A neurodiversity affirming framework for feeding therapy

Feeding Therapy
A neurodiversity affirming framework for feeding therapy

Both neurotypical and neurodivergent kids may experience feeding difficulties during their early years. Limited calorie intake, delayed oral motor skills, anxiety about food, picky eating and choking are some of the many concerns parents report during a feeding evaluation.

It is estimated that about 20 to 50% of typically developing children and 70 to 89% of children with developmental delays, experience feeding difficulties during, childhood (Benjasuwantep et. al., 2013) The prevalence rate among children with developmental delays is reportedly much higher than their neurotypical counterparts prolonging into adolescence and adulthood in many.

While there are several approaches to pediatric feeding therapy, not all of them are effective and neurodiversity-affirming. Approaches that promote rewards, punishments, mechanical and physical restraints, planned ignoring, withholding food or drink to induce compliance and forced feeding are non-neurodiversity affirming and need to be DISCARDED.

In contrast, embracing a neurodiversity-affirming framework in feeding therapy promotes intrinsic motivation, positive affect towards mealtimes and independent feeding skills.

So, what does it look like? A neurodiversity-affirming model is informed by a responsive feeding framework. It considers the differences in brain wiring and provides interventions that consider sensory processing differences, motor learning principles, the child’s interests, learning capacities and autonomy.

Listed below are at least four key aspects for the successful implementation of a neurodiversity-affirming model in your feeding therapy practises.

  1. Build a trusting relationship with the clinician/ parent/caregiver - One of the first things to consider in feeding therapy is to build a friendly relationship with the child. If a good rapport isn’t established, the chances are that the child feels unsafe during mealtimes and cannot build a positive relationship with food.
  1. Intrinsic motivation - A majority of our autistic children are very particular about what goes into their mouths; primarily because of sensory differences and tactile defensiveness that stems from prior experiences. Therefore, as a clinician or parent, be careful not to enforce the child into eating whatever interests you but rather what interest the child. As for expanding food choices build gradually on the existing, textures, tastes, temperatures, and shapes of food, changing one aspect of a category at a time.
  1. Support autonomy - Encouraging the child to choose how much food to be served on the plate, what food will be served on the plate, how the child will interact with the food, choose the utensils and when he would want to close the meal, are a few examples of supporting autonomy during mealtimes. This doesn’t mean that you don’t care or abandon the child. Instead, you are offering opportunities to facilitate their understanding of bodily responses to food consumption, appetite and satiation.
  1. Presumes competence – This could be a new terminology to many of you. What it means, is to BELIEVE that the child has the POTENTIAL to develop feeding skills such as progression of textures, quantity and independence; rather than assuming that he is incapable. The shift in our mindset will induce the child to believe in themselves and promotes self-determination. From picky eating, our kids can soon progress to become food explorers - one meal at a time.

I am certain that these simple strategies will prove useful during your mealtimes – be it at therapy or at home. To learn more, visit our course platform to educate yourself with our self-paced courses.





Chitra Thadathil

Speech Language Pathologist

Founder & Director

Dimensions Centre for Child Development 



Cormack, J., Rowell, K. and Postavaru, G-I. (2020) Self-determination theory as a theoretical framework for a responsive approach to child feeding. Journal of Nutrition Education and Behavior.





  • Share this :

Related article

Make an appointment! Go here!