
Welcome to guest blogger!
Wendy Alexander, OTD, OTR/L
Aspire OT is always excited to celebrate OTs, OTAs, and students who make an impact. Wendy Alexander, OTD, OTR/L, is the Owner and Lead Instructor of Pediatric Feeding Essentials™ and dedicated to supporting children and families across early intervention, home health, autism programming, and school-based evaluation.
I have been a pediatric occupational therapist for over 26 years, working across early intervention, home health, and school-based settings. The first half of my career, I specialized in autism. About 13 years ago, I shifted my focus to pediatric feeding disorders. One insight has been most transformative for my practice: understanding that feeding problems are never just one thing.
There's a systematic way to assess what's really going on with a feeding case—and most therapists miss critical pieces because they weren't taught to look for them. I am more confident in my clinical decisions now because I know how to identify when a child needs medical referral versus skill-building therapy, and when the barrier isn't the child at all—it's the approach we're taking at mealtimes.
This framework aligns with a significant shift in how we approach pediatric feeding disorders. We've moved away from compliance-based strategies—rewards, pressure, "just one bite"—toward responsive feeding approaches that prioritize the child's safety and trust. This isn't just philosophical; it's grounded in trauma-informed care and research showing that pressure tactics often increase feeding aversion rather than resolve it.
One of the most critical elements of effective feeding intervention is caregiver coaching. When we equip caregivers with responsive feeding strategies—helping them recognize their child's cues, reduce mealtime pressure, and create predictable routines—we see sustainable progress that extends far beyond our therapy sessions.
Through this knowledge, I coordinate with medical teams when red flags appear, support families through trauma-informed approaches, and help children who've been stuck in feeding therapy for months finally make progress. I hope to educate other therapists about how we can think more comprehensively about feeding disorders and achieve the outcomes our families desperately need.
There's a systematic way to assess what's really going on with a feeding case—and most therapists miss critical pieces because they weren't taught to look for them. I am more confident in my clinical decisions now because I know how to identify when a child needs medical referral versus skill-building therapy, and when the barrier isn't the child at all—it's the approach we're taking at mealtimes.
This framework aligns with a significant shift in how we approach pediatric feeding disorders. We've moved away from compliance-based strategies—rewards, pressure, "just one bite"—toward responsive feeding approaches that prioritize the child's safety and trust. This isn't just philosophical; it's grounded in trauma-informed care and research showing that pressure tactics often increase feeding aversion rather than resolve it.
One of the most critical elements of effective feeding intervention is caregiver coaching. When we equip caregivers with responsive feeding strategies—helping them recognize their child's cues, reduce mealtime pressure, and create predictable routines—we see sustainable progress that extends far beyond our therapy sessions.
Through this knowledge, I coordinate with medical teams when red flags appear, support families through trauma-informed approaches, and help children who've been stuck in feeding therapy for months finally make progress. I hope to educate other therapists about how we can think more comprehensively about feeding disorders and achieve the outcomes our families desperately need.
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