In this blog post, I dive into an insightful conversation with Erin Forward, a speech pathologist who specializes in trauma-informed feeding. Erin shares her journey and passion for working with neurodivergent children, offering valuable insights into how trauma affects feeding therapy. She discusses the core principles of trauma-informed care, the complexities of each child’s feeding experience, and the crucial role of building trust and engagement with both children and caregivers.
Erin emphasizes the need to shift our approach to feeding therapy to better support children and their caregivers. In this post, we explore how understanding children’s cues, allowing them to feel safe and in control during mealtime, and slowing down the process can foster a positive feeding experience. We also touch on the importance of recognizing each child’s unique needs, especially when trauma or neurodiversity is involved, and the vital role caregivers play in creating a supportive mealtime environment.
Meet Erin Forward
Tara: Hey there, Erin. I am so interested in picking your brain today about trauma-informed feeding. So can you start first by telling everyone a little bit about yourself?
Erin: Hi! I’m so excited to chat today. Feeding is near and dear to my heart, and my journey has shaped how I approach it. I’m Erin Forward, a speech pathologist based in Charleston, SC, working at Carolina Milestones. My experience spans inpatient feeding teams, early intervention, and private practice, primarily with autistic children.
Initially I focused on medically complex feeding and AAC, and discovered a deep passion for working with neurodivergent children through collaboration with an OT. Becoming an expert in DIR Floortime transformed how I approach feeding therapy—shifting to child-led, play-based methods.
Tara: Wow, it's so impressive when we kind of find our way, find what we're passionate about within our field, because speech language pathology is such a vast field. It becomes a passion and I can feel that from you.
We're going to talk about trauma-informed feeding. How do you define it? Why is it such a critical approach working with some children?
Trauma-Informed Feeding Therapy
Erin: Trauma-informed feeding therapy recognizes that nearly every child seeking support has experienced some level of trauma related to feeding. It prioritizes safety, trust, empowerment, collaboration, and cultural sensitivity.
Neurodiversity-affirming care falls under the broader umbrella of trauma-informed care, as highlighted by Rachel Archambault. Kim Barthel’s work reinforces the need for a trauma-sensitive approach, acknowledging that trauma isn’t limited to major events but includes repeated experiences, like struggles with breastfeeding or feeling misunderstood.
At its core, trauma-informed feeding therapy is individualized—what works for one child may not work for another. The key is ensuring that children feel safe, can advocate for themselves, and have the autonomy to say “no,” which is often missing in traditional feeding therapy.
Tara: Every neurodivergent child learns differently, even with the same diagnosis. While some thrive with common teaching methods, others require a more individualized approach. The creative challenge of finding what engages each child—whether through trust-building, deep interests, or tailored activities—is the most rewarding part of my work. Rather than feeling overwhelmed, I see it as an opportunity to discover each child’s unique path to learning.
Mealtime Literacy
Erin: Learning about feeding isn’t so different from how children learn other things, especially for neurodivergent kids. Infants explore by mouthing toys, which later translates to trying food. But for some children, feeding doesn’t develop smoothly due to sensory challenges, allergies, or co-regulation difficulties.
That’s why I focus on mealtime literacy—understanding how each child feels safe learning about food. Some need to smell it, touch it, watch it being made, or be deeply involved in the process. Instead of rigid protocols, we need to honor their unique learning styles, building comfort and trust over time.
Building Trust and Connection
Tara: Last weekend, my mom passed me and my sister a wrapped mint. I asked my sister if it was winter mint or peppermint—because I hate peppermint. She didn’t know, so I smelled it but still couldn’t tell. I ended up lightly licking it while my sister tried not to laugh. The moment I tasted peppermint, I wrapped it back up and put it in my purse—no way was I eating that!
Erin: Right. You can communicate that. Feeding challenges aren’t just about the food—it’s about trust. Caregivers often feel frustrated when a child suddenly refuses a familiar food, but slight differences in taste or personal preferences (like craving eggs one day and avoiding them the next) can play a role. Feeding can’t be forced, so a key shift in therapy is helping caregivers trust their child’s instincts.
Studies show that the vast majority of feeding differences aren’t behavioral, and children aren’t refusing food just to be difficult. Progress often happens when we focus on engagement and communication first. Once a child feels safe and connected, they become more open to exploring food naturally—sometimes simply because they see someone they trust eating it. Comfort leads to curiosity, and that trust-based relationship is the foundation of real progress.
Tara: Connection comes first. What are some signs that a child may have experienced trauma related to feeding or mealtime?
Understanding Pediatric Feeding Disorders
Erin: Feeding Matters is a great resource for understanding pediatric feeding disorders, which can stem from medical, nutritional, skill-based, or psychosocial factors. Trauma-related feeding issues can present subtly—dilated pupils, tense posture, heavy breathing, avoiding eye contact, or fleeing at mealtime.
Children with past feeding trauma often arrive with a “suit of armor” to protect themselves, and trust takes time to rebuild. Caregivers should focus on creating a safe, pressure-free environment by consistently reassuring children that they don’t have to eat. Anxiety can suppress hunger, so feeling secure at mealtime is crucial.
Additionally, caregivers may have their own food-related trauma that influences mealtime dynamics. Recognizing their own triggers and shifting from frustration to understanding can help rebuild positive interactions around food. The goal isn’t just expanding a child’s diet but restoring trust in the feeding experience.
Tara: In the classroom, multiple adults—paraprofessionals, OT, PT—bring different backgrounds, food experiences, and philosophies. There's often someone who believes kids just need to be made to eat, but that’s not the reality. I’ve had students who wouldn’t come to the table, likely due to trauma. It’s crucial to talk to parents—many aren’t concerned if their child doesn’t eat during a short school period. Kids adapt, and forcing them to the table isn’t worth it. Instead, offer a sensory or play activity. Many children graze, and in a self-contained classroom, that’s perfectly fine.
Erin: The idea of three meals and two snacks is often neurotypical and ableist. Some kids need to graze for their gut health, and forcing them to sit at the table can disrupt their interoception, preventing them from feeling hunger. Children with food insecurity, for example, need access to safe foods without earning them, as elevating a “safe food” creates a harmful reward system. Caregivers often do their best, but many children face issues like allergies or eosinophilic esophagitis, which make eating painful. Autistic children, in particular, may struggle with interoception and can't always communicate discomfort, making eating even harder.
Building Trust and Engagement in Feeding Therapy
Tara: Pushing kids with trauma surrounding food can make things worse. Some worry that not forcing kids to sit at the table will impact kindergarten, but IEPs are meant to meet kids where they are. Kids will be supported in kindergarten, regardless of whether they’re eating at a table or not, and aren’t expected to suddenly conform to neurotypical expectations.
Erin: Feeding is now part of speech pathologists' scope of practice in South Carolina, but it's a growing challenge with already heavy workloads. Children need proper nutrition to learn, and supporting feeding within IEPs is essential. For many kids, school environments like lunchrooms can be overwhelming, making it hard to eat. Progress in this area recognizes that nourishment is educational. Caregivers may feel frustrated when told to “do less,” but reducing pressure helps children build trust in themselves. Intensive feeding programs can show short-term progress but often lead to trauma and lack long-term success if they're compliance-based or reward-driven.
Tara: Yeah. What advice would you give to caregivers and educators who want to create a safe and supportive mealtime environment? I think we've probably touched on some things today while we've talked already, but maybe if you could list out a couple.
Recognizing Children’s Cues: Key to Successful Feeding Therapy
Erin: To create a safe mealtime environment, caregivers should:
Break negative associations: Changing the environment or routine can help disrupt negative feeding experiences and encourage new food exploration in a safe space.
Honor “no”: Let children express when they're done or not ready to eat. Respecting their cues builds trust.
Meet them where they're at: Recognize how children learn best. For example, incorporating their interests (like a vacuum or toys) can make mealtimes more comfortable and engaging.
Find joy: Mealtime doesn’t always have to involve food. Explore activities like reading a book about food or watching food-related videos together.
Be attuned to emotions: Understand and sit with a child’s frustration or anxiety during mealtime. Acknowledge their feelings rather than trying to dismiss them.
The Importance of Slowing Down for Positive Feeding Experiences
Tara: Super interesting! If you could leave us with one key message about trauma-informed feeding, what would you want it to be?
Erin: The key is slowing down. When we move slowly, it signals safety and reduces stress. Taking deep breaths, speaking slower, and giving yourself time to process helps. I encourage caregivers to video mealtimes to catch subtle cues from children—like a glance at food—that might otherwise be missed. These small signals, like a lean or reach, show curiosity or readiness to try something. Slowing down creates a safer, less pressured environment, which helps both the caregiver and child feel more at ease and improves connection over time.
Tara: Slowing down and reducing pressure is key to co-regulation and creating a calm environment. Before moving forward, it’s important to reassess and create safety first. This approach applies not only to feeding but to any situation that triggers stress in kids. I appreciate all your insights, Erin. This has been so informative for me, especially as I don't have expertise in this area but have worked with many kids who fit this profile. Can you share where people can find you and learn more about your offerings and podcast?
Connect With Erin Forward
Erin: Thank you! I could talk forever about this, especially with my own ADHD. You can find me on Instagram at @AaronForwardSLP. I co-host the First Bite Podcast with Speech Therapy PD, which offers CEUs. I also run a trauma-informed feeding course, Nourishing Connection, a nine-week program covering play, therapeutic use of self, gestalt language processing in feeding, and more. It's a small group for mentorship, as I felt there was a gap in trauma-informed, neurodiversity-affirming feeding approaches. The course offers 18 ASHA CEUs and has been a great way to continue learning.
Listen to Episode #110
Erin Forward's Website: https://www.erinforwardslp.com
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