By: Brianna Brown, MS, CCC-SLP

Our Treatment Progression Pyramid is a visual representation of the specific steps we address during our Tube Weaning treatment. Our program looks a little different from most treatment programs because we believe that a strong foundation for kids to learn about what their bodies need is crucial. Self-regulation skills are the skills that lead children with and without feeding challenges to build a healthy relationship with food and eating. While other programs may start therapy with the focus on the “how” to eat, such as building chewing skills, we focus first on the “why”. This includes comfort, togetherness, curiosity, and hunger.  

The bottom 3 steps provide the foundation. They are focused primarily on caregivers and the work to be done while a child learns to rest and heal from previous experiences. The steps include First Do No Harm, Build Trust, and Create Responsive Mealtimes.  

The next two steps are focused on a child’s learning and development. These steps are called Discover Internal Drives to Eat and Support Skill Development. Our program allows for children to experience hunger within the medical parameters set with their existing medical team. In many therapies the focus is to improve oral skills before kids are hungry. This results in skills that are not learned in a meaningful environment. When children can experience natural motivators to eating while learning to listen to their bodies there is a life-long impact.  

Finally, the peak of the pyramid we call “Thrive” describes the point at which a child is able to participate together in mealtimes that are responsive and enjoyable. Here is when a family can focus on togetherness, comfort, and having manageable mealtimes. This is also the time where a child is able to self-regulate independently and demonstrate the ability to grow and develop at an age-appropriate rate. 

For a full description of our program and more information about the treatment progression check out our Tube to Table Podcast, Episode 6 “First things first”.  

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