Feeding and Esating in Early Intervention. A Trust Based Approach

Feeding
and Eating in Early Intervention: A
Trust Based Approach
Feeding and Mealtimes are for…
Eating in Early
Intervention: a
Trust‐Based
Approach
STEPHANIE COHEN, M.A.,
CCC‐SLP, CLC
KAREN DILFER, M.S., OTR/L
1 2
Mealtimes should feel good!
Feeding and
Positive tilt = Parent and little Relationships
one leaning into each other
(Klein, 2015)
3 4
The Feeding Relationship by Ellyn Satter
Zero to Three article
“Feeding is a reciprocal process that depends on
the abilities and characteristics of both the parent
and the child.
Feeding and The child indicates an interest in being fed, with

more or less clarity, and the parent responds to
Relationships that interest readily, reluctantly, or not at all.”
‐ Ellyn Satter, The Feeding Relationship,
www.zerotothree.org, 1992
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Feeding and Eating in Early Intervention: A
Feeding development should
be considered
transactional or bi‐directional,
in context of a long‐term
relationship between parent
and child.
Mealtimes
(Walton, Kuczinski, Haycraft et al., 2017)
Occur…
8‐12 times/day for 5‐8 times/day for
infants toddlers
7 8
Responsive Feeding is American
Embedded in the
Theoretical Academy of
Framework of Pediatrics
Responsive Parenting and
Responsive
Black & Aboud, 2011 • Responsive behaviors are:
• prompt
Feeding
• emotionally supportive
• contingent
• developmentally appropriate
(Black & Aboud, 2011)
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Feed infants directly and assist older children when
they feed themselves, being sensitive to their hunger
and satiety cues;
Responsive Parenting  Responsive Feeding
Feed slowly and patiently, and encourage children to
Responsive Feeding eat, but do not force them;
Respond promptly to cues of
Prompt hunger and satiety
If children refuse many foods, experiment with
Emotionally Focus on learning Feed patiently GUIDING PRINCIPLES FOR different food combinations, tastes, textures and
No pressure and love and slowly COMPLEMENTARY FEEDING OF methods of encouragement;
Supportive
THE BREASTFED CHILD,
Acknowledge the child's If child struggles, experiment with PAHO/WHO, 2003
Contingent communication different combinations, tastes, textures… Minimize distractions during meals if the child loses
interest easily;
Developmentally Support self‐ Model positive Expose to new foods,
Appropriate feeding mealtime behaviors tastes, textures
Remember that feeding times are periods of learning
and love ‐ talk to children during feeding, with eye to
(Black & Aboud, 2011) eye contact
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Definition
• Prevalence between 33% to 80% in
children who have developmental
“Impaired oral intake that is disorders, incidence increasing
Pediatric not age‐appropriate, and is associated Pediatric (Lefton‐Greif, 2008)
Feeding with medical, nutritional, feeding skill, Feeding
and/or psychosocial dysfunction.” • For these infants and children,
Disorder (PFD) Disorder (PFD) every bite of food can be painful,
Goday et al., 2019 scary, or impossible, potentially
impeding nutrition, development,
growth, and overall well‐being
(www.feedingmatters.org)
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Prematurity Developmental experiences or lack thereof
Poor growth Environmental challenges
Pediatric Chromosomal abnormalities Pediatric
Feeding Syndromes Feeding Sensory processing difficulties
Disorder Disease/Disorders
Disorder Mental Health
(PFD) may (PFD) may
Neurological problems
occur with: occur with: Poor Attachment
Dysphagia
Trauma
Allergy or intolerance
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• Babies who are fed responsively are
more likely to continue being breastfeed
• Breastfeeding was associated with lower When pre‐term infants are fed using
levels of control compared to formula cue‐based practices:
feeding (Brown & Lee, 2013)
• Parent‐led routine for infant feeding may Cue‐Based Feeding
Breastfeeding discourage breastfeeding; encouraging a in the NICU: Using • Focus of feeding is on
baby to feed to a parent‐led routine
is Responsive rather than its own natural patterns may the Infant’s experience not on “getting it all
promote obesity Communication as in”
Feeding • The association between maternal a Guide • Infants gain physiologic stability
anxiety and formula use has been well
established. (Brown & Arnott, 2014) • Infants gain enhanced self‐
• Please seek out education, can and
regulation and coping skills
should happen through EI
(Shaker, 2013)
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3
• Medical/feeding hx:
• Milk and soy protein intolerances
• T he infant behaves certain ways during in infancy
feeding for a reason.
• Gagged and coughed with early
• Volume‐driven responses to physiologic
Reading the instability may create a pattern of stress introduction of solids
Feeding and feeding refusal behaviors. • Diet slowly expanded with
• Focusing on emptying the bottle, or therapist and sitter
SATTER
defining an empty bottle as success, may Division of • Mealtime Dynamics:
Catherine Shaker alter the preterm infant's feeding
experience and adversely affect Responsibility • B still would not eat well with her
neuromaturation and feeding outcomes. parents
• If each feeding is as stress‐free as • Parents would offer separate meal
possible, however, the infant learns to for B
ASHA Leader, 2013 respond positively to feeding. Case Study: B • Parents would prepare additional
foods as B requested at meals
• Parents prompted and tried to
convince B to try new foods
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“Controlling feeding may arise when children
• Recommendations: experience problems in feeding or growth, such as
recovery feeding after illness.
• Parents coached to serve food
family style, including 1 of B’s
Under these circumstances, recommendations tend to
favorites at each meal be guided by a children's nutritional needs, focusing on
• Encouraged B to serve others the quantity and quality of food and the frequency of
SATTER • Parents modeled positive mealtime feeding.
Division of behavior
Responsibility As a result, health and nutrition counselors may not
• Parents stopped prompting focus on parent responsivity and parents may interpret
• Outcomes: the recommendations as a mandate to use controlling
strategies to "get their child to eat.”
• Family meals more pleasant Controlling Feeding
• Parents felt less stress
Case Study: B • B seemed more relaxed at
This strategy has the potential to undermine the child's
trust in an otherwise responsive parent. “
mealtimes and tried new foods (Black & Aboud, 2011)
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Feeding Problems and Mealtime Dynamics
The Worry Cycle
Conflict
Increased attempts to
Feeding Problems control
Decreased sharing of
pleasure
(Aviram, 2014)
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Impact of feeding problems on relationships
Maternal stress related to mothers’ own
sense of competence
Discussion
Paternal stress is more related to child
temperament and individual characteristics
(Aviram et al., 2014)
25 26
Trauma Individual trauma results from an event, series
• Feeding relationship and bonding of events, or set of circumstances experienced
Impact of (Satter, 1995) by an individual as physically or emotionally
harmful or life‐threatening with lasting adverse
feeding • “The lack of a feeding relationship
disturbs the development of maternal
effects on the individual’s functioning and
problems on identity, and the loss of oral feedings
mental, physical, social, emotional, or spiritual
well‐being.
can be assumed to have a traumatic
relationships impact.” (Wilken, 2012)
http://www.integration.samhsa.gov/clinical‐practice/trauma
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Acute OR Chronic ACES STUDY
ACES:
Trauma Trauma
• Physical Emotional or Sexual
abuse
• Physical or Emotional neglect
• Parental mental illness
• Substance dependence
• Incarceration
• Parental separation
http://www.integration.samhsa.gov/clinical‐practice/trauma • Domestic violence
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Traumatic Experiences
Trauma Trauma
Normal Traumatic
Developmental Stress
Stress
Stress Event Danger
Response
(Walkey & Cox, 2013)
31 32
Grief
Impatience
Establishing
Parents Frustration Relationships and
Building Trust
Failure
Confusion
(Klein, 2015)
33 34
• Kids are often unable to
Establishing Relationships and Building Trust eat with family
• Feel guilt over child’s diet
• Concern of child’s
nutrition
• Don’t understand their child’s
logic
Parents must be heard and included Parents need support Do not feel heard by healthcare
professionals Understanding the • Lack of social support
• May not be supported by
63% reported that healthcare
providers did not address their
Family’s Experience physician
• May feel isolation
concerns
in a sample of 300 parents
(Zucker, 2015)
(Klein, 2105)
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6
Parents may have tried a variety of
different things to help: How do we assess and describe…
Parent • Children?
Solutions: •
•
Offer same foods in the same way
Feed child separately
Judgement • A child’s eating patterns?
What’s working • No eating out
and Bias • Foods?
for NOW • Use of screens or other distractions • Parents/Caregivers?
(Klein, 2015)
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Noun
1. an act or instance of judging.
• Breastfeeding vs. bottlefeeding
2. the ability to judge, make a decision, or form an opinion • Cultural feeding practices
objectively, authoritatively, and wisely,
especially in matters affecting action; good sense; discre • Homemade vs. storebought baby
tion: a man of sound judgment. food
What Do
3. the demonstration or exercise of such ability or capacity:
The major was decorated for the judgment he showed un
der fire. Judgment We Judge?
• Organic vs. non‐organic
• Homemade blend vs. formula
4. the forming of opinion, estimate, notion, or conclusion,
as from circumstances presented to the mind:
(tube‐fed kids)
Our judgment as • Mealtime expectations for toddlers
to the cause of his failure must rest on the evidence.
• Mess at mealtimes
5. the opinion formed: He regretted his hasty judgment.
• Manners
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ALTERNATIVE Language we use to describe children:
AVERSION FOOD REFUSAL DELAYED HYPERSENSITIVE “BEHAVIORAL” Conversations with

Parents
___________ ___________ ___________ ___________ ___________
___________ ___________ ___________ ___________ ___________
___________ ___________ ___________ ___________ ___________
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7
Early Intervention
Guidelines
Questions Have you seen this
so far? document?
Raise your hand if yes.
https://blogs.illinois.edu/files/6039/114615/4529.pdf
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Early Intervention
Guidelines Mission and Key Principles
Part C early intervention builds upon and provides
“SLPs in EI may provide services for children supports and resources to assist family members
with feeding/swallowing deficits related to and caregivers to enhance children’s learning and
sensory integration, medically stable development through everyday learning
oropharyngeal disorders and behavioral
issues only.
opportunities.
All other feeding/swallowing deficits are
medically related and should be referred to
the child’s primary medical physician or
medical home for medical intervention.”
https://blogs.illinois.edu/files/6039/114615/4529.pdf
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Before Assessment Day
Evaluation/Assessment
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Review Growth
Medical history
• Birth history
• Diagnoses
• History of medical procedures
Review • Hospitalizations, significant illnesses Review
Paperwork •
•
Past and present assessments and/or therapies
Medications
Paperwork
• Psychosocial history
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Who’s on the Team? • Avoid ”this is how we always
do it”
• FAMILY • Child care educator • What is best for this family?
• Extended family members • Gastroenterologist Who Should • The family should know their
• Pediatrician • Allergist be Present at options
• Service coordinator • ENT • Evaluators should have
Initial specialized expertise
• Social worker • Pulmonologist • Best practice is a
• Registered dietician • IBCLC
Eval/Assess?
multidisciplinary perspective
• Speech‐Language pathologist • Nurse
• Occupational therapist • Psychologist
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Build Rapport BEFORE the visit
Listen to parent concerns
Prepare the
Parent Conversation
Assessment
Explain what will Feeding
happen
Feedback
Ask parent to bring familiar foods,
utensils, etc.
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• Review information from paperwork
• Gauge parent(s)’s understanding of
Medical child’s diagnoses, medical procedures,
Parent Interview History
test results
• Family history of feeding problems,
allergies, other illnesses
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Feeding History
• Current diet/food repertoire
• Report of mealtime structure and routine
• Describe early feeding experiences: • Any special preparation or modification of
• Bottle fed or breast fed? food that is required
• Formula? What kind?
• Breast milk, via breast or bottle? Current Status • Utensils and vessels used
• NG or G tube? • Typical quantity of intake
• When were solids introduced?
• Were there any difficulties with transition to
• Coughing, gagging, protective responses
solids? • Behavioral responses during mealtimes
• How did early feeding experiences feel for the parent?
Child? • Family and mealtime dynamics
• How did any complications influence the child’s ability to
eat?
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Pre‐Feeding
Skills Checklist Feeding Observation
Morris & Klein, 2000
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10
Oral‐Motor Exam Feeding Observation
Symmetry and
Oral and facial muscle
formation of oral Resting mouth position Breathing patterns
tone
structures
Strength, range of
motion, and REMIND THE PARENT PARENT AS PRIMARY PARENT FEEDS AS OBSERVE AND MAKE
coordination of facial, Oral sensory function Vocal quality Oral motor planning OF WHAT WILL FEEDER HE/SHE TYPICALLY SUGGESTIONS IF
jaw, lip, and tongue HAPPEN NEXT WOULD WARRANTED
musculature
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Observe: Is the parent reading the child’s nonverbal cues?
• How is the child positioned?
How does parent respond to successes/difficulties?
• What is the environment?
• What foods are offered? Feeding Is distraction used?
Feeding • What is the child’s reaction to the food? Observation: Is the child engaged?
• What is working best?
Observation Mealtime
• What are the challenges? Does the child help with the feeding?
Dynamics
Does the child seem happy?
*Ask if this meal resembles typical Is the pacing appropriate?
mealtimes.
(Klein, 2015)
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Feeding Observation:
Assess Foods Offered
•Taste Feeding
•Texture Observation:
Assess Skills • Breastfeeding
•Variation • Bottle drinking
• Cup drinking
• Straw use
• Utensil use
• Oral preparation/swallowing
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Feeding Observation:
Understanding the Dyad
Avoid making assumptions
Ask parents questions:
• I’m noticing that…What do you think
this means?
What is
• What has worked in the past?
working?
• Where is the child receiving their primary source of nutrition?
• What seems to be the ”easiest”/most natural for the child?
• When does the child lean in? ean in?
(Morris & Klein, 2000)
67 68
Describe what may be contributing to feeding
difficulty
• Narrate what is happening
• It looks like______________. Allow parent to
feed child/
implement
Problem‐
Areas of
Solving Describe
changes in
Need function
Together based on
suggestions
Make gentle
adjustments and ask
questions
•Would it be okay if I tried to feed them?
•Could we try____________?
•What do you think would happen if _____?
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JAL [2]10
“I’m noticing that ____________.” Making a Plan
“What would happen if ____________.”
Check‐in: parent’s Make sure the Create outcomes Are there other

Communication “Could we try__________?” emotional state parent knows what
to do, and have
together professionals or
resources that
them try would be helpful?
strategies/practice
“What would you think about_________?” what you’ve
demonstrated
Find out what is important
to them: Out if everything
we’ve tried today, what was
“Would it be okay if ___________?” the most useful to you?
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Slide 71
JAL [2]10 Jones, Alissa Leigh, 6/5/2019

Making a Plan
• Use parent‐friendly language
• If necessary, have report translated
Ensure that parent Report • Avoid jargon

• Use professional language
understands Make sure parent
recommendations
in the context of
Written
recommendations
understands what
will happen next
Writing • Define professional language
• Describe what happened (don’t use value‐based
development terminology)
• Jack refused his mother’s presentation of the spoon.
• Jack turned his head away when his mother
presented the spoon.
Handout, pg. 24
73 74
Developing Outcomes
Key Principle #4 (NE):
Outcomes and Key Principle #4
The early intervention process, from initial
contacts through transition, must be dynamic
and individualized to reflect the child’s and
Strategies (NE) family members’ preferences, learning styles and
cultural beliefs.
http://www.nectac.org/~pdfs/topics/families/Principles_LooksLike_DoesntLookLike3_11_08.pdf
75 76
Parents are:
Developing Outcomes
• more invested in
Outcome reaching goals
Key Principle #5
Key Principle #5 (NE):
IFSP outcomes must be functional and based on
Writing: • more satisfied with
children’s and families’ needs and priorities. Parents as services
(NE)
• more hopeful about
Partners managing life
(SAMHSA: Concept of Trauma and Guidance for a Trauma‐Informed Approach, NTCSN)
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Ensure parent/caregiver
understands child’s
Recommendations: Caregiver Considerations
strengths and areas of
need
Emotional
Outcome resources (anxiety,
depression, stress)
Financial resources Time
Writing : Additional referrals
What are the family’s
priorities?
Parents as Outside support
(mental health, Cognitive ability Cultural practices
family, community)
Partners
Which disciplines can What are the family’s
best address these individual and cultural
outcomes? practices? Personal history
79 80
____________ so he can participate in
mealtime routines with his family.
High quality IFSP functional outcomes:
 are necessary and functional for the child’s and family’s life
Sample  reflect real‐life contexts/settings (mealtime routines) Sample Jose will be able to drink comfortably
and efficiently from the bottle so he can
Outcomes  integrate developmental domains and are discipline‐free
 are jargon‐free, clear, and simple
Outcomes grow well.
 emphasize the positive, not the negative
 use active rather than passive words
Kate will eat a variety of table foods and
be able to drink liquids from a cup so
From IL EI Provider handbook that she can participate in family
mealtimes.
81 82
What EI or •
Consider more than one discipline
Speech
other •
•
Occupational therapy
Physical therapy
Treatment
supports are • Social work
available? •
•
Nutrition
Include physicians and specialists outside of EI
• Assistive technology
83 84
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Feeding issues are
The focus of EI is to encourage the active participation of
families in the therapeutic process by embedding
intervention strategies into family routines.
complicated.
Key Principle #2 It is the parents who provide the real early intervention Treatment
by creatively adapting their child care methods to facilitate
(EI) the development of their child, while balancing the needs
of the rest of their family. Children need to FEEL
GOOD before they
can eat.
(Edwards et. al., 2015)
85 86
Start with What is Working
Gross motor Fine motor
Use
Development Cognitive Communication FAMILIAR
As a Guide
Feeding skills
(Morris & Klein, 2000)
87 88
Help
Caregivers
Learn a Child’s
Cues
• Educate all caregivers
• Online observations
Parent Coaching • Ask parent to interpret behavior
• Video review
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JAL [2]9
“I’m noticing that ____________.”
“What would happen if ____________.” Responsive Modeling positive

eating behavior at Encourage shared No pressure
mealtimes
Feeding (Harper, 1975)
mealtimes (Galloway et al., 2006)
Communication “Could we try__________?” Strategies: Avoid using food as Respond promptly to

Supporting rewards for eating child’s cues of hunger
other foods and satiety
Development of Trust (Finnanne et al, 2017) (Black & Aboud 2011)
“What would you think about_________?” Between Child and
Caregiver
“Would it be okay if ___________?”
91 92
Continuum of Options
• What worked today?
• Offer a few options for integrating Child Motivated Adult Motivated
Making new strategies into routines
Changes • Parent helps choose what to
implement next
• Give the parent a “game plan” for
every mealtime Self‐feeding Force feeding
(Klein, 2012)
93 94
Sequential Oral
Get Permission
Sensory Approach
Approach (Klein)
(Toomey)
Child‐Led,
Relationship‐ Mealtime Partners Behavioral
SOFFI Method
Based, (Suzanne Evans
(Ross) Modification
Morris)
Trust‐Based Strategies
Approaches
STEPS Approach
Food Chaining
(McGlothlin &
(Fraker & Fishbein)
Rowell) Arvedson, Brodsky,
Lefton‐Greif, 2020
95 96
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JAL [2]9 I left this "left block" black to match the earlier slide (101) and
reactivate prior knowledge
Jones, Alissa Leigh, 6/5/2019
Building Trust:
• Educate parents about typical infant and toddler feeding
Education development patterns
Building Trust with Expectations
• Develop appropriate expectations
Families
• Start with “what’s working”
Strengths
• Ongoing discussion of the child’s strengths and areas of need,
Ongoing parent’s changing goals
97 98
Building Trust: Caregiver Considerations
• Cultural responsiveness is about
reciprocity and mutuality. The
Emotional process involves exploring
resources (anxiety, Financial resources Time
depression, stress)
differences, being open to
valuing clients’ knowledge and
Cultural expertise, and recognizing the
unique cultural identity of each
Outside support
(mental health, Cognitive ability Cultural practices
Considerations individual client (Munoz, 2007).
family, community) • When cultural considerations
are addressed, outcomes are
better (Davis‐McFarland, 2008)
Personal history
99 100
• Parent stress/mental health • Make intentional language choices
• Misunderstanding of therapeutic relationship • Consider questions we ask and how we
Barriers to ask them (e.g, “How did things go this
• Misunderstandings regarding Avoid
Communication individual/personal factors
week? What did you try?)
Judgment • Anna’s mom‐ “I almost didn’t want you
with Parents • Practitioner judgement/bias
to come today because I haven’t done
• Practitioner difficulty grading communication any feeding and I should be doing more. I
need to do more.”
101 102
17
How do we contribute to this?
Questions
How can we avoid contributing to so far?
this?
103 104
EI requires a collaborative relationship between
families and providers, with equal participation
by all those involved in the process.
Teaming and Key Principle #3
Collaboration (EI)
An on‐going parent‐professional dialogue is
needed to develop implement, monitor, and
modify therapeutic activities.
105 106
Team Collaboration & Communication
Teaming and
Collaboration
All team members are aware Use IFSP development time Connect with team
of the plan and parent is wisely members outside of EI
supported throughout the (includes consultation with
week physicians identified on the IFSP)
107 108
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Teaming and Can you think of a time when you
collaborated with another member of
Collaboration: the team in a way that benefitted the
Discussion family?
109 110
• 12 Families with children with “FTT”
diagnosis
Families felt part of the team when
• One third of families (4 families) felt medical professionals:
as if they were part of the team
Teaming and Teaming and • Accepted their assessment of the child’s
condition
Collaboration • Almost all families described:
Collaboration • Listened to them
• Feeling helpless (Thomlinson, 2002)
• Not feeling heard
• Feeling blamed for their child’s diagnosis
• Feeling isolated
(Thomlinson, 2002)
111 112
A multidisciplinary team can holistically
• At four months Spencer’s
address a child’s health and well‐being: parents noticed motor delay
• Low tone
• Medical management • Started working with
Spencer at 18 months
• Sensorimotor skill • Non verbal
Teaming and building • Ataxic movement
• Behavioral support • Not growing well
Collaboration • Hunger provocation • Feeding skills
• No self feeding
• Pain management
• Was refusing spoon
• Sensory integration feeding from parent
difficulties • Was bottle drinking
Case Study: Spencer • Was not self‐feeding
(Edwards et. al., 2015)
113 114
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Interventions with young children and family
Key Principle #7 members must be based on explicit principles,
Resources
validated practices, best available research and
(NE): relevant laws and regulations.
115 116
JAL3
Resources Resources
• American Speech‐Language Hearing Association: www.asha.org • Frequently Asked Questions (FAQs) SLP Provider Information Notice (04/19/11):
• Catherine Shaker Swallowing and Feeding Seminars: www.shaker4swallowingandfeeding.com http://www.wiu.edu/ProviderConnections/policy/EIProviderUpdate.php?id=172
• Chicago Feeding Group: http://www.chicagofeedinggroup.org/ • Helping Your Child with Extreme Picky Eating (Rowell & McGlothlin): www.extremepickyeating.com
• Clarification of Existing Policy/Procedure Regarding Developmental Services Provided by Speech‐Language • Mealtime Notions (Klein): www.mealtimenotions.com
Pathologists to Children Eligible for Early Intervention • New Visions (from Suzanne Evans Morris, Ph.D.): www.new‐vis.com
http://www.wiu.edu/ProviderConnections/pdf/InfoNoticeclarifyingSLPPolicyProcedures1122.pdf
• PAHO/WHO Guiding Principles for Complementary Feeding of the Breastfed Child:
• DEC Recommended Practices: https://divisionearlychildhood.egnyte.com/dl/tgv6GUXhVo https://www.who.int/nutrition/publications/guiding_principles_compfeeding_breastfed.pdf
• Dysphagia Resource Center: www.dysphagia.com • Pediatric Feeding News (Krisi Brackett): http://pediatricfeedingnews.com/
• Expert Feeding Help for Parents and Professionals (Melanie Potock): www.mymunchbug.com • Principles of Early Intervention: https://eitp.education.illinois.edu/principles.html
• Feeding Flock assessment tools: https://www.feedingflock.com/tools • Seven Key Principles: Looks Like / Doesn’t Look Like from Workgroup on Principles and Practices in Natural
• Feeding Flock: https://www.feedingflock.com/ Environments:
• Feeding Matters: www.feedingmatters.org
• The Feeding Relationship, by Ellyn Satter: https://www.zerotothree.org/resources/1071‐the‐feeding‐
relationship
117 118
Pediatric Swallowing and Feeding: Assessment and Management by Joan
Arvedson, Linda Brodsky
Dysphagia listserv (www.dysphagia.com)
Pre‐Feeding Skills: A Comprehensive Resource for Mealtime Development
– 2nd edition by Suzanne Evans Morris, Ph.D., and Marsha Dunn Klein,
M.Ed., OTR
ASHA Division 13 (listserv and newsletter)
How to Get Your Kid to Eat‐‐But Not Too Much by Ellyn Satter RD, A.C.S.
(https://www.asha.org/SIG/13/) W.
Resources:
Listservs, Pediatric Feeding and Dysphagia Newsletter (Krisi
Brackett, SLP) (http://pediatricfeedingnews.com/)
Recommended Child of Mine: Feeding With Love and Good Sense by Ellyn Satter, RD,
A.C.S.W.
Newsletters, or Reading Helping Your Child with Extreme Picky Eating by Katja Rowell, MD, Jenny

Groups FeeDR Pediatric Dysphagia Facebook group
McGlothlin, MS, CCC‐SLP
(https://www.facebook.com/groups/88445812069/)
Baby Self‐Feeding, by Nancy Ripkin & Melanie Potock
The Chicago Feeding Group
Raising a Happy, Healthy Eater, by Melanie Potock
(www.chicagofeedinggroup.org)
Check the EIC Lending Library for these https://eiclearinghouse.org
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JAL3 I noticed some resources or references were listed twice so I

omitted them. I put titles in front of the links that were originally
just links and alphabetized
Jones, Alissa Leigh, 5/22/2019
• Alvisi, P., Brusa, S., Alboresi, S., Amarri, S., Bottau, P., Cavagni, G., … Agostoni, C. (2015).
Recommendations on complementary feeding for healthy, full‐term infants. Italian Journal of Pediatrics,
41(1), 36. doi:10.1186/s13052‐015‐0143‐5
• Morris, S.E., & Klein, M.D. (2000). Pre‐feeding skills: A comprehensive resource for mealtime
• Aviram, I., Atzaba‐poria, N., Pike, A., Meiri, G., & Yerushalmi, B. (2015). Mealtime Dynamics in Child development. Austin, TX: Pro‐Ed.
Feeding Disorder : The Role of Child Temperament , Parental Sense of Competence , and Paternal
Involvement, 40(1), 45–54. • Rowell, K. (2012). Love me, feed me: The adoptive parent's guide to ending the worry about weight,
picky eating, power struggles, and more. St. Paul, MN: Family Feeding Dynamics.
• Black, M. M., & Aboud, F. E. (2011). Responsive Feeding Is Embedded in a Theoretical Framework of
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Feeding

Feeding and The child indicates an interest in being fed, with

AVERSION FOOD REFUSAL DELAYED HYPERSENSITIVE “BEHAVIORAL” Conversations with

_____ _ _ _ _______

_____ _ _ _ _______

Check‐in: parent’s Make sure the Create outcomes Are there other

JAL [2]10 Jones, Alissa Leigh, 6/5/2019

Ensure that parent Report • Avoid jargon

“What would happen if ____________.” Responsive Modeling positive

Communication “Could we try__________?” Strategies: Avoid using food as Respond promptly to

Newsletters, or Reading Helping Your Child with Extreme Picky Eating by Katja Rowell, MD, Jenny

JAL3 I noticed some resources or references were listed twice so I

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