What Are Feeding Difficulties?

​Feeding difficulties refer to challenges related to eating, drinking, accepting foods or participating in mealtimes.
Children may experience:
  • Picky eating
  • Food refusal
  • Limited food variety
  • Texture aversions
  • Difficulty transitioning to new foods
  • Mealtime anxiety
  • Difficulty self-feeding
  • Prolonged mealtimes
Feeding difficulties can occur for many reasons and may affect nutrition, growth, family routines and participation in everyday activities.
What Are Swallowing Difficulties?

Swallowing difficulties, also known as dysphagia, occur when a child has difficulty safely moving food, fluids or saliva from the mouth to the stomach.
Swallowing is a complex process involving the mouth, throat, muscles and nervous system.
When swallowing is affected, children may experience:
  • Choking
  • Coughing during meals
  • Gagging
  • Difficulty chewing
  • Food remaining in the mouth
  • Difficulty managing saliva
  • Frequent respiratory infections
  • Reduced food or fluid intake
Swallowing difficulties can vary from mild to significant and may require professional assessment and support.
What Is the Difference Between Feeding Difficulties and Swallowing Difficulties?

Although they often occur together, feeding difficulties and swallowing difficulties are not the same.

Feeding Difficulties
Feeding difficulties relate to:
  • Food acceptance
  • Food preferences
  • Sensory sensitivities
  • Mealtime behaviours
  • Limited food variety
  • Oral motor skills

​Swallowing Difficulties (Dysphagia)
Swallowing difficulties relate to:
  • Moving food or fluids safely through the mouth and throat
  • Coordinating swallowing muscles
  • Reducing choking and aspiration risks
  • Safe eating and drinking
Some children experience feeding difficulties without swallowing concerns, while others experience both.
Common Signs of Feeding and Swallowing Difficulties

Every child presents differently, but common signs may include:
  • Choking during meals
  • Coughing while eating or drinking
  • Gagging on foods
  • Refusing certain textures
  • Avoiding entire food groups
  • Taking a long time to eat meals
  • Difficulty chewing food
  • Pocketing food in the mouth
  • Frequent respiratory infections
  • Poor weight gain
  • Weight loss
  • Distress during mealtimes
  • Fatigue while eating
  • Difficulty transitioning to age-appropriate foods
If these concerns are present, assessment may be beneficial.

What Causes Feeding and Swallowing Difficulties?

​Feeding and swallowing difficulties can occur for many reasons.
Contributing factors may include:

Developmental Delays
Children may experience delays in the development of oral motor, chewing and swallowing skills.

Sensory Processing Differences
Some children are highly sensitive to certain textures, temperatures, tastes or smells, which can affect food acceptance and participation in mealtimes.

Autism Spectrum Disorder
Some autistic children experience feeding differences related to sensory preferences, food routines, oral motor skills or restricted food choices.

Neurological Conditions
Conditions such as Cerebral Palsy, acquired brain injury and other neurological differences can affect chewing, swallowing and feeding skills.

Gastrointestinal Conditions
Reflux, gastrointestinal discomfort and other digestive conditions can impact feeding behaviours and food acceptance.

Structural Differences
Conditions such as cleft palate, airway differences and oral structural variations can affect feeding and swallowing safety.
​
Prematurity and Medical Factors
Premature birth, low birth weight and certain medical conditions may increase the likelihood of feeding and swallowing difficulties.
Feeding Difficulties and Autism

Feeding differences are common among autistic children.
Children may experience:
  • Strong food preferences
  • Texture sensitivities
  • Limited food variety
  • Brand-specific food preferences
  • Difficulties with changes in food presentation
  • Mealtime anxiety
These feeding differences are often linked to sensory processing, predictability and comfort rather than behaviour alone.
Support focuses on creating positive mealtime experiences while respecting the child's individual needs and preferences.
What Is Dysphagia?

​Dysphagia is the clinical term for swallowing difficulties.
Dysphagia may affect:

Oral Stage
Difficulties chewing, controlling food or moving food around the mouth.

Pharyngeal Stage
Difficulties moving food safely through the throat.

Oesophageal Stage
Difficulties moving food through the oesophagus towards the stomach.
Assessment helps determine where difficulties are occurring and what supports may be beneficial.
How Feeding and Swallowing Difficulties Can Affect Daily Life

​Feeding and swallowing difficulties can impact many areas of life.

Nutrition and Growth
Children may struggle to consume enough food or fluids to meet their nutritional needs.

Family Mealtimes
Mealtimes may become stressful or frustrating for families.

Social Participation
Children may avoid social situations involving food such as parties, school events or family gatherings.

Safety
Swallowing difficulties may increase the risk of choking, aspiration and respiratory complications.
​
Emotional Wellbeing
Children may develop anxiety around eating or become distressed during mealtimes.
Signs Your Child May Benefit From a Feeding Assessment

​It may be beneficial to seek professional support if your child:
  • Frequently coughs or chokes during meals
  • Refuses multiple food textures
  • Eats a very limited range of foods
  • Experiences prolonged mealtimes
  • Has poor weight gain
  • Avoids eating with others
  • Experiences frequent chest infections
  • Has difficulty transitioning to age-appropriate foods
  • Appears distressed during meals
Early support can help identify underlying factors and guide appropriate intervention.
How Speech Pathologists Help With Feeding and Swallowing Difficulties

​Speech Pathologists play an important role in assessing and managing feeding and swallowing difficulties.
Support may include:
  • Feeding assessments
  • Swallowing assessments
  • Dysphagia management
  • Oral motor skill development
  • Chewing skill development
  • Texture progression support
  • Safe swallowing strategies
  • Parent education and coaching
  • Mealtime management recommendations
Recommendations are tailored to the child's individual needs.
How Occupational Therapists Help With Feeding Difficulties

​Occupational Therapists may assist with:
  • Sensory processing differences
  • Mealtime routines
  • Self-feeding skills
  • Seating and positioning
  • Regulation during meals
  • Participation in family mealtimes
Many children benefit from collaborative support from both Occupational Therapy and Speech Pathology.
When Should Parents Seek Support?

If you have concerns about your child's eating, drinking, chewing, swallowing or mealtime participation, seeking professional advice can help identify strengths, support needs and next steps.
Early assessment may help reduce risks associated with feeding and swallowing difficulties and support positive mealtime experiences for the whole family.
Feeding and Swallowing Support Across Western Australia

​Belong Health provides feeding and swallowing assessments and therapy services across Perth, Mandurah, Rockingham, the Peel Region and regional Western Australia.
Services may be provided in homes, schools, childcare centres, community settings and via telehealth where appropriate.

Our Speech Pathologists and Occupational Therapists work alongside families, educators, healthcare professionals and support networks to help children develop safe, positive and successful feeding experiences.
Steps for Parents: Addressing Suspected Swallowing Difficulties and Feeding Issues

​1. Observe and Document:
Keep a record of your child’s feeding behaviours and any difficulties experienced during meals. Note specific instances of choking, coughing, or refusal of certain foods and textures.

2. Check for Developmental Milestones:
Review typical feeding and swallowing milestones appropriate for your child’s age. This can help identify potential delays or areas of concern related to eating and swallowing.

3. Engage in Positive Mealtime Experiences:
Create a relaxed and positive mealtime environment. Encourage family meals to foster social interaction and model healthy eating behaviours.

4. Consult with Caregivers and Educators:
Discuss your concerns with your child’s teachers or caregivers. They may provide insights into your child’s eating behaviours in different settings and help identify any patterns.

5. Experiment with Textures:
Gradually introduce new textures or types of food in a supportive manner. Encourage your child to explore various foods without pressure to eat them.

6. Schedule a Feeding and Swallowing Assessment:
If concerns persist, arrange for a comprehensive assessment with a speech-language pathologist or occupational therapist specialising in feeding and swallowing disorders.

7. Participate in the Evaluation:
Be actively involved in the assessment process by sharing your observations and any relevant documentation regarding your child's feeding and swallowing difficulties.

8. Discuss the Findings:
Review the evaluation results with the professional, who will explain any identified feeding or swallowing issues and recommend appropriate interventions or therapy options.

9. Implement Recommended Strategies:
Follow the professional's recommendations for therapy, which may include specific exercises to improve swallowing, strategies for transitioning to different textures, or behavioural techniques for addressing picky eating.

10. Monitor Progress:
Track your child’s progress in improving their feeding and swallowing skills over time. Maintain regular communication with the professionals involved in their care to adjust strategies as needed.

11. Encourage Positive Communication:
Create a supportive environment that encourages your child to practise their speech. Praise their efforts and improvements to build their confidence in speaking.
​
12. Educate Your Child:
Help your child understand their feeding difficulties in an age-appropriate way. Encourage open communication about their preferences and feelings towards food.
​
13. Provide Nutritional Support:
Work with a dietitian or nutritionist if necessary to ensure your child receives adequate nutrition despite their feeding challenges. Explore alternative food options that meet their dietary needs.

14. Stay Informed:
Educate yourself about swallowing difficulties and feeding issues. Seek resources, attend workshops, or connect with support groups for parents of children facing similar challenges.

Have a question? or need more information

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Frequently Asked Questions - Swallowing Difficulties and Feeding

What are swallowing difficulties?
Swallowing difficulties, also known as dysphagia, occur when a person has difficulty safely moving food, drinks or saliva from the mouth to the stomach. Swallowing difficulties can affect nutrition, hydration, safety and overall wellbeing.

What is dysphagia?
Dysphagia is the clinical term for swallowing difficulties. It may affect any stage of the swallowing process and can occur in infants, children, adolescents, adults and older adults.

What is the difference between feeding difficulties and swallowing difficulties?
Feeding difficulties relate to eating behaviours, food preferences, sensory sensitivities, oral motor skills or mealtime participation.
Swallowing difficulties involve challenges safely moving food and liquids through the mouth and throat during swallowing.
Some individuals experience feeding difficulties, swallowing difficulties or a combination of both.

What causes swallowing difficulties?
Swallowing difficulties may be associated with:
  • Neurological conditions
  • Prematurity
  • Developmental delays
  • Oral motor difficulties
  • Structural differences
  • Gastrointestinal conditions
  • Autism
  • Genetic conditions
  • Brain injuries
  • Medical conditions affecting the muscles involved in swallowing

What are the warning signs of dysphagia?
Warning signs may include:
  • Coughing during meals
  • Choking on food or drinks
  • Wet or gurgly sounding voice
  • Difficulty chewing
  • Food remaining in the mouth
  • Frequent chest infections
  • Difficulty swallowing medications
  • Prolonged mealtimes

Is coughing when eating or drinking normal?
Occasional coughing may occur from time to time. However, frequent coughing, choking, throat clearing or a wet-sounding voice during meals may indicate swallowing difficulties and should be assessed by an appropriately qualified healthcare professional.
What are signs that someone may be aspirating?Aspiration occurs when food, liquid or saliva enters the airway.
Possible signs may include:
  • Coughing during meals
  • Choking episodes
  • Wet or gurgly breathing
  • Frequent respiratory infections
  • Changes in voice quality after eating or drinking
If aspiration is suspected, professional assessment is recommended.

What are the four types of dysphagia?
Swallowing difficulties may be classified according to where the difficulty occurs, including:
  • Oral dysphagia
  • Oropharyngeal dysphagia
  • Oesophageal dysphagia
  • Functional swallowing difficulties
Assessment helps determine the nature of the swallowing difficulty.

Can swallowing difficulties be serious?
Yes. Untreated swallowing difficulties may increase the risk of choking, aspiration, respiratory infections, poor nutrition, dehydration and reduced quality of life. Early assessment can help identify appropriate management strategies.

What are the most common causes of dysphagia in children?
Common causes may include:
  • Prematurity
  • Neurological conditions
  • Developmental delays
  • Autism
  • Oral motor difficulties
  • Structural differences such as cleft palate
  • Gastrointestinal conditions
  • Genetic conditions

What are feeding difficulties?
Feeding difficulties involve challenges related to eating, drinking or mealtime participation.
Examples may include:
  • Picky eating
  • Food refusal
  • Limited food variety
  • Texture aversions
  • Difficulty transitioning between food textures
  • Mealtime anxiety

Is picky eating the same as a feeding disorder?
Not necessarily. Many children experience periods of picky eating. Feeding disorders typically involve more significant challenges affecting nutrition, growth, health, safety or participation in mealtimes.

Can autism affect feeding and swallowing?
Yes. Some autistic children experience feeding differences related to sensory sensitivities, food preferences, texture aversions, routines or oral motor challenges. Support can help children expand food acceptance and develop positive mealtime experiences.

Why does my child refuse certain food textures?
Texture refusal may occur due to:
  • Sensory sensitivities
  • Oral motor difficulties
  • Previous negative feeding experiences
  • Medical conditions
  • Anxiety around eating
Assessment can help identify contributing factors.

How long should mealtimes take?
While every child is different, mealtimes that are consistently prolonged, stressful or difficult may indicate feeding difficulties that warrant further assessment.

What happens during a feeding and swallowing assessment?
A feeding and swallowing assessment may explore:
  • Medical history
  • Feeding development
  • Oral motor skills
  • Chewing abilities
  • Swallowing safety
  • Food and texture preferences
  • Sensory factors
  • Mealtime routines
Recommendations are tailored to the individual's needs.

How do Speech Pathologists help with feeding and swallowing difficulties?
Speech Pathologists may support:
  • Swallowing safety
  • Oral motor skills
  • Chewing skills
  • Texture progression
  • Feeding assessments
  • Dysphagia management
  • Mealtime strategies

How can Occupational Therapists help with feeding difficulties?
Occupational Therapists may support:
  • Sensory processing differences
  • Mealtime routines
  • Self-feeding skills
  • Seating and positioning
  • Participation in mealtimes
Many individuals benefit from collaborative support from both Speech Pathologists and Occupational Therapists.

Can swallowing difficulties improve?
Some swallowing difficulties improve with intervention, therapy or medical treatment. Outcomes vary depending on the underlying cause and individual circumstances.

What happens if dysphagia is left untreated?
Untreated swallowing difficulties may increase the risk of:
  • Choking
  • Aspiration
  • Respiratory infections
  • Poor nutrition
  • Dehydration
  • Reduced quality of life
Professional assessment can help identify appropriate supports and strategies.

What foods should be avoided if someone has swallowing difficulties?
Recommendations vary depending on the individual's swallowing abilities. Changes to food textures or fluid consistency should only be made under the guidance of appropriately qualified healthcare professionals.

When should I seek help for swallowing difficulties?
It may be beneficial to seek support if you notice:
  • Choking or coughing during meals
  • Difficulty chewing
  • Food refusal
  • Texture aversions
  • Poor weight gain
  • Frequent respiratory infections
  • Concerns about swallowing safety

Do swallowing difficulties only affect children?
No. Swallowing difficulties can occur across the lifespan and may affect infants, children, adolescents, adults and older adults.

Can adults develop swallowing difficulties?
Yes. Adults may develop swallowing difficulties following stroke, neurological conditions, acquired brain injury, Parkinson's disease, dementia, cancer treatment or other medical conditions.

Is support available through the NDIS?
Some individuals may be eligible for NDIS-funded Speech Pathology or Occupational Therapy supports depending on their circumstances and eligibility criteria.

Can feeding therapy be provided through telehealth?
Some feeding and swallowing supports can be delivered through telehealth, particularly parent coaching, education and consultation services. Suitability depends on the individual's needs.
Related Resources

Speech Pathology Services
Feeding & Mealtime Supports
Autism & Neurodevelopment
Occupational Therapy Supports
Additional Supports
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