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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Intensive Multidisciplinary Intervention for Young Children with Feeding Tube Dependence and Chronic Food Refusal: An
William G Sharp1, Valerie M Volkert1, Kathryn H Stubbs2
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Children's Healthcare of Atlanta, Atlanta, GA.
Insights
This study shows intensive multidisciplinary intervention effectively improves oral intake and reduces feeding tube dependence in young children with chronic food refusal. Many children achieved full tube weaning post-intervention.
Area of Science:
- Pediatric Gastroenterology
- Developmental Pediatrics
- Behavioral Therapy
Background:
- Chronic food refusal and feeding tube dependence significantly impact young children's development and quality of life.
- Multidisciplinary interventions are crucial for addressing complex pediatric feeding disorders.
Purpose of the Study:
- To evaluate the effectiveness of an intensive multidisciplinary intervention for children with chronic food refusal and feeding tube dependence.
- To assess changes in oral intake, anthropometric measures, and tube feeding weaning rates.
Main Methods:
- Retrospective study of 81 children (birth to 21 years) undergoing a 5-year intensive intervention program.
- Intervention combined behavioral therapy, parent training, nutrition, oral-motor therapy, and medical oversight.
- Data collected on oral intake, weight, and tube feeding status pre- and post-intervention and at follow-up.
Main Results:
- Oral intake improved by 70.5% at discharge, with 33% of patients fully weaned from tube feeding.
- Weight gain was observed (mean 0.39 kg).
- At follow-up, 72% of patients were successfully weaned from tube feeding.
Conclusions:
- The intensive multidisciplinary intervention model is effective in enhancing oral intake and reducing tube feeding reliance in children with chronic food refusal.
- Further research is needed to explore the generalizability of this approach to diverse feeding/eating disorder subtypes and treatment settings.
Objective:
To assess characteristics and outcomes of young children receiving intensive multidisciplinary intervention for chronic food refusal and feeding tube dependence.
Study Design:
We conducted a retrospective study of consecutive patients (birth to age 21 years) admitted to an intensive multidisciplinary intervention program over a 5-year period (June 2014-June 2019). Inclusion criteria required dependence on enteral feeding, inadequate oral intake, and medical stability to permit tube weaning. Treatment combined behavioral intervention and parent training with nutrition therapy, oral-motor therapy, and medical oversight. Data extraction followed a systematic protocol; outcomes included anthropometric measures, changes in oral intake, and percentage of patients fully weaned from tube feeding.
Results:
Of 229 patients admitted during the 5-year period, 83 met the entry criteria; 81 completed intervention (98%) and provided outcome data (46 males, 35 females; age range, 10-230 months). All patients had complex medical, behavioral, and/or developmental histories with longstanding feeding problems (median duration, 33 months). At discharge, oral intake improved by 70.5%, and 27 patients (33%) completely weaned from tube feeding. Weight gain (mean, 0.39 ± 1 kg) was observed. Treatment gains continued following discharge, with 58 patients (72%) weaned from tube feeding at follow-up.
Conclusions:
Our findings support the effectiveness of our intensive multidisciplinary intervention model in promoting oral intake and reducing dependence on tube feeding in young children with chronic food refusal. Further research on the generalizability of this intensive multidisciplinary intervention approach to other specialized treatment settings and/or feeding/eating disorder subtypes is warranted.
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