Major focus area

Feeding Therapy -> Sensory

Short description

Responsive Feeding Therapy (RFT) is an overarching approach to feeding and eating interventions which facilitates the (re)discovery of internal cues, curiosity, and motivation, while building skills and confidence. It is flexible, prioritizes the feeding relationship, and respects and develops autonomy (Rowell et al., 2020).

Long description

Responsive Feeding Therapy (RFT) is an overarching approach to feeding and eating interventions which facilitates the (re)discovery of internal cues, curiosity, and motivation, while building skills and confidence. It is flexible, prioritizes the feeding relationship, and respects and develops autonomy (Rowell et al., 2020). The RFT approach and respective values build on a body of research from the field of pediatric feeding and related areas of study. This includes, but is not limited to, responsive parenting (Black & Aboud, 2011), humanistic psychology (Davies et al., 2006), attachment theory and interpersonal neurobiology (Walton et al., 2017), theories of development (Slaughter & Bryant, 2004), self-determination theory (Cormack et al., 2020), and trauma physiology (Galloway et al., 2006). A comprehensive history and physical exam (with further testing as indicated) must be undertaken to rule out or identify underlying anatomical, GI, metabolic, and other factors that impact eating and digestion. In cases where medical interventions are necessary (such as enteral feeding or IV hydration) the RFT values can still guide individualized treatment. RFT has three core goals, which both drive clinical decision making, and result from the application of the RFT values. 1) To prioritize felt safety and nervous system regulation: RFT centers the child’s embodied experience of interoception, emotions, and nervous system regulation within the complex interconnectedness of mind and body. Felt safety refers to an unconscious sense of being secure, where the body’s threat system is not activated. Felt safety is health-promoting in and of itself; a child in felt safety experiences optimal physiology in regards to digestion and gut function, the cardiovascular system, hormones, and immune function. In felt safety, appetite, capacity for relationships, and curiosity can emerge. Parents are supported to observe the child and provide co-regulation, which supports emotional and physical self-regulatory capabilities over time. 2) To support and optimize children’s relationship with food and their bodies: Research in adults suggests that internally (versus externally) guided eating results in many positive outcomes. RFT is held to optimize self-regulation of energy intake to the best of each individual’s ability (considering barriers to interoception), via a supportive and accommodating feeding environment. 3) To provide individualized care: When autonomy, relationship, competence, intrinsic motivation, and holism are applied in concert, the resulting values-driven treatment framework is, by its very nature, highly individualized. Such individualized care is a defining characteristic of RFT, in contrast to a manualized approach.