Table 1 Inclusion/exclusion criteria

Child has a G or G/J tube

Parents have known significant developmental delay or cognitive impairment

Child receives > 80% kcal from the tube

Child ages 0 year 9 months 0 day through 8 years 31 days

Child is receiving intensive behavioral feeding therapy (> 1 session per month) at the time of consent. Oral motor therapy is not an exclusion.

Physician permission to participate

Parents primary language other than English

Child has sufficient oral motor and behavioral skills for oral eating (see Table 4)

Child has > 3-month history of feeding problem

Child receiving inhaled or oral steroids

Child has behavioral skills necessary for mealtime (see Table 4)