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–Moving from Gastrointestinal Discomfort to Inner-Directed Eating–

Children are born with the inner ability to eat and to grow appropriately. During infancy they learn to interact with adults as they expand their eating skills and enjoy both the food and the mealtime environment. Some children experience a disruption of this normal cycle because of difficulties in physical, sensory, gastrointestinal, and environmental skills and opportunities.

One of the most critical variables in the success of a feeding program is the level of comfort that the child experiences in the gastrointestinal system.  The presence of reflux, nausea, gagging and retching strongly influences children’s relationship with food and mealtimes and makes them reluctant participants in therapy programs to enhance feeding skills.   Many children develop strong aversions to eating and receive their nutrition primarily through feeding tubes. They say "No" to eating and drinking orally, to accepting a diverse diet, and to eating enough food to support their need for nutrition and growth.

The workshop will explore many of the gastrointestinal roadblocks that limit the development of eating skills and comfort.  Strategies designed to increase gastrointestinal comfort and eating confidence will be explored. The emphasis will be placed on helping children learn to say "Yes" as they move from gastrointestinal discomfort to inner-directed eating and drinking. The course will address the feeding and mealtime issues of children who eat and drink by mouth as well as those who receive their nutrition through a feeding tube.



Please contact the sponsoring organization for a brochure and registration information for workshops in 2018



This workshop is not scheduled for 2018.




Suzanne Evans Morris, Ph.D., is a speech-language pathologist with New Visions near Charlottesville, Virginia. She is nationally and internationally known for her work in identifying and treating young children with feeding and pre-speech disorders. Dr. Morris is the director of New Visions, which sponsors innovative workshops for the teaching of feeding-related skills, and provides family-oriented clinical services. She maintains a practice which includes direct clinical work, continuing education workshops, development of clinical materials and clinical research. Dr. Morris has studied Neurodevelopmental Treatment approaches extensively in England, Switzerland, and the United States. She is the author of the Pre-Speech Assessment Scale, a rating scale for the measurement of pre-speech behaviors in children from birth through two years, and coauthor of Pre-Feeding Skills: A Comprehensive Resource for Mealtime Development (2nd edition), the Mealtime Participation Guide. and the Homemade Blended Formula Handbook.



This workshop will enable the participant to

  • describe the anatomy and physiology of the gastrointestinal system.

  • identify ways in which gastrointestinal comfort and discomfort impact a child’s desire to eat.

  • identify multiple reasons why children with gastrointestinal discomfort are often reluctant eaters who experience delays in their development of feeding and mealtime skills

  • describe medical interventions used to reduce the impact of gastrointestinal discomfort

  • describe therapeutic strategies that support mealtime comfort and feeding skill development for this group of infants and children.

  • create a positive mealtime journey that will build inner-ddirected eating and drinking skills.







Understanding the Gastrointestinal System and the Impact of Gastrointestinal Discomfort

Normal function

Gastrointestinal discomfort

  • Reflux

  • Dysmotility

  • GERD and its symptoms

  • Medical management of GERD

  • Side-effects of medications and surgery

  • The role of stress





Frequency of gastrointestinal discomfort in children receiving therapy for feeding disorders

Development of feeding aversion in response to gastrointestinal discomfort




Taking Care of the Self:  Children’s Functional Responses to Discomfort

  • Seeking comfort  

  • Moving away from discomfort

  • Fear-based care of the self

    • Perpetuation through personal safety rules, resistance, increased selectivity and avoidance




  • Trust-based care of the self

    • Change through mealtime participation, food exploration, comfort strategies, self-knowledge, desire to eat and building eating skills


End of Session



Identifying the Feeding Challenges That Relate to Gastrointestinal Discomfort

  • Neurophysiological foundations

  • Anticipation of pain and discomfort

  • Increased physical tension

  • Increased mucus and saliva production

  • Reduced tolerance for food volume





  • Reduction of water intake

  • Limited dietary variety and risk of allergic sensitivities

  • Antibiotic use

  • Feelings of powerlessness–taking control





Learning Strategies to Increase Comfort and Reduce Feeding Aversions

  • Building a foundation of trust and partnership

  • The small steps to "YES"

  • Identifying the subtle and initial signals of gastrointestinal discomfort

  • Stopping food intake at the first sign of discomfort

  • Reducing physical, sensory and emotional tension

  • Building the child’s awareness and discovery of what helps

  • Empowering the child



Afternoon Break


  • Increasing stomach acceptance of larger volumes of water and food

  • Reducing the impact of respiratory congestion

  • Exploring diet and nutritional changes

  • Incorporating strategies to reduce sensory processing and integration difficulties

  • Developing confidence

  • Developing oral feeding mastery skills



End of Session

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