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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Outcome of intensive oral motor and behavioural interventions for feeding difficulties in three children with
E P Clawson1, K S Palinski, C A Elliott
1Children's Hospital, Richmond, VA, USA. bclawson@chva.org
Insights
This study shows that a combined oral motor and behavioral feeding program significantly improved eating abilities in children with Goldenhar Syndrome, reducing tube feeding dependence and enhancing nutrition.
Area of Science:
- Pediatric Gastroenterology
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Goldenhar Syndrome frequently causes facial anomalies and surgical needs, often resulting in significant feeding difficulties for affected children.
- Many children with Goldenhar Syndrome require tube feeding due to these complex feeding challenges.
Observation:
- A day patient pediatric feeding program was implemented for three children with Goldenhar Syndrome, all initially dependent on tube feedings.
- The program involved intensive daily therapeutic sessions including oral motor interventions, behavioral techniques, and structured meals over an average of 8 weeks.
Findings:
- Significant improvements were observed: food/drink acceptance increased from 52% to 88.7%, expels decreased from 30% to 14%, and mouth cleaning improved from 9.3% to 97%.
- Inappropriate feeding behaviors reduced from 83% to 27.3%, and oral intake per meal increased dramatically from 3.4g to 105.4g.
- Two out of three children were successfully weaned off tube feeding by the program's end.
Implications:
- Combined oral motor and behavioral interventions are effective for treating feeding problems in children with Goldenhar Syndrome.
- This approach can help children with Goldenhar Syndrome achieve oral feeding, improving their nutritional status and overall quality of life.
Objective:
The facial anomalies and surgeries associated with Goldenhar Syndrome often lead to feeding problems. The purpose of this study was to demonstrate the outcome of Goldenhar Syndrome children admitted to the day patient paediatric feeding programme.
Subjects:
Three children with Goldenhar Syndrome and feeding difficulties participated, mean age 3 years. Average length of stay was 8 weeks. Upon admission all were dependent on tube feedings.
Methods:
The children received four therapeutic sessions daily. The sessions included oral motor interventions, behavioural techniques and a structured meal. Data regarding children's feeding were collected at admission and discharge.
Results:
The patients had 52% acceptance of food/drink at admission and 88.7% at discharge. Expels were 30% at admission and 14% at discharge. Mouth clean was 9.3% at admission and 97% at discharge. Total inappropriate feeding behaviours averaged 83% at admission and 27.3% at discharge. Children averaged 3.4 g per meal at admission and 105.4 g at discharge. Two children were completely weaned from tube feedings by discharge.
Conclusions:
Results support the hypothesis that combining oral motor and behavioural interventions offer effective treatment for children with Goldenhar Syndrome. Many children with Goldenhar Syndrome are reliant on tube feedings and this regimen allows them to eat orally, thereby improving their nutrition and quality of life.
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