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Lukas Boland’s sixth birthday was more than just a celebration—it was a milestone that marked a turning point in his independence. For the first time ever, he could safely enjoy a cupcake. An avid Sesame Street fan, Boland celebrated with a “Letter of the Day”-themed party at his school, Manhattan Star Academy (MSA), a YAI affiliate on the Upper West Side of Manhattan. Donning a royal blue birthday crown adorned with colorful stars, he eagerly took his first bite of a lemon cupcake with raspberry cream his father had brought in. Instantly his face lit up with delight as he motioned that he wanted to try more. The moment captured just how far he had come in his feeding journey—a journey that began with a strict puree-only diet and years of careful progress.
At home, Boland continued the celebrations with his family. Maja Horn, Boland's mother, baked him a German cheesecake, which he got to eat for the first time and enjoy alongside his younger twin siblings.
Boland was born with STXBP1, a rare genetic disorder that disrupts brain function, leading to early-onset seizures, significant developmental and speech delays, and movement challenges. At four years old, he was also diagnosed with a pediatric feeding disorder – a condition where a child has difficulty eating, drinking, or getting the necessary nutrition to grow and thrive. This can include problems like trouble chewing, swallowing, or accepting a variety of foods.
Roughly 25% of children experience some form of feeding disorder, with the rates skyrocketing to 80% among children with developmental delays, according to recent studies. The consequences of feeding disorders can be serious, leading to growth failure and increased vulnerability to chronic illnesses. Feeding disorders require specialized diagnosis and treatment, often involving speech-language pathologists (SLPs) trained in feeding therapy.
"Feeding is not instinctive, it's a learned behavior that requires explicit teaching,” said Julia Gonzalez, Boland’s SLP at MSA. “Many people think eating is something that just happens naturally, but for children with feeding disorders, especially those with developmental disabilities, it's a complex skill that needs to be taught and developed.”
“This is why early intervention is so crucial,” added Lindsay Wasserman, another SLP at MSA. “It helps develop those motor pathways and makes changes easier, much like learning a language early in life.”
Treatment typically combines thorough assessments with tailored therapy sessions aimed at building a positive relationship with food. This may include the use of adaptive equipment and techniques, along with a strong emphasis on parental and caregiver involvement to ensure progress continues at home and in everyday settings.
“It’s been amazing working with MSA to address Lukas’ needs,” said Horn. “Feeding therapy isn’t typically offered in schools, so discovering MSA’s program was a huge relief. Having professionals guide me through the mechanics of feeding takes so much pressure off—it’s one less thing to worry about as I learn how to safely feed my son.”
Recognizing the importance of feeding evaluations for diagnosing pediatric feeding disorders, in 2024 MSA partnered with Columbia University’s Teachers College to bring these evaluations directly into the classroom. The three-year collaboration highlights how graduate programs and schools like MSA can enhance feeding therapy for students by advancing SLP education.
“Many speech pathologists, across both public and private sectors, report low confidence in diagnosing and treating feeding disorders,” said Gonzalez. “Early intervention is critical for improving students’ quality of life, and this issue needs national attention to strengthen the field as a whole.”
MSA is one of the few schools in New York City offering feeding therapy. Boland, who has attended MSA since age three, has progressed from an all-puree diet to a variety of healthy foods, including pasta, bagels, muffins, and some vegetables and meats. He receives feeding therapy twice a week for 30 minutes, with SLP staff working closely with his teacher, OT, paraprofessional, and parents to ensure everyone feels confident supporting his feeding journey.
Horn described the training she received from the staff as eye-opening and essential, helping her better understand how to discuss food and use language that was previously unfamiliar to her.
“It’s reassuring to have a plan and know what foods will be introduced next,” said Horn. It’s like I’ve been given a roadmap for safely monitoring Lukas’ intake, so I’m no longer choosing foods haphazardly.”
This approach aligns with the school’s pilot cooking classes that started last fall, part of a new curriculum incorporating feeding therapy principles. The play-based group sessions introduce students to new foods, especially vegetables, in a low-pressure setting, benefiting those with food sensitivities or restricted diets.
"Our goal is to ensure every child can enjoy meals safely and independently,” said Wasserman. “By addressing feeding disorders early and collaboratively, we're not just improving nutrition—we’re opening doors to academic success, social engagement, and lifelong independence."