Session 1:
Peace, Love, and Understanding: Responsive Feeding Therapy, the Origins, the Journey, and the Future
Description
Presented by Jo Cormack, M.A. MBACP.
RFT centers on the application of responsive feeding concepts in a clinical setting. Before the core elements of RFT are considered in this webinar series, this initial session looks back at how the term ‘responsive feeding’ gained traction, how it came out of the responsive parenting literature, and how it has been developed clinically. From the field of self-determination theory, the three basic needs of autonomy, relatedness, and competence will be introduced, as well as what they mean for feeding. Finally, there will be a glance to the future, as research directions and clinical implications are discussed. Feeding professionals will get some valuable context for RFT as well as the opportunity to think about different definitions and interpretations of the term ‘responsive’.
RFT centers on the application of responsive feeding concepts in a clinical setting. Before the core elements of RFT are considered in this webinar series, this initial session looks back at how the term ‘responsive feeding’ gained traction, how it came out of the responsive parenting literature, and how it has been developed clinically. From the field of self-determination theory, the three basic needs of autonomy, relatedness, and competence will be introduced, as well as what they mean for feeding. Finally, there will be a glance to the future, as research directions and clinical implications are discussed. Feeding professionals will get some valuable context for RFT as well as the opportunity to think about different definitions and interpretations of the term ‘responsive’.
Key Learning Outcomes
- Identify key papers in the evolution of responsive feeding
- Describe how responsive feeding emerged from the area of responsive parenting
- List key features of the definition of responsive feeding
- Explain how responsive feeding informs RFT
- Describe the key tenets of basic needs theory
Time Ordered Agenda
| Duration | Subject | Objective |
|---|---|---|
| 5 min | Introductions and Disclosures | – |
| 5 min | Responsive feeding and infants | – |
| 10 min | The 2010 symposium on responsive feeding | 1 |
| 10 min | Responsive parenting | 2 |
| 5 min | The work of Black & Aboud (2011) | 1 and 2 |
| 10 min | Defining responsive feeding | 3 |
| 10 min | Introducing RFT | 4 |
| 10 min | Basic needs theory | 5 |
| 5 min | Differing interpretations of ‘responsive’ | – |
| 5 min | Future directions for RFT | – |
| 15 min | Q and A | – |
Session 2:
I Did it My Way: Child Autonomy in Responsive Feeding Therapy
Description
Presented by Jo Cormack, M.A. MBACP.
Autonomy is said to be a basic need essential to intrinsic motivation. It is at the heart of a responsive approach to feeding and there is a wealth of research evidence demonstrating what happens when children’s eating is externally rather than internally (autonomously) driven. This session will examine WHY parents may find it hard to give their child autonomy and how practitioners can work with this. Feeding professionals will learn about helping parents gain insight into their responses and unconscious processes, how to help them recognise that these may be getting in the way of child-autonomy, and what they can do instead. There will be a focus on working with parental expectations because parental feeding goals can interact with non-responsive practices that block autonomy. Whether working directly with parents or not, it is necessary for feeding professionals to appreciate the relational aspects of feeding challenges; a nuanced understanding of child-autonomy is essential to supporting the feeding relationship.
Autonomy is said to be a basic need essential to intrinsic motivation. It is at the heart of a responsive approach to feeding and there is a wealth of research evidence demonstrating what happens when children’s eating is externally rather than internally (autonomously) driven. This session will examine WHY parents may find it hard to give their child autonomy and how practitioners can work with this. Feeding professionals will learn about helping parents gain insight into their responses and unconscious processes, how to help them recognise that these may be getting in the way of child-autonomy, and what they can do instead. There will be a focus on working with parental expectations because parental feeding goals can interact with non-responsive practices that block autonomy. Whether working directly with parents or not, it is necessary for feeding professionals to appreciate the relational aspects of feeding challenges; a nuanced understanding of child-autonomy is essential to supporting the feeding relationship.
Key Learning Outcomes
- Define autonomy
- List three reasons why parents may thwart child-autonomy in a feeding context
- Describe a means of helping parents identify beliefs underpinning their use of pressure to eat
- Explain why autonomy support does not equate to a permissive approach to feeding
Time Ordered Agenda
| Duration | Subject | Objective |
|---|---|---|
| 5 min | Introductions and Disclosures | – |
| 15 min | Theoretical background and definition of autonomy | 1 |
| 10 min | Helping parents understand why they may be thwarting autonomy | 2 |
| 10 min | Strategies to help parents gain insight into their responses to child eating behaviors | 3 |
| 5 min | Helping parents recognise thwarted autonomy | – |
| 10 min | Working with parental expectations | – |
| 5 min | Helping parents replace pressureful feeding practices | – |
| 5 min | What autonomy support is not | 4 |
| 5 min | Case study | – |
| 20 min | Q and A | – |
Session 3:
What’s Love Got to Do With It: Relatedness in Responsive Feeding Therapy
Description
Presented by Katja Rowell, M.D.
Feeding is by definition relational, and humans are wired for connection. Beginning with attachment, adding recent learning about neurobiology and development points towards a theory of regulation and co-regulation as pivotal to wellbeing. This session will explore the importance of self-regulation for health and feeding and digestion, and then expand to consider how adults can offer co-regulation to support healthy feeding. Feeding professionals will learn concrete steps to offer co-regulation to children as well as their parents. Co-regulation and cue-based feeding has been utilized in pre-term infant feeding. There’s plenty of research suggesting it’s time to extend a relational focus for feeding beyond infancy.
Feeding is by definition relational, and humans are wired for connection. Beginning with attachment, adding recent learning about neurobiology and development points towards a theory of regulation and co-regulation as pivotal to wellbeing. This session will explore the importance of self-regulation for health and feeding and digestion, and then expand to consider how adults can offer co-regulation to support healthy feeding. Feeding professionals will learn concrete steps to offer co-regulation to children as well as their parents. Co-regulation and cue-based feeding has been utilized in pre-term infant feeding. There’s plenty of research suggesting it’s time to extend a relational focus for feeding beyond infancy.
Key Learning Outcomes
- Examine the importance of a relational understanding of feeding and eating in contrast to a view of eating challenges located solely in the child
- Relate how attachment and now regulation theory impacts feeding
- List the body systems impacted by stress as described by the states of arousal of fight or flight with a freeze, compared to a calm state (felt-safety)
- List ways feeding professionals can offer co-regulation to a child and their parent in a therapeutic context
Time Ordered Agenda
| Section | Duration | Subject | Objective |
| 1 | 5 min | Feeding by definition is relational and impacts intake | 1 |
| 2 | 5 min | Attachment and feeding: biological imperative to be in relationship | 2 |
| 3 | 20 min | Felt-safety and connection: neurodevelopmental lens of the regulation theory | 3 |
| – | Biology of felt safety, fight-flight, freeze | ||
| 4 | 25 min | Co-regulation in feeding in feeding relationships (parent-child, professional-parent, professional-child) | 4 |
| – | Pre-term infant studies | ||
| – | Co-regulation as a tool in counseling (informational and emotional per ASHA source) | ||
| 5 | 5 min | Strengthening and tapping into the need for connection in therapy | 4 |
| 6 | 25 min | Q and A |
Session 4:
“I'll tell you what I want, what I really, really want...” :
Intrinsic Motivation in Responsive Feeding Therapy
Description
Presented by Heidi Moreland, M.S., CCC-SLP, BCS-S, CLC and Jennifer Berry, M.S., OT/L
When a child has eating differences, loving caregivers and well-meaning professionals often try a multitude of strategies to get them unstuck. Unfortunately, strategies and therapies often move ahead with the focus of getting children to eat through external motivation. Instead, therapies and interventions should be focused on helping a child discover internal or intrinsic drives to eat. When children learn to trust, understand and be intrinsically motivated to eat, skill development improves and progress is lasting. In this course we will explore the natural intrinsic motivations to eat, their importance, and practical strategies to help children and families uncover the internal drives to eat.
When a child has eating differences, loving caregivers and well-meaning professionals often try a multitude of strategies to get them unstuck. Unfortunately, strategies and therapies often move ahead with the focus of getting children to eat through external motivation. Instead, therapies and interventions should be focused on helping a child discover internal or intrinsic drives to eat. When children learn to trust, understand and be intrinsically motivated to eat, skill development improves and progress is lasting. In this course we will explore the natural intrinsic motivations to eat, their importance, and practical strategies to help children and families uncover the internal drives to eat.
Key Learning Outcomes
- List and describe the basic intrinsic motivations to eat
- Describe the different barriers to recognizing and responding to intrinsic motivators to eat.
- Explain how age and development impact intrinsic motivations to eat
- Discover the existing evidence about the importance of internal motivation for eating in the lifelong healthy eating
Time Ordered Agenda
| Section | Duration | Subject | Objective | Presenter |
| 1 | 5 min | Introductions – who we are and who are the kids | Jennifer | |
| 2 | 20 min | Introduction to intrinsic motivations to eat | 2, 3, 4 | Jennifer |
| – | Contrast with external | |||
| – | Homeostatic vs. Hedonic overview | |||
| – | Lifelong impact | |||
| – | Important across populations | |||
| – | Barriers | |||
| 3 | 20 min | Intrinsic motivations and how to facilitate them | 1, 2 | Heidi |
| – | Hunger – data, also why it isn’t enough | |||
| – | Connection – and how it can be used to elicit compliance, refer back to felt safety too | |||
| – | Curiosity – how play can be overtaken | |||
| – | Joy – JO and autonomy PTE | |||
| – | Pleasure, comfort, impact of past experiences on those | |||
| 4 | 10 min | Ages/Stages – how does it change? | 3 | Jennifer |
| – | Relationship roles to support development of intrinsic motivation | |||
| – | Self-regulation and being able to pull it all together | |||
| 5 | 15 min | Common missteps and how to start better | 2 | Heidi |
| – | How to tell internally vs. Externally motivated m. Quality vs. Quantity of interactions | |||
| – | Better outcome measures – medical goals vs. data on initiation and enjoyment – more things to come! – GAS – how did this meal feel to you? | |||
| – | Kids with disabilities, how and when to use extra supports without compromising intrinsic motivations | |||
| 6 | 20 min | Q and A, Closing | Both |
Session 5:
I Believe I Can Fly: Skills and Confidence in Responsive Feeding Therapy
Description
Presented by Heidi Moreland, M.S., CCC-SLP, BCS-S, CLC and Jennifer Berry, M.S., OT/L
In order to be competent in feeding, children need to feel safe, enjoy positive relationships around food, enjoy mealtimes, and be allowed to develop skills at their own rate. This means that children need to be able to respond to their body’s cues confidently and develop their own preferences as their skills mature. Parental competence is important as well, as they learn to support children as they grow and change. This course will cover the importance of presumed competence, the benefits of building on strengths instead of targeting weaknesses and ways that therapists can help families provide scaffolding/supports for kids in a timely way.
In order to be competent in feeding, children need to feel safe, enjoy positive relationships around food, enjoy mealtimes, and be allowed to develop skills at their own rate. This means that children need to be able to respond to their body’s cues confidently and develop their own preferences as their skills mature. Parental competence is important as well, as they learn to support children as they grow and change. This course will cover the importance of presumed competence, the benefits of building on strengths instead of targeting weaknesses and ways that therapists can help families provide scaffolding/supports for kids in a timely way.
Key Learning Outcomes
- Describe the impact that self-motivation plays in motor skill development
- Explain the cycle of therapy
- Identify small indications of progress that parents and therapists can help children build upon
- Adapt current goals into goals that will facilitate self-directed eating
- Discriminate when scaffolding is helpful and appropriate
Time Ordered Agenda
| Section | Duration | Subject | Objective | Presenter |
| 1 | 5 minutes | Introduction | Heidi | |
| 2 | 5minutes | Competence – more than bites and “tolerance” | 1 | Heidi |
| 2.a | Subjective and Objective (and parenting) | |||
| 2.b | Continuum | |||
| 3 | 20 minutes | How does competence develop? | 1, 2, 5 | Both |
| 3.a | Felt-safety first – pyramid | |||
| 3.b | Autonomy is important in subjective competence – revisit/mention | |||
| 3.c | Relationship – revisit/mention | |||
| 3.d | Safety – | |||
| 3.e | Motivation | |||
| 3.f | Motor Learning | |||
| 3.g | Presume competence first, support after | |||
| 4 | 15 minutes | Goal Development | 3, 4 | Jennifer |
| 4.a | Define progress with parents | Jennifer | ||
| 4.a.i | Introduction to coaching | |||
| 4.a.ii | Pyramid unpacked | |||
| 4.a.iii | Builds over time, not instant | |||
| 4.b | Develop different goals to assess competence than # of bites | Both | ||
| 4.b.i | Initiation | |||
| 4.b.ii | Enjoyment | |||
| 4.b.iii | Parent Stress | |||
| 4.b.iv | Well-being | |||
| 4.c | Skill building vs. Working on weakness | Heidi | ||
| 4.c.i | Measure functional in context of child and family (oral motor scale) use the difference between 0, 1 etc. | |||
| 5 | 20 minutes | Scaffolding if invited | 5 | Heidi |
| 5.a | Therapy cycle diagram | |||
| 5.b | ZPD and play good indicators on where to go | |||
| 5.c | How can you tell they need extra help, role of overall development | |||
| 6 | 5 minutes | writing goals Objective 4 | Heidi | |
| 7 | 20 minutes | Q & A and closing | Both |
Session 6:
All of Me : Considering the Whole Child in Responsive Feeding Therapy
Description
Presented by Katja Rowell, M.D. and Jo Cormack, M.A., MBACP.
This session will discuss a whole child lens to feeding challenges. We begin with a brief reminder of child factors to consider (sensory, growth and nutrition, medical concerns…), then examine the interplay with the family and wider community. How might food insecurity, ableism, cultural feeding practices, or weight-stigma impact a child’s eating? Real-world examples show how looking only to the child for assessment or treatment misses important opportunities for healing. We will examine definitions and models for integrative care from related fields and offer tools and assessment tips to help you see the whole child.
This session will discuss a whole child lens to feeding challenges. We begin with a brief reminder of child factors to consider (sensory, growth and nutrition, medical concerns…), then examine the interplay with the family and wider community. How might food insecurity, ableism, cultural feeding practices, or weight-stigma impact a child’s eating? Real-world examples show how looking only to the child for assessment or treatment misses important opportunities for healing. We will examine definitions and models for integrative care from related fields and offer tools and assessment tips to help you see the whole child.
Key Learning Outcomes
- Show the importance of considering child, family, culture and social factors in pediatric feeding therapy.
- Give three examples of how community or cultural factors impact eating.
- Outline options for assessment and gathering “whole child” information in treatment.
Time Ordered Agenda
| Section | Duration | Subject | Objective |
| 1 | 5 min | “Person in situation” with child factors and family, community, culture | 1 |
| 2 | 5 min | Related models for whole child care, disability and family systems model | 1-3 |
| 3 | 20 min | Pitfalls of looking only at child factors | 1 |
| – | Case vignettes of missed opportunities | ||
| 4 | 25 min | Whole child lens vs child-focused protocol | 2 |
| – | Considering broader influences with examples including food insecurity, weight stigma, ableism, cultural foods… | ||
| – | Assessing whole child factors | ||
| 5 | 10 min | Barriers to whole child care | 3 |
| 6 | 20 min | Q and A |
About the Presenters
Jo Cormack, M.A. MBACP
Jo Cormack, MA, MBACP, counselor and PhD candidate
Jo is a feeding dynamics specialist, researcher, and registered therapist. She helps families of avoidant eaters with the relational and emotional aspects of food and feeding. Jo is also an award-winning writer on feeding and defends her PhD thesis in psychology this fall. Her research area is parental feeding practices in the context of avoidant eating, in a UK healthcare (NHS) setting. Jo is the author of Helping Children Develop a Positive Relationship with Food (Jessica Kingsley Publishers). She trains and supervises feeding professionals and is interested in helping clinicians from diverse disciplines draw on psychological and psychotherapeutic theory in their practice.
Disclosures:
Financial:- Jo is a founder of RFPro
- Receives royalties for book sales
- Receives income from her training and consultancy practice.
- Employed by Bishop Grosseteste University, UK.
- None
Katja Rowell, M.D.
Katja Rowell, M.D.
Katja is a family doctor, author and responsive childhood feeding specialist. Described as “academic, but warm and down to earth,” she is a popular speaker and blogger and has appeared in numerous publications. Katja has developed an expertise in anxious and avoidant eating (including ARFID), food preoccupation, and supporting foster and adopted children and families. Katja is on the SPOON medical advisory board and founder of The Feeding Doctor. Her books include: Helping Your Child with Extremely Picky Eating: A Step-by-Step Guide to Overcoming Selective Eating, Food Aversion, and Feeding Disorders. Learn more about Katja at The Feeding Doctor.
Disclosures:
Financial:- New Harbinger Publications book royalty
- Amazon KDP book royalty
- Responsive Feeding Pro consulting and speaking fees
- peaking engagement honoraria
- Spoon Foundation adoption nutrition, volunteer advisory board
Heidi Moreland, M.S., CCC-SLP, BCS-S, CLC
Heidi Moreland, M.S., CCC-SLP, BCS-S, CLC
Heidi is a speech therapist and feeding specialist with Thrive by Spectrum Pediatrics. Heidi is a self-proclaimed “research geek”, but also has 30 years of practical experience in working with children. For the last 25 years she has specialized in working with children who have feeding challenges in a variety of settings. Relying on her training in communication, childhood development and feeding and swallowing development, Heidi helps children develop a trusting relationship with food that allows their skills to flourish. She loves helping children and families work together to develop happy and healthy mealtime communication and habits that will last and grow as they do. Heidi supports families virtually and in-person, and is a frequent speaker on pediatric feeding treatment nationally and internationally.
Disclosures:
Financial:- Heidi is compensated for her work on this course by way of her salary at Spectrum Pediatrics.
- Spectrum Pediatrics will be receiving a speaking fee and royalties for Heidi’s participation in this course.
- Spectrum Pediatrics financial success impacts Heidi’s pay.
- Methods and outcomes from Spectrum Pediatrics will be discussed in this course.
- Heidi is a team member of RFPro.
- Heidi is a co host of the Tube to Table Podcast and the upcoming Eat Love Thrive Podcast about responsive feeding.
Jennifer Berry, M.S., OT
Jennifer Berry, M.S., OT/L
Jennifer is an occupational therapist and feeding specialist with Thrive by Spectrum Pediatrics. Jennifer has more than 2 decades of experience helping children overcome challenges they face when it comes to eating. Using her extensive knowledge of learning, sensory processing, attachment, and motor skill development, Jennifer facilitates children’s abilities to trust, understand and relate to food now and long into the future. Coaching parents into confidence around feeding their kids and family mealtimes brings her great joy and impactful results to the families she serves. Jennifer supports families virtually and in-person through family mealtime coaching, remote responsive feeding therapy, and the Thrive by Spectrum Pediatrics Feeding Tube Weaning Program.
Disclosures:
Financial:- Jennifer is compensated for her work on this course by way of her salary at Spectrum Pediatrics.
- Spectrum Pediatrics will be receiving a speaking fee and royalties for Jennifer’s participation in this course.
- Spectrum Pediatrics financial success impacts Jennifer’s pay.
- Methods and outcomes from Spectrum Pediatrics will be discussed in this course.
- Jennifer is a team member of RFPro.
- Jennifer is a co host of the Tube to Table Podcast and the upcoming Eat Love Thrive Podcast about responsive feeding.
Total Duration:
9 hours.
Content Disclosure:
This learning event does not focus exclusively on any specific product or service.