In paediatric feeding therapy, language plays a pivotal role in feeding development and clinical feeding therapy outcomes. With clinical examples, this presentation will explore the significance of language use in this specialised field, highlighting its impact on perceived pressure, autonomy, skill development and desensitisation. We will look at language used by the child, the parent/caregiver, and therapist’s use of language in feeding therapy.

Language serves as a powerful tool for education in feeding, however language can also lead to increased pressure and anxiety. Particular forms of language can perpetuate perceived pressure, increase anxiety/worry and increase conflict at mealtimes. Other forms of language foster inquisition, growth, and development. This presentation will explore the contextual nuances of language and their impact on feeding success.

Children with feeding disorders often experience frustration, anxiety, and fear around food. A language-rich, and pressure-free environment allows them to express their emotions and build trust/relatedness with their therapists and caregivers, which is crucial for successful therapy outcomes.

Language fosters cognitive growth and desensitisation in the feeding space. Language is a vessel for developing associations between foods, exploring preferences, and understanding sensory, emotional and relational difficulties during mealtimes.

Finally, language also plays a role in promoting independence, conveying wants/needs and making choices regarding food preferences. This autonomy is essential for building a positive relationship with food and fostering a sense of control.

In conclusion, language is a multifaceted and essential component of paediatric feeding therapy. It enhances communication and relational bonds, supports emotional well-being, facilitates education, and empowers children to become more independent in their feeding journey. By recognising the importance of language in this context, speech pathologists can provide comprehensive and holistic care to children with feeding disorders, improving their quality of life and overall well-being.

1. An understanding of the importance of language in feeding therapy, with reference to relevant theories and feeding frameworks.

2. An understanding of positive, neutral and negative language in the feeding setting with examples.
3. Examples of how to modify/implement language in therapy sessions.

Ability WA’s In-Home Baby Intervention Service (IBIS) is a unique offering by a highly skilled therapy team, intent on providing timely, quality and practical supports. Therapy is home-based, for infants under two years, at-risk of developmental delay/disability. This Telethon-funded service has changed the lives of 433 vulnerable infants and their families, since 2017.

Objectives
• Improve outcomes by delivering best practice;
• Connection with professionals for early diagnosis;
• Family wellness;
• Reduction of parental stress;
• Access to on-time equipment;
• Smooth transition to future services, if required.

Method
IBIS ‘closes the gap’ for at-risk infants unable to access mainstream supports. A comprehensive assessment is completed within one month of acceptance of referral. Families drive the therapy goals; skilled therapists provide individualised support. The team facilitate play-based learning in the child’s natural environment, with immediate access to therapeutic equipment via AssisTkids loan library.

Results
IBIS supports over 100 children every year, 30% with culturally and linguistically diverse and 5% with Aboriginal backgrounds. The impact is evidenced by: at least 30% achieving their therapy goals (no longer requiring therapy input) or transitioned to State funded ‘mainstream supports’ and up to 50% supported to access NDIS. IBIS consistently provides a service that demonstrates strong outcomes with high parental satisfaction, strong working relationships with key stakeholders such as tertiary hospitals, child development services, Wanslea and NDIS. Due to the outcomes achieved for families, the demand for IBIS continues to increase every year.

Conclusion
Quality early intervention is life changing for infants and families. Families unable to access mainstream supports need to be offered home-based services. Investment in ‘best practice’ early childhood supports, including family wellness, leads to longer term positive outcomes for the child, their family and the community

1. Quality early intervention is life changing for infants and families.

2. Families unable to access mainstream supports need to be offered home-based services.

3. Investment in best practice early childhood supports, including family wellness, leads to longer term positive outcomes for the child, their family and the community

Aim: To understand parent/carer experiences feeding their infant with a cleft palate and/or lip (CPL) within an Australian context (to add an Australian perspective to the international literature).

Method: A small-sample cross-sectional survey based on international surveys was designed and piloted. It was circulated to cleft support organisations across Australia, and participants were invited to participate via social media posts. The survey was self-administered, voluntary, and anonymous. Descriptive statistics was used to calculate the means and percentages. Open ended questions were analysed using thematic analysis.

Results: Most families had initially planned to breastfeed but changed their decision upon learning about the cleft diagnosis. Families fed their infants with CPL by mixed feeding methods (43.1%), exclusive breastmilk feeding (37.5%,) formula feeding (16.7%), and breastfeeding (2.8%). The most common feeding concerns that parents reported included difficulties for their infant to generate adequate suction and attach onto breast or teat (70.8%), longer feeding times (69.4%), gas or colic (62.5%), fatigued and/or frustrated infant (62.5%), and nasal regurgitation (59.7%). The majority of families (88.8%) received support and information on how to feed their infant with a cleft palate. The families who received support had mixed experiences; some (56.3%) were satisfied, and others were not (37.5%), while the remaining 6.3% were neutral. The parent's comments reflected their positive and negative experiences.

Conclusion: This survey has provided an Australian perspective of feeding infants with CPL. Most families experienced challenges with feeding their infant with CPL, no matter the feeding method. Families require health professionals to provide consistent, timely, accurate and empathetic support and information for parents who have an infant with a CPL. Results are similar to those experienced in Europe, North America, and Africa.

At the end of the presentation, attendees will learn that:
1. Parents encountered difficulties while feeding their infant with cleft, no matter the feeding method,
2. Families received support but had a mix of positive, negative, and neutral experiences, and
3. There is a need for more education and support from the cleft care team as parents navigate feeding infants with cleft