Upcoming Live

The Get Permission Approach to Tube Feeding with Love

February 21-23, 2024
8:00am-2:30pm CT

with Marsha Dunn Klein OTR/L, M.Ed., FAOTA, Karen Dilfer, M.S., OTR/L

Live via Zoom

Register $599

Save your seat now!

Group rates available for 4 or more!
Email hello@getpermissioninstitute
for more information!

Course Description

Get Permission is a trust-based approach to pediatric feeding intervention. This three-day (16.5 hours) long workshop will provide a comprehensive overview of feeding tubes using the Get Permission framework. Content will include an introduction to the mechanics of feeding tubes, why a child may receive a feeding tube, and how feeding tubes can be used to support a child’s growth. There will be a special emphasis on helping course participants learn how feeding tubes can be used to support the relationship between parents and their children. Participants will learn how feeding tubes can be used to promote emotional well-being of parents and support a child’s mealtime participation. A significant portion of the course will be devoted to helping participants develop clinical reasoning skills to identify when a child may be ready to transition off of a feeding tube and begin oral eating. Additional topics will include: The benefits of a homemade blended diet, strategic use of hunger, oral-motor skill acquisition, and application of Get Permission strategies for treatment success. Video examples and real-life case studies will be used to help participants apply Get Permission principles to their own practice. This workshop is filled with practical mealtime and treatment suggestions.

You will learn to:

  • Identify different types of feeding tubes, including: a nasogastric tube (NG tube), a gastrostomy tube (G-Tube), gastro-jejunal tube (G-J Tube), and a percutaneous endoscopic gastrostomy (PEG) tube.

  • Implement strategies to support the feeding relationship between parents and tube-fed children

  • Identify red flags that may indicate a need for changes in tube-feeding routines (including a child’s distress with feeding)

  • Identify when a child demonstrates readiness to transition off of a feeding tube.

  • Understand the importance of internal motivation and factors that contribute to a child’s development of appetite

  • Use tube feedings to help a child learn to eat orally

  • Incorporate information from growth charts into treatment planning

  • Collaborate with a child’s family and medical team in order to problem-solve tube feeding challenges

International registrants welcome!

No matter where you are from or what time zone you are in, we welcome you! Find out when the course runs near you using the link below.

What Marsha & Karen's Past Students Have To Say:

  • “This course was eye opening and filled with strategies I can use to help a child and their family transition from tube feeding. I highly recommend the course.” - Gianda M, SLP

  • “Thank you for developing a course that challenges health professionals working with tube fed children to think critically about using a responsive feeding approach to help families to move toward oral feeding.”
    -Christine B., SLP

CEU Info

Certificates will be issued verifying participation in 16.5 hours of continuing education once full attendance has been verified. Please allow 1 week for certificates to be sent. Check with your professional organizations licensing bodies to determine exactly what may be accepted for you. This course is eligible for ASHA’s professional development hour requirements. You will not require ASHA pre-approval for this. See here [https://www.asha.org/certification/FactDef/] for more information. This course is eligible for AOTA credits. Please check your state's guidelines for specific information about how this continuing education activity may apply to your state's CEU guidelines. 


This intermediate level course is appropriate for OTs, SLPs, PTs, assistants, educators, early intervention providers, parents/caregivers, and other professionals (social workers, nurses, registered dieticians, etc.) working with children with feeding tubes. Please contact us at [email protected]  with any needs regarding accommodations.

What is Get Permission?

Get Permission is a relationship-based approach used to support families who have children with feeding challenges. The approach is rooted in the principles of responsive feeding and actively promotes a child’s autonomy while fostering connection, trust, and consistent communication between the child and caregiver. In this approach, adults support children to "give permission" by demonstrating physical and emotional readiness for eating. Get Permission strategies are based on typical development and help children discover their internal drive to eat through appetite, enjoyment, and relationships.  

Children who participate in feeding therapy using the Get Permission Approach develop the skill, confidence, and internal motivation they need to thrive. Families who adopt the principles of the Get Permission approach learn to respect a child’s individual differences while helping them to participate in mealtimes, feel celebrated, and develop a positive relationship with food. As a result, children learn to try new foods independently and enjoy eating without pressure. Therapists who use Get Permission benefit from understanding how they might support parents and children in a pressure-free way that is rich with practical strategies for treatment.

Speaker bio:

Founders and Senior Instructors Marsha Dunn Klein, OTR/L, M.Ed., FAOTA and Karen Dilfer, OTR/L

Marsha Dunn Klein, OTR/L, M.Ed., FAOTA
Marsha is a pediatric occupational therapist who has specialized in pediatric feeding for almost 50 years. She has co-authored Pre-Feeding Skills, First Edition, Pre-Feeding Skills: Second Edition, Mealtime Participation Guide, and Homemade Blended Formula with Suzanne Evans Morris, Ph.D., CCC-SLP. She co-authored Feeding and Nutrition for the Child with Special Needs with Tracy Delaney. Her newest book is Anxious Eaters, Anxious Mealtimes: Practical and Compassionate Strategies for Mealtime Peace. When it is not the middle of a global pandemic, she presents nationally and internationally. She is a food celebrator and is passionate about supporting children and their families.

Karen Dilfer, 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.

Save your seat today!

Group rates available-contact us: [email protected]


Cancellations must be in writing and will incur a $50 fee. We are unable to give refunds after 9/1/2023. If the Get Permission Institute or speaker should need to cancel, course fees will be refunded or transferred to another course at the discretion of the participant.