Behavioral conceptualization, assessment, and treatment of pediatric feeding disorders

Families of children with feeding disorders frequently present to primary care settings. Although providers are often knowledgeable about medical and developmental etiologies, behavioral etiologies may go unidentified and untreated. In this article, the authors review a biobehavioral approach for the assessment and treatment of feeding disorders. First, factors that affect the development of feeding behaviors are described including sensitive developmental periods for acquiring feeding skills and the effects of interpersonal relationships on feeding. Second, behavioral assessment and conceptualization strategies are discussed including the use of feeding questionnaires, caregiver interviews, and the use of feeding observations. Third, behavioral treatment strategies are described including the uses of feeding structure, manipulation of hunger, contingency management, shaping, and parent training. Finally, consideration of various behavioral treatment options are considered including the integration of psychology as part of an interdisciplinary team and the use of intensive behavioral treatment protocols that include inpatient behavioral programs.