Eating Strategies
Geneva Centre for Autism Parent Online Training Registration Form
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Phone Number
*
(000) 000-0000
Your Child's Name
*
First Name
Last Name
Your Child's Date of Birth
*
-
Month
-
Day
Year
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Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What are you hoping to work on with your child/teen?
Increase variety of foods consumed
Increase independence during mealtimes
Increase cooperation with mealtimes (e.g., sitting/staying at the table)
Increase appropriate mealtime behaviours (e.g., functional communication, eating neatly, eating at a slower pace)
Other
If you select other, please describe
What feeding challenges are you currently experiencing? (Check all that apply)
Picky eating/Food refusal
Resistance to mealtime routines (e.g., refusal to sit for meal times, leaving the table)
Not self-feeding (e.g., relying on others to feed them, requiring reminders to take a bite)
Messy eating
Occurrence of challenging behaviour during mealtimes (e.g., throwing food, crying/screaming)
Other
If you select other, please describe
What strategies (if any) have you found to be helpful?
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