The relationship between feeding development and early speech production has received increasing interest over the past 30 years. If a relationship between the motor control systems for feeding and communication is present, it could have implications for the early identification of communication deficits in children. Theoretical support exists for a relationship between the feeding and speech motor systems based on evolutionary theory (Blanchard, 1963), and anatomical similarities in oral motor function (Morris, 1985, 1990, 1991, 1998). However, the existence of a causal relationship between early feeding and communication development remains uncertain due to a lack of empirical research. A model proposed by Carpendale and Lewis (2004) encompasses the triadic interaction between the environment, maternal factors, and infant factors, which can influence both feeding and communication development. Clinical feeding assessments typically employed by clinicians and researchers are most often carried out with observational checklists. Data reflecting the theoretical foundation, validity, and reliability for these tools are limited. Observation tools assess specific aspects of feeding and oral motor control from a modular perspective, without regard for the infant’s total feeding system. Rogers and Arvedson (2005) highlighted the need for a single standardised assessment tool to assess infant feeding descriptively and objectively. The primary aim of the project was to determine whether the same motor control mechanisms are utilised for oral feeding and communication. The first stage of the study involved the development of a theoretically informed assessment protocols to document systematically the development of feeding skills from birth, the Feeding Assessment Observation (FAO) and the Feeding Assessment Questionnaire (FAQ). / The assessment protocol was piloted on 10 term and 10 preterm infants at 1 to 2 weeks, 4, 8 and 12 months corrected age (CA) for preterm infants and chronological age for term infants. The second stage of the project examined the progression of feeding and communication development in a group of term and preterm infants over a 12 month period. The progression of 8 preterm and 7 term infants was observed at 1-2 weeks, 4, 8 and 12 months CA and chronological age for term infants. The mean gestational age for preterm infants was 30 weeks, 6 days (SD = 6.8 days), and term infants was 39 weeks, 5 days (SD = 9.4 days). Assessment of the infants’ feeding and communication skills, environmental and maternal influences was conducted using the initial questionnaire, Feeding Assessment Observation (FAO), Feeding Assessment Questionnaire (FAQ), Home Screening Questionnaire (HSQ), Receptive Expressive Emergent Language Scale, second edition (REEL-2), and the infant-toddler checklist of the Communication and Symbolic Behavior Scales Developmental Profile (CSBS-DP), to determine the nature and impact of environmental and social factors on feeding and/or communication development. Preliminary reliability testing of the FAO was conducted. Sixty seven percent (10/15) of observation items achieved greater than 90% inter-observer agreement. There was no significant difference in feeding and communication development between term and preterm infants. The negative linear trend for the development of feeding efficiency on liquids for infants was opposed to the positive linear trend for communication development. Infant feeding efficiency on solids showed parallel positive linear developmental trends with communication development. / Comprehensive data were collected on influencing factors from infant, maternal and environmental domains during the initial assessment, and the 4, 8 and 12 month CA developmental reviews. The data revealed significant differences between the term and preterm groups for infant and environmental factors, but no significant differences were found for maternal influences. The study provided some support for the hypothesis of integrative motor control and co-development of feeding and communication. The prediction that infant, maternal, and environmental factors would significantly influence feeding and communication development was not supported. In addition, there was no difference in the impact of influencing factors for the term and preterm groups. The feeding and communication skills of preterm infants developed at corrected age levels, and were not significantly slower than term infants. Furthermore, predicted delays in feeding development were not associated with concomitant delays in communication development for term and preterm infants. Further investigation of the subsequent communication development of infants with definitive feeding difficulties and with a larger sample is suggested.

<p dir="ltr">The development of feeding skills is essential for infant health, growth, and family well-being. Despite the importance of this skill, relatively little is known about the development of independent solid feeding skills relative to other body systems – like vocalizations – or external factors including caregivers or the feeding environment. The purpose of this preliminary study was to examine the relationship between feeding skills, vocalizations, and caregiver feeding responsiveness at the same point in 6-8-month-old infants. We conducted this study remotely in order to obtain the most accurate assessment of infant skills and include diverse infant feeding experiences within their own home environments. Twenty-five typically developing – low-risk – infants and a pilot group of ten infants at increased risk for feeding and communication disorders completed the study, along with their caregivers. Infants were categorized as “at-risk” if they spent time in the Neonatal Intensive Care Unit. We collected feeding data through caregiver-recorded videos of typical mealtimes, vocalization measures from daylong audio recordings, and responsiveness assessments from video-conferencing interviews with caregivers and the mealtime feeding videos. In our sample, it was feasible to use these remote data collection methods, and we obtained high inter- and intra-rater reliability for all measures (> 90%). In our preliminary study, we found that infants in the low- and at-risk groups demonstrated different oral motor feeding skills. In hierarchical regression models, the interaction between risk group and utterance duration was the most significant predictor of oral motor feeding skills, while neither vocalization measure was strongly related to eating efficiency. In the opposite direction, feeding skills were not predictive of either normalized child vocalization count or utterance duration. Relative to caregiver feeding responsiveness, we found that caregiver feeding responsivity alone did not predict feeding or vocalization measures. Responsivity in combination with weeks of feeding experience and medical risk group was related to oral motor feeding skill but not related to vocalization measures. Overall, this study provided initial evidence that feeding skills develop as a dynamic system, influenced by multiple within-child and external factors, and future research is warranted on the influence of these factors on feeding and communication skill development.</p>