Feeding Milestones
At around 18 months, children should be eating most table foods with increasing variety.
What is the expected feeding milestone for Ella’s age?
Ella’s gagging on textures may indicate underdevelopment in this area needed for chewing.
What are oral-motor skills?
This mealtime strategy helps reduce stress by letting the child explore food without pressure to eat.
What is food play or sensory exploration?
Parents should avoid this type of pressure during mealtime to reduce stress.
What is urging or forcing the child to eat?
This specific skill trained in oral-motor therapy allows a child to move food from side to side and prepare it for chewing.
What is tongue lateralization?
This type of cup is typically introduced between 12–18 months and practiced with caregiver assistance.
What is an open cup and when is it introduced?
This tongue movement is needed for managing soft solids and beginning to chew more textured foods.
What is lateralization?
OTs often introduce this type of cup to replace bottles gradually.
What is an open cup or a small training cup?
Caregivers can use this structured approach where they decide what/when to serve and the child decides how much to eat.
What is the Division of Responsibility?
This self-feeding skill should be emerging by 18 months, even if messy.
What is feeding with a spoon?
Gagging on textured foods is common when a child has difficulty progressing through these stages of food introduction.
What are sensory and oral-motor texture progression stages?
Children need this oral skill to remove food from a spoon without relying on their lips being scraped.
What is lip closure/lip control?
To help with texture progression, OTs might use this technique that involves slowly increasing sensory complexity.
What is graded food texture exposure?
Parents can model cup drinking by practicing this behavior during shared meals.
What is drinking from an open cup alongside the child?
This theory explains that feeding skills develop step-by-step and build upon earlier abilities.
What is developmental theory?
By this age, most children should have transitioned fully off the bottle.
What is 12–18 months?
Using a bottle for too long may limit strengthening of these muscles critical for chewing and sipping.
What are oral-facial muscles (cheeks, lips, jaw)?
This postural setup supports safer feeding and better oral control, especially in toddlers.
What is: slighty reclined and head and tuck supported?
Families should be educated about this type of routine, which supports predictability, reduced stress, and improved intake.
What is a consistent mealtime routine?
Practice, repetition, and feedback during feeding activities come from this learning approach.
What is motor learning theory?
This developmental skill supports chewing and safe management of more complex textures.
What is rotary (or mature) chewing?
This protective reflex decreases as infants gain experience with food but may be over-responsive in Ella’s case.
What is the gag reflex?
To reduce gagging and improve tolerance, OTs may incorporate these activities during therapy sessions.
What are oral-motor warm-ups (e.g., cheek massage, tapping, vibration)?
Coaching families to understand oral-motor delays and feeding expectations is part of this OT practice model.
What is family-centered or caregiver-coaching intervention?
Parents reporting stress, uncertainty, and safety concerns about introducing textures reflects this type of challenge.
What are caregiver or family challenges?