The FOCUS Institute for Mealtime Success offers the highest quality evaluation and treatment for children with feeding and mealtime challenges. There are a few different types of evaluations that are offered through the FOCUS Institute. Our intake coordinator will be happy to discuss with you which evaluation will best meet your needs. Wondering if your child would benefit from support in this area? Click here to find out. Click here to learn how to get started.
Most children require a full, comprehensive evaluation in order to begin occupational therapy services. Our comprehensive evaluation requires 12 hours of therapist time. This evaluation will give you a complete picture of your child’s sensory processing and motor needs, including how these contribute to eating and mealtime challenges. It includes 2 1/2 to 4 hours of direct assessment, a comprehensive detailed written report, and an evaluation feedback meeting. The assessment tools used for this evaluation vary depending on the child’s age, abilities, and needs but may include the Sensory Integration and Praxis Tests (SIPT), the Miller Assessment for Preschoolers (MAP), the OTA-Watertown Sensory Modulation and Discrimination Evaluation, the FOCUS Oral Motor Assessment, or a number of other assessment tools.
Specialty FOCUS Oral Motor Evaluation
The FOCUS Oral Motor Evaluation is a specialized developmental evaluation that assesses in detail the sensory and motor foundational skills related to mealtime and eating performance. This evaluation is recommended if a family has primary concerns around eating/feeding with some potential mild concerns related to overall sensory processing and overall motor development. Specific information regarding the child’s oral motor abilities – including oral structure coordination and strength, chewing and drinking patterns, patterns of food selectivity, and other factors that impact eating performance – will be thoroughly assessed as part of this focused evaluation. It includes 2 hours of direct assessment, a detailed written report, and an evaluation feedback meeting. The assessment tools used for this evaluation vary depending on the child’s age, abilities, and needs but can include the FOCUS Oral Motor Assessment, portions of sensory assessments such as the Sensory Integration and Praxis Tests (SIPT), the OTA-Watertown Sensory Modulation and Discrimination Evaluation, or a few other assessment tools.
Clients whose evaluation is covered by Harvard Pilgrim Health Care (HPHC) insurance plans are eligible for our abridged evaluation to assess oral motor and feeding skills. This evaluation requires 45 minutes to 1 hour of assessment and includes a brief two-page written report. An evaluation feedback/goal-setting meeting is strongly encouraged but not covered by this insurance plan and must be paid for out-of-pocket, if desired. This evaluation is not comprehensive but is sufficient to determine eligibility for occupational therapy services.
In rare instances, an occupational therapy screening for eating and mealtime skills may be appropriate. This screening is most often used when children are receiving other services at OTA The Koomar Center, such as speech therapy, and believe there may be other sensory-based problems that are impacting their feeding skills. At times, it can be unclear from an initial intake if a child has sensory integration difficulties and a screening may be recommended as a first step before starting a comprehensive evaluation. A comprehensive evaluation may be recommended if indicated by the screening. A screening consists of one hour of assessment and a feedback checklist is provided at the end of the screening.
Intervention at The FOCUS Institute for Mealtime Success works to address the foundational areas that are required for successful eating. Eating is a complex and multisystem skill, so FOCUS practitioners believe it is not helpful to target treatments solely on the individual’s mouth, but to consider the child’s entire body and all environmental, contextual, physical, and psychological causes as part of a collaborative and systematic approach to treatment. Each therapeutic treatment program is based on the individual needs of the child and is tailored to meet the family’s unique goals. A combination of whole-body work as well as targeted oral motor skill work is included throughout the course of treatment. Treatment goals may include: strengthening the postural muscles necessary for eating, increasing strength and control of different oral structures necessary for eating, decreasing oral sensitivities, and working towards exploration with food to expand food repertoire. In addition to these specific goal areas, other areas addressed on an ongoing basis include environmental set-up, food preparation skills, and promotion of organization and regulation during mealtime.