle Tunnel- Use a few pool noodles down a hallway and create a fun pool noodle tunnel for kiddos to crawl under, take a look here at our blog post Play Tunnel Activities. Use skewer sticks to secure noodles outside, and create a pool noodle hurdles.
  • Pool Noodle Wand- Create a Pool Noodle wand for reaction time, coordination, and balance. All of these skills can be addressed with the simple use of a pool noodle and PVC pipe to create the stick.

  • Pool Noodle Hurdles- We shared how to make pool noodle hurdles in our Family reunion activities post. Simply cut a pool noodle and use paint stirrers to stick small pieces into the ground. Then balance a long pool noodle on top for a balance, coordination, and gross motor activity that kids can step over, jump, or hop over in an obstacle course.
  • Pool Noodle Relay Race- This pool noodle game is great for lawn games, outdoor sensory diets, and family fun. Divide players into teams. Each team has a pool noodle. Players can race to a certain spot and then turn around and pass the noodle to the next player in the line. The first team to get all of their players to run with the pool noodle is the winner. This game can also be played in the swimming pool.
  • Pool Noodle Balance Game- Cut a pool noodle into smaller pieces (about one half of a pool noodle). Each player receives a piece. Balance a ball on top of the pool noodle hole. The players should race across the lawn or room while balancing the ball on their pool noodle. This is also a great addition to an obstacle course while challenging changes in positioning.

  • Balance Beam- A pool noodle is a great way to create a DIY balance beam, which provides balance opportunities, works on core strength, and provides vestibular input to help improve regulation.

  • Wobble Board- Use a pool noodle as a wobble board by adding a platform or boogie board over the noodle. Here’s another great idea for a DIY wobble board.
  • Pool Noodle Limbo- Want to limbo this season? Use a pool noodle for a fun game of limbo at home, or during therapy. Have children perform animal walks under the limbo stick. Easy, simple, effective and FUN! This one allows kids to work on multiple body skills. 
  • Gross Motor Drum Sticks- Use pool noodles as gross motor drum sticks. When you use pool noodles as desk drumsticks, you address core strength, eye-hand coordination, bilateral coordination, and motor planning.  Desk drumsticks can build fitness, and give a quick movement break to the entire class, with very little effort and cost. Now, that’s a winner in my book! To add gamification to this pool noodle idea, add music and play to the music. When the music stops, everyone needs to stop playing. It’s a great auditory processing activity.

  • Pool Noodle Skipping- You can use pool noodles as a tool to teach skipping.

Here are several more gross motor coordination activities to add to your toolbox. Don’t forget to stock up on gross motor toys when treatment planning.

Fine Motor activities using pool noodles

Pool noodles can be used on a small scale, too to work on fine motor skills. Try some of these ideas.

  • Pool noodles and rubber bands – Cut a pool noodle into smaller pieces. Use rubber bands to wrap around the pool noodle. This is an easy fine motor activity that you can create. Learners work on stretching the bands around the noodle, which will provides a fun, but effective fine motor strengthening tool, and a good bilateral coordination activity.
  • Press pipe cleaners into pool noodles- This is another easy, but fun activity to work on important fine motor, and bilateral coordination skills. Slide beads onto the chenille stems (pipe cleaners) to work on threading, or have them string in a specific order to add an opportunity for working on listening and following directions. 
  • Threading activity- Use those same pipe cleaners pressed into the pool noodles and add beads, buttons to place onto the pool noodles. Learners will work on fine motor skills, eye-hand coordination, and finger strengthening with these fun activities. You can also thread pool noodles on a jump rope like we did with this pool noodle sensory bin idea.
  • Pool noodle and pom-pom transfer is just what you are looking for if you need a child to work on tong use, or practice pre-scissor skills using a pair of tongs. Children use tongs to transfer pom-pom balls into the holes of the pool noodle slices. Not only is this for fine motor skill development, but look at the built-in eye hand coordination too!
  • Put a cork in it! is a super fun activity that works on finger strengthening and bilateral coordination, as children will work to twist and push corks into the holes of pool noodle slices. Where do you find corks without having to drink dozens of bottles of wine (which is not terrible). Go to any craft store and they are available for purchase.
  • Pool noodle pom-pom shooter is a fun pool noodle activity that works on fine motor strengthening, as children work to pull the rubber band back to shoot the pom-pom from the pool noodle chunk. It most cases, the farther they pull the rubber band backwards, the farther the pom-pom will go. Set up a target using a laundry basket or box, and see if they can shoot the pom-poms into the target to score points. 
  • Make a creature- Cut a pool noodle into small pieces. Affix or draw monstors or pictures of people or animals onto the pieces. Learners can then mix and match creature blocks with pool noodle chunks to build their own creatures. You can take pictures of completed creatures and have children attempt to copy the picture by stacking the appropriate pool noodle pieces, they work on visual perceptual skills.

Sensory pool noodle activities:

  • Sensory Bins- Use pool noodles as part of a Pool Noodle Sensory Bin to give the illusion of the ocean, and/or bubbles that you see in the ocean. Children can stack, fill, or squeeze them. 
  • Pool Noodle Boats- How about some pool noodle boats for bathtub time, in a water bin? Take a look at how easy making these pool noodle boats are, and what fun they will be to play with during water playtime. 
  • Letter Scoop Race- Cut a pool noodle into small pieces. Write letters on the outside of each piece. Then, place the noodle pieces into a sensory bin or on a tray. Ask the learner to scoop letters and as fast as they can match upper case letters to lower case letters, or letter to letter. They can stack the matching letters on top of one another to work on fine motor skills.

Eye-Hand Coordination using pool noodles:

  • Marble Maze- After an adult slices the pool noodles in half, have kiddos work on taping a variety of pool noodle pieces onto the wall with painter’s tape to create a fun Pool Noodle Marble Maze. Kiddos can change it up, making new mazes. It makes for a great STEM activity that builds problem-solving, and eye-hand coordination. This is a great DIY marble run for a visual scanning activity.
  • Pool noodle track- Easily create a visual tracking and bilateral coordination activity with use of a pool noodle circle track which requires a pool noodle sliced in half, taped together in a circle, and a marble inserted for rotating around the track. Making your own race track is a fun and challenging pool noodle activity, as you have to keep the speed of the marble going around the track so it will not fall out. Definitely for higher level learners, but a fun one!
  • Pool noodle batting is a simple activity using pool noodle pieces and a balloon or a beach ball suspended from the ceiling with a string. This provide a great opportunity to work on eye-hand coordination, upper extremity strengthening, and range of motion. 
  • Javelin Throw– Use pool noodles to create a pool noodle javelin throw activity to work on visual motor skills as children throw a pool noodle javelin through a circled pool noodle suspended from the ceiling.  
  • Pool Noodle Bowling- In this bowling game all you have to do is cut pool noodles into equal sized pieces, and you have a set of bowling pins! Anyone can use a set of simple bowling pins for a fun eye-hand coordination activity. You can use pool noodle slices stacked into a pyramid shape for the same purpose!

Here are some outdoor fun lawn games to round out your activity plan.

Pool noodle Tools or equipment Ideas: 

Everything listed here is all about tools, adaptations, apparatus, or simple equipment ideas to children at home or school. Take a peek, and see if any of these ideas can help your learners. 

  • Pool Noodle Card Holder- Know a child that has a hard time grasping and holding a set of cards? Make this great pool noodle card holder just for them! It can be used in the classroom, during therapy, and at home. Have a child that cannot hold cards, but needs to see them? Try this quick hands-free card holder adaptation. 
  • Pool Noodle Adapted Seat- Maybe you need a pool noodle seat for a kiddo that has difficulty knowing where their seat ends due to poor body awareness.  If so, this simple pool noodle seat will give them the physical cue they need to help with body awareness and balance within a chair. You know that one kiddo who frequently falls out of their chair? Try this and see if it helps! Here are more flexible seating ideas and DIY adapted seating (perfect for pool noodles!)
  • Pool Noodle Feet Positioner- How about a quick feet fix when a kiddos feet do not quite touch the floor, or they need a little movement for their feet while seated. Check out this pool noodle feet positioner.
  • Pool Noodle for High Tone Seating Needs- Sometimes there is that one kiddo that needs a little flexion positioning due to their excessive extension pattern, due to have high tone. Take a look at how to use a simple pool noodle and bungee cord to provide a little buffer for the excessive extension.  
  • Therapy Ball Seat Positioner- If you tape a pool noodle into a circle, you can use it as a pool noodle ball chair by placing the therapy ball on top of the pool noodle to hold in place. Kiddos can still move slightly on it, just not excessively. This makes the ball less distractive, and kept within their personal space at their desk! 

Summer is fast approaching, run and stock up on pool noodles now. One last thing that I want to remind you about pool noodles, remember to purchase them now, or when they are on clearance at the end of the season! They are just a few cents and you can use them all year long whenever you need them!  

Regina Allen

Regina Parsons-Allen is a school-based certified occupational therapy assistant. She has a pediatrics practice area of emphasis from the NBCOT. She graduated from the OTA program at Caldwell Community College and Technical Institute in Hudson, North Carolina with an A.A.S degree in occupational therapy assistant. She has been practicing occupational therapy in the same school district for 20 years. She loves her children, husband, OT, working with children and teaching Sunday school. She is passionate about engaging, empowering, and enabling children to reach their maximum potential in ALL of their occupations as well assuring them that God loves them!

The terms kids, kiddos, and children are used throughout this post. These pool noodle activities can be used for learners of all ages and developmental levels.