Changing the World for Children with Complex Feeding Difficulties: Cultural-Historical Analyses of Transformative Agency



How to bring about positive change is a key concern in cultural-historical theory. There is an urgent imperative to address questions of transformation at the nexus of the individual and the social. One way to approach this is through the concept of agency, the means through which people go beyond coping with problems or adapting to the status quo, instead striving to make the future that ought to be a reality. This paper takes up ideas from Stetsenko’s transformative activist stance (TAS), Sannino’s transformative agency by double stimulation (TADS), and Edwards’ relational agency, tracing the emergence and enactment of agency among parents of children with complex feeding difficulties. These children were unable to eat orally, instead using a tube to feed. Each family strived towards, and realised, futures where their child was able to feed orally, without a tube. Parents acted agentically in ways that were contingent upon relevant cultural tools. Such tools are key to futures that are more inclusive, equitable and nurturing for all children and their families. The paper highlights the value of contemporary cultural-historical approaches to agency in understanding and provoking transformation at the nexus of the individual and social.

General Information

Keywords: agency, transformation, cultural tools; parenting, feeding, Vygotsky, tube-weaning, tube-feeding dependency, enteral feeding, health consumer engagement

Journal rubric: Educational Psychology


Funding. The reported study was funded by Maridulu Budyari Gumal / The Sydney Partnership for Health, Research, Education & Enterprise: ELDOH Clinical Academic Group Seed Grant, 2017-18 2018-19.

Acknowledgements. The authors acknowledge SUCCEED’s other founding members Ann Dadich and Kady Moraby, and appreciate the contribution from the mothers whose stories are shared in this paper.

For citation: Hopwood N., Elliot C., Pointon K. Changing the World for Children with Complex Feeding Difficulties: Cultural-Historical Analyses of Transformative Agency. Kul'turno-istoricheskaya psikhologiya = Cultural-Historical Psychology, 2021. Vol. 17, no. 2, pp. 155–166. DOI: 10.17759/chp.2021170215.


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Information About the Authors

Nick Hopwood, Doctor of Medicine, MD Honoris Causa in Medicine, Associate Professor at the School of International Studies and Education, University of Technology Sydney, affiliated as Extraordinary Professor at the Department of Curriculum Studies, University of Stellenbosch, Stellenbosch, South Africa, Australia, ORCID:, e-mail:

Chris Elliot, dual Fellow of the Royal Australasian College of Physicians (General Paediatrics and Community Child Health), Consultant Paediatrician St George Hospital, Sydney, Conjoint Lecturer at University of New South Wales Australia. Also affiliated as Honorary Consultant in Community Child Health at Sydney Children’s Hospital Randwick, Australia, e-mail:

Keren Pointon, Australia, e-mail:



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