Full Course Description
What’s Typical? Understanding Normal Feeding & Swallow Development
Know when to wait. Know when to worry. Know when to act.
Every feeding evaluation starts with one essential question: Is this normal?
But in complex pediatric cases, “normal” isn’t always obvious — especially when GI discomfort, breathing patterns, sensory aversions, or behavioral resistance start muddying the waters.
This foundational module gives you the clinical clarity to confidently distinguish developmental variation from dysfunction. You’ll walk through typical feeding and swallowing milestones from infancy through early childhood — from suck-swallow-breathe coordination and early solids to utensil use and food variety. More importantly, you’ll learn how deviations across systems can silently derail progress.
Whether you’re screening a toddler with suspected oral-motor delay or supporting an infant post-NICU, this session helps you spot early red flags, prevent misdiagnosis, and make targeted, system-aware intervention decisions.
You’ll walk away able to:
- Detect signs of dysfunction before they become long-term problems
- Connect feeding delays to respiratory, GI, or sensory-based causes
- Justify evaluations and referrals with confidence — and clinical evidence
Program Information
Objectives
- Describe key developmental milestones for feeding and swallowing from birth through toddlerhood, including suck-swallow-breathe coordination, utensil use, and food variety acceptance.
- Identify at least 5 clinical red flags that indicate deviation from typical feeding development and may warrant early intervention or referral.
- Differentiate between expected developmental variation and functional impairment using a systems-based framework that includes respiratory, sensory, GI, oral-motor, and behavioral components.
Outline
I. Introduction: Why “Normal” Matters
- The role of developmental norms in clinical reasoning and differential diagnosis
- How misinterpreting typical variation leads to misdiagnosis or over/under-referral
- Overview of systems involved in feeding: respiratory, GI, sensory, oral-motor, behavioral, and neurological
II. Suck-Swallow-Breathe Coordination (Birth–6 Months)
- Physiological foundation for oral intake in infancy
- Respiratory patterns and swallow timing
- Functional tie: Detecting discoordination that leads to aspiration or inefficient feeding
III. Progression to Spoon Feeding, Cup Drinking, and Self-Feeding (6–24 Months)
- Normative milestones for utensils, chewing, rotary jaw movement, tongue control
- Sensory tolerance of new textures, flavors, temperatures
- Functional tie: Recognizing when delay = dysfunction vs. developmental lag
IV. Red Flags Across Developmental Stages
- “Wait and see” vs. “Refer now”: when to intervene
- Common signs of dysfunction: fatigue, poor weight gain, stress cues, oral aversion
- Clinical relevance: Supports justification for feeding eval or early treatment
V. Multifactorial Interplay of Systems
- How breathing, GI discomfort, tone, sensory modulation, and behavior affect progress
- Case examples: delays that stem from underlying systemic contributors
- Functional tie: Promotes interdisciplinary referrals and whole-child care planning
Target Audience
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/17/2026
Aspiration, Respiration, and Swallow Safety
Aspiration isn’t always obvious — but it’s often serious.
Aspiration is one of the most urgent concerns in pediatric feeding — and it can be one of the hardest to spot. Silent aspiration, breathing-swallow discoordination, and subtle signs often go unnoticed until they lead to pneumonia, weight loss, or feeding refusal.
This module gives you the tools to recognize aspiration risk early, intervene appropriately, and protect the airway without derailing developmental progress. You’ll learn how to distinguish clinical vs. instrumental red flags, optimize postural support, and apply strategies like pacing and texture modification for real-world safety.
Whether you’re working with a fragile infant or a high-functioning toddler who coughs intermittently, this session will reshape how you evaluate risk, document findings, and guide next steps.
You’ll learn to:
- Spot the red flags of silent aspiration before it’s too late
- Use respiration-swallow timing to guide treatment
- Know when to refer — and when not to
- Equip caregivers with strategies that protect safety without causing fear
Program Information
Objectives
- Identify key clinical signs and symptoms of overt and silent aspiration across pediatric populations.
- Differentiate between clinical and instrumental assessment approaches for aspiration, including appropriate criteria for referral.
- Apply airway protection strategies (e.g., pacing, positioning, texture modification) to reduce aspiration risk during pediatric feeding sessions.
Outline
I. Introduction to Aspiration in Pediatric Populations
- Pharyngeal swallow function
- Defining aspiration vs. penetration
- Silent aspiration: prevalence, challenges, and red flag indicators
- Aspiration related illnesses and complications
- Functional tie: Why airway safety must guide all feeding decisions
II. Swallowing-Respiration Coordination
- How timing breakdowns impact airway protection
- Populations at risk: preterm infants, children with hypotonia, respiratory conditions
- Respiratory supports and oral feeding
- Functional tie: Improves early detection of unsafe feeding behaviors
III. Clinical vs. Instrumental Assessment
- Signs and symptoms of aspiration: overt and silent
- Clinical feeding evaluations: what they can and cannot tell you
- When to refer for VFSS, FEES, or pulmonary workup
- Functional tie: Supports defensible clinical decision-making and referrals
IV. Interventions to Support Airway Safety
- Diet modification: when it helps and when it hinders
- Oral hygiene and pneumonia prevention
- Pacing and positioning strategies
- Sensory interventions
- Exercises and activities
- Coordinating with PT/OT for postural and respiratory optimization
- Functional tie: Reduces risk while improving feeding endurance and efficiency
Target Audience
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Physicians
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/17/2026
GI Development, Reflux, and the Gut-Brain-Feeding Connection
When feeding problems start in the belly — and what to do about it.
Many pediatric feeding disorders don’t start in the mouth — they start in the gut. Reflux, constipation, motility problems, and food sensitivities can wreak havoc on appetite, arousal, and behavior, often triggering feeding refusal that’s misinterpreted as defiance or sensory avoidance.
In this eye-opening module, you’ll learn how to spot the GI red flags, guide families through functional feeding adjustments, and collaborate with medical teams when nutrition, medication, or diagnostic workups are needed.
We’ll cover positioning strategies, blended diet basics, allergy-related symptoms, and which “gut health” interventions are grounded in research (and which are just hype). You’ll walk away with real tools to bring to the table — and a better understanding of what’s really driving feeding difficulty for many kids.
You’ll learn to:
- Spot GI signs that impact feeding, behavior, and food tolerance
- Use practical interventions to reduce discomfort and improve intake
- Support whole-body care by integrating gut-focused strategies into feeding plans
Program Information
Objectives
- Explain how GI immaturity or dysfunction (e.g., reflux, constipation, allergy) contributes to feeding delays and food refusal.
- Identify at least 3 signs of GI-related feeding intolerance that may require medical or nutritional referral.
- Apply at least 2 positioning or feeding interventions that reduce GI symptoms and support functional oral intake.
Outline
I. Foundations of Digestion and GI Development in Early Childhood
- GI system maturation prenatally and post-natally
- Gut development and gut priming
- The gut microbiome – eubiosis and dysbiosis
- Common disruptions: reflux, constipation, motility issues
- Functional tie: How underdeveloped or dysregulated GI systems impact hunger, satiety, and feeding behaviors
II. Eubiosis vs Dysbiosis
- Physiologic vs. pathologic reflux — when is intervention needed?
- Symptoms beyond spit-up: coughing, arching, poor sleep, feeding refusal
- Constipation – pressure throughout the GI tract
- Functional tie: Differentiates normal variation from dysfunction that impairs safe feeding or limits intake
- How gut discomfort affects appetite, behavior, and food variety
- Food sensitivities/allergies, atopy, and mast cell disorders: GI symptoms and behavioral overlap
- Functional tie: Supports interdisciplinary collaboration with nutrition, GI, and behavioral care teams
III. Assessment of GI functions
- Clinical assessment – what is the feeding therapist looking for?
- Instrumental assessment – what do these tests tell us about our clients?
- Functional tie – Supports interdisciplinary assessment and provides therapists with “red flags” that should trigger referral to medical specialists
IV. Dietary & Positioning Interventions
- Functional positioning for reflux and motility
- Timing, volume, and pacing strategies to reduce GI burden
- Dietary interventions – exclusion diets, supplements, low FODMAP diets
- Role of probiotics, prebiotics, and other gut-targeted supplements
- Medications and medical interventions – when feeding therapy isn’t enough
- Functional tie: Improves clinical reasoning around when diet changes are clinically indicated vs. faddish
Target Audience
- Chiropractors
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Physicians
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/17/2026
Oral-Motor & Postural Strategies That Drive Mealtime Progress
It’s not about “strength” — it’s about function.
Kids who can’t chew effectively, pocket food, or fall apart after a few bites don’t always need “stronger” muscles — they need smarter strategies. This module shows you how to assess and treat oral-motor dysfunction in the context of posture, tone, and tool selection.
You’ll explore why jaw stability starts at the trunk, how posture impacts swallow safety, and when to integrate targeted oral-motor techniques that actually support progress. You’ll also get clear guidance on utensil adaptations and texture progressions that help kids eat more, try more, and participate more at the table.
Whether you’re working with toddlers with low tone or older children stuck on purées, this module will help you build confident oral skills and safe, functional mealtimes.
You’ll learn to:
- Use posture and positioning to unlock oral-motor success
- Select the right oral-motor strategies for the right child — and avoid what doesn’t work
- Integrate texture, flavor, and tool changes that support chewing, swallowing, and independence
Program Information
Objectives
- Examine the relationship between postural stability, oral-motor coordination, and functional feeding outcomes.
- Apply at least two oral-motor intervention strategies matched to developmental skill level and tone presentation.
- Identify how utensil and tool selection influence oral-motor performance and food acceptance in pediatric feeding therapy.
Outline
I. Foundations of Oral-Motor Function
- Functional anatomy and physiology of the oral mechanisms involved in feeding
- Developmental progression of chewing, tongue mobility, jaw control
- What do we know about oral motor interventions – the state of the current research
- Functional tie: Identifies root cause of inefficient chewing, drooling, or poor bolus control
II. Postural Stability and Feeding Efficiency
- Role of trunk and neck stability in oral control and respiration
- Interplay between posture, fatigue, endurance, and function
- Infant and child specific interventions
- PT/OT/SLP collaboration: optimizing positioning for safe intake
- Functional tie: Enhances safety, coordination, and mealtime success with simple adaptations
III. Oral Motor Assessment: What are we Looking for?
- What are we seeing and what does it mean – identification of underlying causes
- What are we seeing and what does it mean – implications for function
- Functional tie: Helps clinicians choose the right tool at the right time for the right client
IV. Oral-Motor Interventions: When and How to Use Them
- What about exercise? Evidence-based strategies vs. outdated practices
- Implementing the principles of exercise physiology
- Assessing readiness and adapting tools and utensils to match oral-motor ability
- Stepwise progression through utensils, food types
- Functional tie: Supports real world goals like expanding food repertoire and utensil independence
Target Audience
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Physicians
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/24/2026
Sensory & Behavioral Strategies to Reduce Refusal and Build Flexibility
When it’s “just behavior” — and when it’s not.
Is the child refusing food because of anxiety? Sensory overload? Past trauma? Lack of hunger cues? Or are they stuck in a learned pattern that needs to be reshaped?
This module helps you decode what’s really going on — and what to do about it. You’ll explore the intersection of sensory processing, behavioral reinforcement, and emotional regulation, with clear strategies to reduce refusal, expand food tolerance, and foster positive mealtime experiences.
You’ll learn how to reframe power struggles, engage caregivers, and use step-by-step methods to build food flexibility without triggering shutdown or stress.
You’ll learn to:
- Identify the underlying reasons behind feeding refusal
- Implement behavior and sensory-based interventions that actually stick
- Expand food repertoires with compassionate, evidence-informed tools
Program Information
Objectives
- Differentiate between sensory-based and behaviorally driven feeding refusal using observable patterns and contextual factors.
- Apply at least two reinforcement or shaping strategies to reduce refusal and increase food variety in children with feeding challenges.
- Develop a sensory-informed intervention approach using graduated exposure and co-regulation techniques to build feeding flexibility.
Outline
I. Feeding Refusal: Root Cause or Red Herring?
- The role of interoception, anxiety, and past trauma in refusal
- Sensory systems that impact feeding: oral, tactile, gustatory, olfactory, vestibular
- Sensory seeking vs. avoiding profiles — and how they show up at mealtime
- Functional tie: Helps identify root causes of food refusal to tailor strategies to facilitate food acceptance
II. Behavioral Reinforcement Without Power Struggles
- The 5-part behavioral model: environment, hunger, reinforcement, shaping, caregiver training
- Finding the function behind the behavior (escape, attention, sensory, etc.)
- Matching reinforcement strategies to developmental level and cognitive readiness
- Functional tie: Supports carryover of feeding goals without coercion or trauma
III. Expanding Food Repertoire
- Strategies to reduce rigidity and expand preferred foods
- Tolerance hierarchies and graduated exposure
- Incorporating play, visuals, and co-regulation
- Functional tie: Improves nutritional diversity and reduces family mealtime stress
Target Audience
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Physicians
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/24/2026
Transitioning From Tube Feeds – A Whole-System Approach
Support safe, sustainable transitions from G-tube to the table.
Tube feeding can save lives — but staying on it too long can limit development, delay skill acquisition, and create long-term feeding challenges. This final module walks you through how to assess readiness, choose the right weaning approach, and build a personalized plan that prioritizes safety, connection, and progress.
You’ll explore rapid vs. gradual weans, sensory and oral-motor reintroduction, and how to coach families through one of the most emotional parts of the feeding journey. Whether you're supporting the weaning process directly or collaborating with the broader care team, this session gives you the clarity and tools to help.
You’ll learn to:
- Identify when a child is truly ready to start weaning
- Support oral-motor and sensory skills before, during, and after the transition
- Help families navigate uncertainty with confidence and evidence-based support
Program Information
Objectives
- Identify at least three clinical indicators of readiness for transit
- Compare two evidence-based weaning approaches (rapid vs. gradual) and their application based on child-specific needs.
- Apply at least two intervention strategies to support sensory, oral-motor, or emotional readiness during tube weaning.
Outline
I. Understanding Tube Feeding in Pediatrics
- Common types: NG tubes, G-tubes, blended diets
- Feeding tube schedules and why they matter
- Formula types
- Challenges and impacts of tube feeding – reflux, volume intolerance, feeding tube dependence
- Feeding tube dependence – can we prevent it?
- Functional tie: Clarifies how tube dependency impacts oral skill, sensory engagement, and family dynamics
II. Ensuring Weaning Success
- Assessing readiness - signs of medical, oral-motor, sensory, and emotional readiness
- Gut priming – normalizing digestive function
- The essential role of hunger
- Rapid v gradual weans
- Behavioral interventions
- Functional tie: Supports timely, safe transitions and prevents regressions or re-hospitalization
III. Tools to Support the Transition
- Sensory introduction to oral experiences
- Oral-motor supports
- Coaching parents and caregivers
- Multidisciplinary team coordination
- Tracking progress: volume, variety, behavior
- Functional tie: Helps build trust, tolerance, and lasting oral intake while empowering families
IV. Case Review and Treatment Planning
Target Audience
- Nurse Practitioners
- Nurses
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Physicians
- Speech-Language Pathologists
- Other Rehabilitation and Healthcare Professionals
Copyright :
02/24/2026
Live Q&A Call with Angela Mansolillo
Copyright :
12/08/2026