2012 – The DIR® Approach to Pediatric Feeding



Organized in collaboration with the Programme d’ergothérapie de l’Université de Montréal

Eating is a highly complex process, with great emotional significance for the child, parent(s) and caregivers. This course will illustrate how DIR® (Developmental, Individual differences & Relationships) principles are used within feeding intervention for infants and children (6 months-12 yrs.), with a wide range of feeding challenges.

Through the use of case examples, we will describe the importance of collaboration with families, as well as how to create individualized treatment plans. This coordinated effort has the goal of supporting the child to feel safe and self-motivated in the eating experience as it unfolds within the culture of the family. Building on a sense of trust within therapeutic relationships, children and parents can develop skills that meet their feeding goals around meals. Along the way, they develop a sense of mutual engagement within their relationships finding satisfaction during feeding and around meal times.

Using the DIR® approach we challenge the child to use all their developmental capacities in the feeding experience. The importance of interdisciplinary collaboration, including nutrition, medicine, occupational therapy, speech therapy, Floortime™ and mental health will be illustrated. Participants will gain a better understanding of relationship-based intervention and a set of therapeutic “tools” to guide their practice in the home, clinic and school based setting. Video case studies will be used to illustrate practical solutions to complex feeding disorders.


Diane Cullinane, MD;

Julie Miller, MOT, OTR/L, SWC;

Patricia Novak, MPH, RD, CLE