One of the most meaningful moments of International Play Therapy Week was welcoming an speech therapist and feeding specialist from Seattle Therapy – Skills for Life® to speak with our community. The response was immediate and collective: we need more of this.
Pediatric feeding disorder (PFD) is defined as impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. In practice, this means feeding challenges rarely belongs to a single domain. In play therapy, we often address the psychosocial domain, but it’s important to consider that children with feeding difficulties may also be associated with the medical, nutritional, feeding skill categories.
Organizations like Feeding Matters emphasize that PFD is a complex, multidisciplinary condition—and that early identification and coordinated care are critical, and a useful resource for play therapists.
For play therapists and mental health providers, feeding concerns often show up indirectly:
- Intense anxiety or distress around meals
- Avoidance, shutdown, or rigidity related to food
- Power struggles between caregivers and children
- High levels of parent worry, guilt, and exhaustion
When these patterns persist without appropriate intervention, pediatric feeding challenges can later evolve into more entrenched conditions, including avoidant/restrictive patterns seen in older children and adolescents (Think ARFID). Understanding PFD helps clinicians recognize when feeding-related distress is more than “picky eating” or behavioral resistance—and when early referral matters.
From a prevention standpoint, this knowledge is essential. Mental health clinicians are often among the first professionals families turn to, placing us in a unique position to notice early signs and help guide families toward comprehensive support.
A referral to a feeding specialist may be worth exploring when families report:
- Ongoing, high-stress mealtimes
- Escalating power struggles around eating
- Avoidance, fear, or distress related to food
- Reliance on distraction, pressure, or rewards to get a child to eat
- Significant caregiver stress or worry about food intake
The training highlighted that these experiences are often intertwined with:
- Medical discomfort, reflux, or GI concerns
- Oral-motor or feeding skill delays
- Sensory processing differences
- Nutritional concerns that impact regulation, growth, and development
Without interdisciplinary collaboration, we risk holding only one piece of a much larger picture.
The takeaway was not that play therapists need to become feeding experts. Rather, it’s that we need shared language, shared curiosity, and clear referral pathways.
When occupational therapists, speech and feeding therapists, medical providers, and mental health clinicians collaborate:
- Children receive care that supports both nervous system safety and physical needs
- Caregivers feel less blamed and more understood
- Treatment becomes more attuned, efficient, and humane
Play therapy already centers relationship, pacing, and safety. Interdisciplinary training expands our ability to apply those values responsibly—knowing when to hold, when to refer, and when to collaborate.
This week reinforced something we deeply believe at Seattle Play Therapy: the more connected we are as professionals, the safer children’s systems become.
Check out Seattle Therapy – Skills for Life® blog post on Feeding Tips and Tricks.
