Our Program

We believe that bodily autonomy is a priority for the clients we work with.  When it comes to eating and feeding therapy, it is the child’s choice whether to eat a specific food or not.  If we support them in developing intrinsic motivation, they will be able to better self-regulate their body, explore their appetite, and be curious about new foods. If we support them with confidence and competence, then development is more likely to happen. Research in adults suggests that internally (versus externally – e.g. reward-based motivation) guided eating results in significantly more positive outcomes. There are several reasons why you might choose responsive feeding therapy over behavior-based feeding therapy for your child. Here are some potential considerations:

• Holistic Approach: Responsive feeding therapy takes a holistic approach to feeding difficulties; It addresses the underlying factors that contribute to feeding challenges, such as sensory sensitivities, oral motor skills, and emotional aspects of eating. Responsive feeding therapy focuses not on modifying behavior but on creating a positive and supportive feeding environment.
• Individualized Approach: Responsive feeding therapy recognizes that each child is unique, with their own preferences, needs, and challenges. It emphasizes tailoring the therapy to the specific requirements of the child, begins at the child’s current baseline level of comfort around novel foods, and considers their developmental stage, sensory profile, and nutritional needs. This individualized approach can lead to more targeted and effective interventions.
• Respect for Autonomy: Responsive feeding therapy respects the child’s autonomy and promotes their independence during mealtimes. It focuses on allowing the child to participate actively in the feeding process, make choices, and develop self-regulation of hunger and fullness cues. This approach fosters a sense of empowerment and reduces power struggles around food.
• Long-Term Healthy Habits: By encouraging a positive relationship with food and teaching strategies and skills for exploring new foods, responsive feeding therapy aims to establish long-term positive eating habits. It focuses on maintaining felt safety while expanding their food repertoire, increasing acceptance of exploring and meeting new foods, which can have lasting benefits for their overall health, well-being and ability to feed themselves adequately as adults.
• Emotional Well-being: Responsive feeding therapy recognizes the emotional and social aspects of eating. It prioritizes creating a calm and supportive feeding environment, promoting autonomous skills and strategies, and reducing stress or anxiety related to food. By addressing these emotional factors, responsive feeding therapy can help foster a healthier and more enjoyable mealtime experience for your child and family.
• Family-Centered Approach: Responsive feeding therapy involves and educates the entire family, recognizing their crucial role in supporting the child’s feeding progress. It provides strategies and support to parents and caregivers, empowering them to implement responsive feeding principles at home. This family-centered approach promotes consistency, collaboration, and a positive feeding environment well beyond therapy sessions.

Behavioural approaches to feeding focus on shaping a child’s eating behaviors through external strategies and reinforcements such as rewards. These approaches often involve more direct parental control over what and how much a child eats, with the goal of encouraging specific behaviour (e.g. getting a reward for tasting a new food or eating a specified amount of a particular food at a meal).  It’s possible to see some short-term increases in new foods tried using a behavioural approach; however, the maintenance of accepting these new foods is much less likely, since the child is mostly trying to ‘survive’ the new food experience and block it out as much as possible in order to get the reward.  A responsive feeding approach is considered more supportive of long-term strategies, fosters curiosity for trying new foods, focuses on building a safe and strong parent-child connection, and a positive relationship with food.

Rewards and reinforcers may “work” to get some children to try new foods or have a few more bites, but for many children, it will be too big of a challenge, and the pressure or risk of failure becomes overwhelming. For some children, the risk is gagging or vomiting if the food doesn’t feel safe in their mouth.

If the child is relaxed and happy to try a new food, and they do well with eating overall, then the reinforcers are likely not causing harm. However, it’s likely that you’re here because your child is having difficulty with eating. Most parents seeking our support have tried everything. From food and non-food rewards and sticker charts, pressuring, threatening, restricting preferred foods, raising their voice, etc. to get their child to try a new food or eat more and it’s just not working! This is where Responsive Feeding Therapy offers an alternative.

Research shows us that food rewards (treats, dessert, preferred side dishes) actually serve to teach children that the target food is less preferable, and needs a more preferable food to reinforce eating it. Children are actually less likely to enjoy the target food over time and more likely to request/want/crave the reward food over time. Non-food rewards (stickers, toys, reward charts) have only been found to be successful in the short term, for some children, and do not tend to help the child adopt that food into their regular repertoire of tolerated foods over time.

Research shows us that pressure to eat is the least effective strategy for promoting trying a new food or eating more food, and can often even be damaging and serve to push the child farther from enjoying that food in the future. Research and lived experience from neurodivergent adults tells us that sensory eating usually persists across the lifespan. If you have a child who has difficulty eating, shows anxiety around new or unfamiliar food, has a limited repertoire of tolerated foods, and/or prefers a high level of control and consistency around food and mealtimes, they may be a sensory eater. And they will probably always be a sensory eater. Responsive Feeding Therapy can help them develop functional skills and strategies for feeling comfortable eating food with others, feeling safe to order something new but slightly familiar at a favourite restaurant, explore a new food that they are interested in because it smells good, have enough safe foods to feel satisfied preparing a few days worth of meals for themselves, or know how to prepare select tolerated vegetables in a way that is palatable for them. No one will be “making” them eat when they are adults, and pressure to eat now will likely hinder their long-term relationship with that food. No one will be giving them a reward for eating their vegetables when they are adults.  It will be extremely important to teach these lifelong skills, so that they can be a confident, competent sensory eater as an adult.

It is important to note that responsive feeding therapy is not just eliminating pressure,  letting children eat whatever they want and hoping they will just feel like trying something new one day. A central component of Responsive Feeding Therapy is learning how to incorporate natural, meaningful, and enjoyable opportunities for the child to participate in family meals and interact with foods, free from any pressure to eat anything. Adults know that exposure is important for increasing comfort and familiarity with a food, which is why we feel inclined to ask children to “just try it!”. But when pressure is involved, the exposure is no longer a positive one, and the individual is less likely to enjoy that food. Responsive Feeding Therapy helps parents know how to provide their children with opportunities for positive exposure that are free from any pressure. These are called food rehearsals, and for some children, it can be as simple as observing someone else eat something new from a distance that feels safe.

The term “feeding” feels a little inaccurate when we think about older children and teens. These individuals are more just.. eating, and not ‘feeding’ or ‘being fed’ by an adult. Rest assured that Responsive Feeding Therapy is appropriate for older children, teens, and adults, and is just about getting comfortable talking about and exploring food and eating. It is really important to note though, that the teen needs to be onboard with participating in therapy to work on eating and exploring new foods. If the teen doesn’t feel that they have any difficulty with eating and has no interest in expanding their repertoire of tolerated foods, a good first step might be scheduling a session with our dietician to assess whether there are any gaps in nutrition that are a genuine concern to address. It’s possible that you (the adult)’s perception of a balanced and satisfying diet is different from your neurodivergent teen’s perception of a balanced and satisfying diet. If there is a gap in nutrition or overall intake, it may then be appropriate to enroll in our feeding program to help your teen learn about how to feel comfortable exploring foods and/or supplement options that can help address the nutritional gap in their diet.

Our program involves four steps:

• Intake consultation and assessment with our Occupational Therapist or Speech-Language Pathologist & Registered Dietician.
• Six weekly parent education sessions in an online group format with a program facilitator (OT or SLP).
• Six or twelve weeks of individual feeding therapy in your home or virtually with your feeding therapist from our team, you and your child or teen

Total duration of the program is 12-18 weeks. Our aim is to teach families the strategies they need to continue supporting their child on their food journey.

In most cases, families are welcome to participate in just some components of the program. Some examples:

• If your child/teen isn’t ready for direct food therapy sessions yet, you can participate in just the education sessions to get started learning every day strategies that you can implement right away.
• If your child is already participating in feeding therapy with a Victoria Speech and Language Centre occupational therapist using a responsive feeding approach and you’d like to learn more about how to incorporate this approach outside of therapy sessions, you are welcome to attend just the parent education sessions.
• Families are always welcome back for refresher feeding therapy sessions once they have completed the program with us.

• Option One:
  • Thorough pre-program assessment with Registered Dietician and Occupational Therapist or Speech-Language Pathologist
  • 6 weeks of group parent training
  • 6 weeks of individual feeding therapy (online or in-home)
  • Total =$2250 *additional travel charges apply for home sessions

• Option Two:
  • Thorough pre-program assessment with Registered Dietician and Occupational Therapist or Speech-Language Pathologist
  • 6 weeks of group parent training
  • 12 weeks of individual feeding therapy (online or in-home)
  • Total =$3240 *additional travel charges apply for home sessions

Responsive feeding therapy can benefit individuals of all ages who experience feeding difficulties, are anxious eaters, very selective or ‘picky’ eaters or have a diagnosis of pediatric feeding disorder or ARFID (Avoidant/restrictive Food Intake Disorder). It is an approach to feeding therapy often used with neurotypical children and teens, as well as with autistic children and teens, children with sensory processing difficulties, or other developmental delays.

• Autism Funding (AFU)
• At Home Program
• Extended health benefits for speech therapy or occupational therapy
• Variety Children’s Charity – apply for occupational therapy or speech therapy
• CKNW Kid’s Fund
• Jordan’s Principle: funding for children with Indigenous Status
• Métis (Miyoopimatishihk) Wellbeing Program
• SMILE Charity: Supporting racialized children and youth with disabilities and their families including immigrant and refugee families.
• TLC fund -a local southern Vancouver Island charity for kids.  Will fund therapy or equipment.
• Help Fill a Dream -will fund therapies for children with life-threatening or critical conditions.