Mealtime Connections is the pediatric feeding clinic Marsha co-founded in Tucson. Though she is no longer a partner as she has entered the semi-retirement chapter of her life, Mealtime Connections continues to enthusiastically and sensitively support children who have feeding challenges and their families. The staff are knowledgeable, compassionate and highly trained in supporting a wide array of pediatric feeding challenges. They were the playground for the development of this approach! They GET PERMISSION!
The Get Permission Approach
The responsive, sensitive, and supportive approach to family mealtimes.
What is the “Get Permission Approach” to feeding?
The responsive, sensitive, and supportive approach to feeding therapy, Get Permission strategies lovingly support children and their families. The Get Permission Approach will enable you to view children and families holistically and collaborate with caregivers to create positive change at mealtimes.
The approach was developed by Marsha Dunn Klein, OTR/L, and is based on solid principles of normal development, decades of research, and almost 50 years of clinical experience.
Principles
of the Get Permission Approach
1
The Get Permission Approach is complicated and requires collaboration with team members including parents.
2
The Get Permission Approach acknowledges that children eat best when they feel well.
3
The Get Permission Approach acknowledges that feeding is a relationship.
4
The Get Permission Approach acknowledges that eating is built on a foundation of positive developmentally appropriate experiences.
5
The Get Permission Approach acknowledges parents and supports them to successfully feed their children.
6
The Get Permission Approach is based on what works with happy, self-directed eaters who enjoy eating, are confident in their eating skills and are internally motivated to eat enough.
7
In the Get Permission Approach, adults determine the direction and children determine the pace.
8
The Get Permission Approach is guided by a sensitive reading of the cues.
9
The Get Permission Approach celebrates mealtimes and a love of food!
10
The Get Permission Approach sees the therapist role as offering parents and children achievable, successful options.
Why do we talk about grasshoppers at the Get Permission Institute?
How did Marsha become ‘That Grasshopper Therapist’?


The Book
Anxious Eaters, Anxious Mealtimes
Practical and Compassionate Strategies for Mealtime Peace
How can grasshoppers help parents and feeding professionals teach anxious eaters about new foods?
Marsha Dunn Klein, internationally-cited feeding therapist, provides the answer in this book, highlighting that most anxious eaters do not enjoy the sensations and variability of new foods. In seeking to help them, she asks what you’d need to do to help yourself try a worrisome new food, such as a grasshopper.
Who We Are
MARSHA DUNN KLEIN, OTR/L, MED, FAOTA

Marsha is a pediatric occupational therapist with close to five decades of experience lovingly feeding children. She received her bachelor’s degree in occupational therapy from Boston University, Sargent College in 1971 and then a Masters of Education degree in Special Education from the University of Arizona in 1975. She is trained in neurodevelopmental therapy. She has been a clinician, author, and educator throughout her career. She has co-authored a number of books on feeding including Pre-Feeding Skills, First and Second Editions, Mealtime Participation Guide and Homemade Blended Formula with Suzanne Evans Morris and Feeding and Nutrition for the Child with Special Needs with Tracy Delaney and just recently, Anxious Eaters, Anxious Mealtimes. She developed and distributed the Duospoon. She has been awarded Fellow of the American Occupational Therapy Association. Marsha co-founded a nonprofit in Tucson called NOURISH to provide family and community support for children with feeding challenges and co-founded Mealtime Connections, LLC which continues to provide outpatient pediatric occupational, speech, and physical therapy in addition to dietician support for children with complex medical, developmental, and feeding challenges in Tucson Arizona. While no longer providing direct patient care, Marsha continues to mentor, publish, teach and create resources for The Get Permission Approach with the assistance of Karen Dilfer, OTR/L and BreAnne Robison, OTR/L who both completed the Marsha Dunn Klein Feeding Fellowship.
Marsha has a passion for feeding children and sharing knowledge. She presents locally, regionally, nationally and internationally and loves sharing her responsive and loving approach to pediatric feeding challenges in her Get Permission Approach to Pediatric Feeding Challenges course series. Marsha and her family love to travel and explore foods globally. She considers herself a food celebrator.
KAREN DILFER, MS, OTR/L
Karen Dilfer is an occupational therapist, feeding specialist, and food enthusiast. She has a strong pediatric background and loves to help children with motor, sensory, and mealtime challenges. A Chicago native, Karen enjoys discovering new restaurants and cooking with friends and family. She is a founding member of the Chicago Feeding Group, a non profit organization that seeks to support parents and professions who work with children who struggle to eat. Karen was recently featured in the Chicago Tribune.
Karen has a bachelor of science degree from Calvin College and a master’s of science degree from Washington University in St. Louis. She is Neurodevelopmental Treatment (NDT) trained and has also completed post-graduate education in Sensory Integration. Karen trained under Marsha Dunn Klein at Mealtime Connections, LLC, in Tucson, Arizona.
Karen is a contributing member to the Get Permission team and regularly teaches Get Permission workshops and webinars. She maintains a private practice and actively treats children with feeding challenges. You can learn more about her work here: www.eatwithkaren.com.
Marsha has a passion for feeding children and sharing knowledge. She presents locally, regionally, nationally and internationally and loves sharing her responsive and loving approach to pediatric feeding challenges in her Get Permission Approach to Pediatric Feeding Challenges course series. Marsha and her family love to travel and explore foods globally. She considers herself a food celebrator.

BREANNE ROBISON, MS, OTR/L

Bre is an occupational therapist who loves feeding and loves children! She received her Bachelors in Psychology from the University of Arizona, and then worked in the public school systems for two years as a special education aid, while providing respite and habilitation to children with special needs. She went on to complete her Masters in Occupational Therapy at A.T. Still University in Phoenix. Upon returning to her home town of Tucson, she graduated from the Marsha Dunn Klein Feeding Fellowship Program. Bre specializes in pediatric feeding and “Gets Permission”! When not supporting families clinically through Mealtime Connections in Tucson, she can be seen co-presenting about Anxious Eaters, Anxious Mealtimes with Marsha.