Paediatric Feeding,
Dysphagia (swallowing)
& Early Communication
Support.

For GPs, ENTs, Paediatricians, Lactation Consultants, Child Health Nurses and Allied Health Professionals

Stefanie Le Lievre is a Certified Practising Speech Pathologist with nearly 20 years clinical experience in paediatric feeding, swallowing (dysphagia) and early communication across hospital and community health settings.

Stef is based in Currumbin Waters and supports families across the Southern Gold Coast, Northern NSW and via Telehealth.

Feeding Clinical Focus

This service provides assessment and management of paediatric feeding and swallowing difficulties, with a particular focus on complex and medically-based presentations.

    • Suspected or confirmed oropharyngeal dysphagia

    • Feeding difficulties associated with medical complexity, including:

      • Prematurity

      • Structural abnormalities

      • Neurological conditions

      • Genetic syndromes

      • Cardiorespiratory conditions

      • Gastrointestinal conditions impacting feeding

    • Dependence on modified textures or thickened fluids

    • Tube feeding (NG/PEG) with transition to oral feeding

    • Poor coordination of suck–swallow–breathe (breast and/or bottle feeding)

    • Delayed or disrupted progression of feeding skills, including difficulty advancing textures

    • Persistent feeding challenges impacting nutrition, growth, or family functioning

    Children with selective or limited eating may also be appropriate where there are:

    • Concerns regarding oral motor skills or chewing ability

    • A history of gagging, choking, or difficulty managing textures

    • Very restricted diet impacting nutrition

Communication Clinical Focus

Assessment and support for early communication development (<2 years) where there are concerns regarding language, and social communication development.

  • Limited or absent talking (expressive language):

    • Reduced or absent babbling by ~9 months

    • Limited use of gestures (e.g. pointing, waving, showing) by 12 months

    • Not using words by 16 months

    • Fewer than ~50 words or not combining words by 24 months

    Reduced social communication (pragmatics)

    • Limited eye contact or social engagement

    • Reduced response to name

    • Limited shared attention (e.g. not showing or sharing interest)

    • Preference for interacting with objects over people

    Concerns with understanding (receptive language)

    • Difficulty following simple instructions by 18–24 months

    • Limited understanding of familiar words or routines

    Regression or plateau

    • Loss of previously acquired communication skills

    • Lack of progression over time

    Communication difficulties in the context of risk factors:

    • Prematurity

    • Neurological conditions

    • Genetic syndromes

    • Hearing concerns or recurrent otitis media

    • Developmental delay

Submit a Referral ›

If you are unsure whether a child may benefit from support, here are some common signs that it may be appropriate to refer for feeding, swallowing or communication assessment.

  • Referral is recommended when there are:

    • Signs of dysphagia or airway compromise
      (e.g. coughing, choking, wet breathing/voice, recurrent chest infections, suspected aspiration)

    • Concerns about feeding safety or efficiency
      (e.g. poor suck–swallow–breathe coordination, fatigue, prolonged feeds, reduced intake, poor weight gain)

    • Ongoing need for feeding modifications
      (e.g. thickened fluids, modified textures, difficulty progressing textures)

    • Medically complex feeding presentations
      (e.g. prematurity, neurological, genetic or cardiorespiratory conditions; tube feeding)

    • Persistent feeding difficulties
      (e.g. limited progress despite support, unclear or multifactorial presentation, significant mealtime stress)

    • Parent or caregiver concerns

  • Referral is recommended when:

    • Development is not meeting expected milestones

    • There are parent or caregiver concerns about communication

    • There is uncertainty regarding developmental trajectory

    • Early signs of neurodevelopmental difference are present

    • Skills are not progressing over time

Early support
tailored to family life

Referral ›