Frequently Asked Questions

Answers to the questions parents ask us most about picky eating, feeding disorders, and what feeding therapy at OBAAT actually looks like.

About picky eating vs. feeding disorders

  • Picky eating and feeding disorders look similar on the surface but are clinically distinct. A picky eater grows normally, eats a balanced diet across all food groups (even if from a limited set of foods within each group), and cycles through food preferences — locking onto a food, eating it for weeks, then dropping it. A child with a feeding disorder has typically eliminated entire food groups, eats fewer than 10 foods overall, is not growing as expected, is nutritionally deficient, and often relies on nutritional supplements to meet daily needs.

    If a child fits the picky-eater picture, no intervention is usually needed. If they fit the feeding-disorder picture, professional support is warranted.

  • The clearest indicators that a child needs feeding therapy rather than time are: they've eliminated an entire food group, they're nutritionally deficient (for example, iron deficient), they're not growing as expected, mealtimes are consistently stressful, and family life is being restricted — the family has stopped going to restaurants, avoids visiting friends and relatives, or plans holidays around the child's food. Feeding therapy is appropriate when eating has moved from a private preference into a barrier to health, growth, or family functioning.

  • If the transition from purées and soft foods to table foods was difficult and you've had no success introducing new foods, the age to seek support is 18 months to 2 years — before eating patterns become more entrenched. Waiting rarely helps.

    If your child was previously eating a range of foods, then dropped most of them and you've had no success adding them back, the age to seek support is around 4 or 5. Regression at this age is a signal, not a phase.

  • Five warning signs that suggest a child needs professional feeding support:

    • They've eliminated an entire food group (no protein, no vegetables, no fruit, etc.)

    • Bloodwork shows nutritional deficiency, such as low iron

    • They're not growing as expected on the growth curve

    • Mealtimes are consistently stressful for the child and the family

    • The family has stopped eating at restaurants, at friends' or relatives' homes, or on holidays because of the child's eating

    Any one of these is a reasonable reason to book a discovery call. Two or more, particularly nutritional deficiency or growth failure, warrants faster action.

  • Many children do — but not all, and the distinction matters. Between roughly ages 2 and 3, children go through a normal neophobic stage, meaning a natural fear of new foods. For most children, this phase resolves on its own by age 5 or 6, and they begin accepting foods they previously rejected. This is the "grows out of it" pattern.

    The problem is that many parents interpret their child's initial rejection of a new food as fixed and unchangeable, so they stop offering it. When the food is removed from the child's environment, the child never gets the exposures needed to develop a preference — and what would have been a temporary neophobia becomes a permanent restriction. Research shows that typical eaters between ages 2 and 5 need 15 to 20 tastings of a new food before they prefer it. Children with more severe food selectivity need approximately three times that many exposures. Most parents stop offering a new food after only a few attempts.

    If a child is not resolving out of picky eating by age 5 or 6, or is actively narrowing their diet rather than expanding it, professional support is warranted.

About feeding therapy

  • Feeding therapy is a specialized clinical intervention that directly teaches a child to accept, taste, chew, and eat new foods. At OBAAT, feeding therapy is delivered by Board-Certified Behaviour Analysts (BCBAs) using an evidence-based behavioural approach: gradual exposure, individualized reinforcement, and structured caregiver training built into every session. Sessions are always 1:1 and are delivered in the family's home, in our Vancouver clinic, in a community setting where eating naturally occurs (such as daycare or school), or online for older clients.

    Feeding therapy is not counselling, coaching, or generic nutrition advice. It's direct clinical work with the child.

  • A session focuses on teaching the child to accept and eat new foods, starting from foods that are only slight variations on their current diet. Early sessions are designed to be fun and successful — we want the child to look forward to the next session. As the child shows success, we gradually introduce more complex foods using strategies that keep them motivated and successful.

    We never force a child to eat, and we never "wait them out." Sessions are structured so the child has autonomy: acceptance of a new food is treated as a clinical milestone earned through gradual exposure and positive reinforcement, not through pressure.

    A caregiver is present in at least half of all sessions, learning the strategies as we use them. Simple, effective homework is assigned between sessions so progress carries into everyday mealtimes.

  • Most families see their child trying new foods within the first few sessions. Significant progress typically appears around the twelfth food, when children have built enough trust and curiosity that new foods become easier to introduce.

    Total duration depends on the child's presentation. A teenager adding variety to their diet may need as few as 10 sessions. A child with oral motor delay learning to accept and chew solids may need 40 to 60. In every case, treatment is time-limited by design — ideally no more than six weeks of intensive work, followed by follow-up support at intervals over the next six months to a year. The intervention is structured to end with the family equipped to maintain progress on their own, not to create ongoing dependence on specialty care.

  • Oral motor delay means a child lacks the physical skills needed to chew solid foods — tongue lateralization (moving food side to side) and rotary chew. These skills may be absent, or present but so delayed that eating solid foods requires enormous effort, which makes the child tire quickly and start to avoid solids altogether.

    The distinction matters because the treatment is different. For an oral motor delay, we teach the physical skills needed to chew solid foods. For picky eating (food selectivity), we desensitize the child to a range of tastes and textures through small tastes of new foods. A child can have both, and OBAAT is set up to treat both.

  • Yes. OBAAT works with children who have never eaten orally and are dependent on tube feeds, and with children who rely on formula (such as Pediasure) as their primary source of calories and nutrition. These are the most complex cases we treat, and they respond to the same behavioural framework used with less-severe presentations — starting from wherever the child is and building acceptance gradually.

    One example: Q., a five-year-old with autism, was referred to OBAAT eating nothing at school and, at home, only a syringe-fed mixture of Pediasure and milk. Over 40 in-home intensive sessions, our team supported Q. and her family through a gradual, trauma-informed transition from syringe feeding to age-appropriate oral eating. She now eats 40+ foods across food groups, no longer relies on Pediasure, and shares meals with her family at home and with her classmates at school.

  • We work with children, adolescents, and young adults. OBAAT treats clients from roughly 18 months through young adulthood, including teenagers with ARFID and young adults who want to expand a restricted diet.

  • ARFID (Avoidant/Restrictive Food Intake Disorder) is a diagnosis characterized by severe restriction of food intake that isn't driven by concerns about body image or weight — it's driven by sensory aversion, fear of aversive consequences (choking, vomiting), or a lack of interest in eating. OBAAT treats ARFID in children, adolescents, and young adults using the same behavioural framework — gradual exposure, individualized reinforcement, family-integrated treatment planning, and trauma-informed pacing.

About the OBAAT approach

  • OBAAT uses a multicomponent behavioural approach: reinforcement, environmental arrangements, antecedent strategies, and structured exposure to new foods. The approach is grounded in the behavioural feeding literature, which emerged in the 1980s and now has the largest documented evidence base of any treatment for pediatric feeding disorders.

    Our work is family-centred and trauma-informed. Treatment plans are built around each family's culture, values, and mealtime traditions — we do not impose foods or routines. Reinforcement is individualized: we identify what actually motivates each child, rather than using generic reward systems. The child has autonomy within every session; we never force feeding, restrain children, or use "wait-them-out" procedures.

  • Yes. The behavioural approach to feeding therapy is the only intervention for pediatric feeding disorders with well-documented empirical support in the peer-reviewed literature. The clinical foundation was established in the 1980s and has been refined through four decades of research.

  • No. OBAAT does not use force feeding, restraint, or non-removal-of-spoon procedures (where a spoon is held at the child's mouth until acceptance). We do not endorse these methods. While they can produce short-term compliance, in our experience they carry meaningful risk of food trauma, breakdown of the caregiver-child relationship, and regression once intensive treatment ends.

    We work through gradual exposure, child-led pacing, trust-building, and individualized reinforcement — so gains made during treatment are durable and generalize to the family's everyday mealtimes.

  • Yes. Caregiver participation is essential to long-term success and is built into the OBAAT model. A caregiver is present in at least half of all sessions, learning the strategies as we use them. Between sessions, families work on simple, effective homework — practicing the strategies at everyday mealtimes so gains generalize beyond the therapy room.

    This is what makes short-course intensive treatment durable. By the end of the intensive period, parents are the primary agents of continued progress. Most families do not require recurring specialty involvement after treatment ends.

About who provides the therapy

  • OBAAT's clinical team is composed of Board-Certified Behaviour Analysts (BCBAs). We also have a Registered Holistic Nutritionist and a chef on our team, so nutritional guidance and practical food preparation support are available alongside behavioural feeding intervention.

    New clinicians complete a structured 12-month training progression before working independently. All OBAAT clinicians are supervised by senior consultants throughout their tenure. Average clinician tenure at OBAAT is approximately seven years — unusually stable in the sector.

  • Different disciplines address different pieces of feeding, and often work well together on complex cases:

    • A feeding therapist (BCBA-led at OBAAT) directly teaches the skill of accepting, tasting, chewing, and eating new foods, with structured caregiver training built in.

    • A dietitian provides nutrition assessment and dietary planning — what a child should be eating — but does not directly work on the skill of eating.

    • A speech-language pathologist may address swallowing safety, oral motor coordination, and pre-feeding skills.

    • An occupational therapist may address sensory processing, feeding equipment, and self-feeding skills.

    Many of our referrals come from OTs, SLPs, and dietitians who have identified that a child's presentation exceeds what their discipline addresses.

  • Lauren Binnendyk, the founder and Clinical Director of OBAAT, began research in behavioural feeding intervention in 2001 and has been in private practice since 2009. OBAAT has served families across British Columbia — from Vancouver and Victoria to Haida Gwaii, Prince George, and Burns Lake — for over 15 years.

About locations, virtual sessions, cost, and getting started

  • OBAAT is based in Vancouver, BC, and serves families across British Columbia. Our primary in-clinic location is in Vancouver, and we deliver in-home sessions across the Lower Mainland.

    On Vancouver Island, we serve Greater Victoria, Westshore, Sooke, the Saanich Peninsula and Southern Gulf Islands, Nanaimo, and the Cowichan region.

    For families in rural and remote communities, OBAAT clinicians travel to the family's community for in-person intensives. Recent service locations outside the Lower Mainland include Victoria, Nanaimo, Kelowna, Kamloops, Prince George, Smithers, Haida Gwaii, Gold River, Sayward, Burns Lake, and Fraser Lake.

  • Yes. OBAAT provides feeding therapy on Vancouver Island through a clinician based in Victoria, serving Greater Victoria, Westshore, Sooke, the Saanich Peninsula and Southern Gulf Islands, Nanaimo, and the Cowichan region.

  • Yes. Approximately half of OBAAT's sessions happen in the family's home, where the child eats every day. Home-based delivery makes it easier to build strategies into the family's actual routines, and it removes the disruption of clinic travel for young children. We also deliver sessions in the Vancouver clinic and in community settings where the child eats — daycare, preschool, or school.

  • Yes. OBAAT offers online sessions for teenagers and young adults, and for follow-up support after an in-person intensive with families of any age. Virtual delivery is not appropriate as a primary treatment for young children with complex presentations — for those cases, we travel to the family's community for in-person work.

  • Session rates at OBAAT are:

    • In-clinic sessions: $185 per session

    • In-home sessions: $200 per session

    Assessment and initial consultation are billed separately. We operate a sliding-scale fee structure for families whose financial circumstances would otherwise prevent access — please raise this at your discovery call.

  • Extended health insurance in British Columbia does not currently recognize behavioural feeding therapy as a covered service. Most OBAAT families pay through one of three pathways: direct out-of-pocket, provincial funding through BC's Autism Funding program (for eligible families), or federal funding through Jordan's Principle (for eligible First Nations families). We can provide receipts for reimbursement claims where insurance plans allow.

  • Depending on your family's eligibility, feeding therapy at OBAAT may be funded through:

    • BC Autism Funding Program — for children with an autism diagnosis

    • Jordan's Principle — for First Nations children

    • Métis Nation BC — for Métis children and families

    • CKNW Kids' Fund — grant-based support for BC families

    • School district discretionary funds — occasionally available for in-school work

    • Direct family payment — sliding-scale rates available for families in need

    OBAAT provides administrative support to families applying for these funding pathways, including drafting funding letters and helping navigate the application process. Raise your situation at the discovery call and we'll help you identify what's available.

  • Yes. OBAAT operates a sliding-scale fee structure for families whose financial circumstances would otherwise prevent access to specialty feeding intervention. Please raise this at your discovery call.

  • The first step is a free discovery call with Lauren. On this call, Lauren learns about your child's feeding challenges, your family's situation, and what you're hoping to accomplish. If OBAAT looks like the right fit, we'll walk through next steps, funding options, and scheduling.

    To book a discovery call, contact us via the website or email admin@obaatfeeding.com.

  • OBAAT typically has a waitlist of approximately three months from referral to first session. Occasionally we have earlier openings — please reach out. In our experience, a wait longer than three months causes families to seek services elsewhere — including services that may not be appropriate to the clinical severity of their child's presentation — so we work hard to keep the wait shorter than that.