As more children with special health care needs survive into adulthood, there is an increased need for help with the transition from special feeding routes to oral intakes. In infancy and early childhood, emphasis is often placed on the medical aspects of treatment for these children. As they grow and integrate more fully into the community, attention shifts to their educational needs. Throughout life, however, the need for attention to nutrition issues and needs remains. A case study illustrates the experiences of a young man with special oral intake needs; feeding and related transitions were required for independent functioning as he matured into a young adult. His many struggles are summarized, nutrition implications are outlined, and recommendations are provided for dealing with similar patients.