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Children with Apraxia of Speech and Feeding Difficulties

Suzanne Evans Morris, Ph.D.

The bottom line is that we can’t “get children to eat.” To paraphrase a popular phrase “Eating is an inside job.” As parents and therapists we simple create the environment in which the child is comfortable with food and is able to develop the skills that support eating more skillfully. When we shift our attention to getting kids to eat, we disrupt the balance of mealtime responsibilities that support an easy flow in the eating process.

It is the child’s responsibility to decide what he will eat, how much he will eat, and whether he will eat. It is the parent’s responsibility to choose what foods are served, when they are served and where they are served. When children begin to demand (directly or indirectly) that parents fix them just the foods they want to eat at that moment, they are taking over our responsibilities as adults. When we push them to eat, we are interfering with their responsibility to decide what and how much to eat.

It is understandable that parents want to push and get their kids to eat when they refuse food. An example may be a young child who wants only liquids and refuses solid food. When such a child decides he wants to fill up on liquids and not eat the food the parents are serving, parents may respond by giving the child more of what he wanted rather than deciding what and how much food and liquid was appropriate to serve him. Because the child is drinking more and meeting most of his caloric needs through liquids, he has no inner motivation to eat the food the parent served because he isn’t hungry any more. In the parents concern about non-eating of foods, they may have begun to push or “strongly encourage” the child to eat more food. He feels their concern and anxiety, and like most kids his age, the child responds by saying “NO.”

Part of our responsibility as parents is also to be aware of anything that has changed in our childrens lives that could affect their comfort or skill with eating. This can include signs of reflux or other GI discomforts, allergies, sinus infections, dental problems, etc. If the child has sensory processing issues (which is seen frequently in lots of children with apraxia) we may make special efforts to address the child’s sensory needs before and during the meal. If the child has issues with muscle tone or problems with steadiness in the body, we can select a chair that gives good postural support.

For most kids, we can begin by trusting that they can become aware of their own levels of hunger and fullness and can learn to regulate what and how much they eat according to their inner needs.

Ellyn Satter’s books How to Get Your Kid to Eat: But Not Too Much, Feeding with Love and Good Sense and Secrets of Feeding a Healthy Family are excellent resources. Our web site at New Visions,, also offers more extensive information related to mealtime skills and children with special needs.

(Suzanne Evans Morris, Ph.D. is a speech-language pathologist and director of New Visions near Charlottesville, Virginia. With more than 40 years of clinical experience, she is nationally and internationally known for her work in identifying and treating young children with pre-speech and feeding disorders. Dr. Morris maintains a practice, which includes direct clinical work, continuing education workshops, development of clinical materials, and clinical research. She is the director of New Visions, which sponsors innovative workshops for the teaching of feeding-related skills, and provides family-oriented clinical services.)

© Apraxia-KIDS℠ – A program of The Childhood Apraxia of Speech Association (CASANA)