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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Feeding disorders in preschoolers: a short-term outcome study in an Italian Family Care Program
Sandra Maestro1, Olivia Curzio2, Sara Calderoni1,3
1Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128, Calambrone, Italy.
Insights
Two-thirds of preschoolers with feeding disorders (FD) resolved their condition within six months of multidisciplinary treatment. Emotional and relational issues were linked to FD resolution in children.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Developmental Pediatrics
Background:
- Feeding disorders (FD) in preschoolers present a significant clinical challenge.
- Early identification and intervention are crucial for managing pediatric feeding issues.
- Understanding the factors influencing treatment outcomes is essential for improving care.
Purpose of the Study:
- To describe a cohort of preschoolers with feeding disorders (FD).
- To evaluate the short-term clinical outcomes of multidisciplinary treatment for FD over six months.
- To identify factors associated with FD resolution in young children.
Main Methods:
- An inception cohort study with a longitudinal observational design was employed.
- 42 preschoolers with FD were assessed using DC-0-3R criteria.
- A multidisciplinary treatment approach was offered, with 62% of families agreeing to participate; outcomes were compared between treated and untreated groups over six months.
Main Results:
- Two-thirds (66.7%) of children with FD achieved resolution within six months.
- Specific FD subtypes, like Feeding Disorder of Caregiver-Infant Reciprocity, were associated with higher resolution rates.
- Factors such as "Anxious-Depressed" mood, and "Isolation" problems were linked to a greater probability of FD resolution.
Conclusions:
- Preschool feeding disorders are often intertwined with emotional development and parent-child relationship dynamics.
- Persistent FD can exacerbate emotional and relational difficulties in young children.
- Further research is recommended to explore the underlying factors maintaining feeding disorders in preschoolers.
Purpose:
To provide a description about a cohort of preschoolers with feeding disorders (FD) recruited from the therapeutic nursery "Cerco Asilo" of a tertiary care University Hospital, and to evaluate the short-term clinical outcome after 6 months of multidisciplinary treatment.
Methods:
The present inception cohort study was based on an observational longitudinal research design comparing families who underwent the multidisciplinary treatment and those who did not. 42 children (47.6% female; 52.4% males-mean age 36.7 months, SD 17.2, range 2.3-65 months) underwent FD assessment according to the DC-0-3R diagnostic criteria (T0). At the end of the assessment, 62% of families with FD children agreed to be included in the family-based treatment. Both treated and untreated children with FD underwent a follow-up clinical evaluation after 6 months (T1) from baseline. Comparison of clinical features at T0 between groups of subjects resolving or not the FD was performed. To evaluate baseline factors associated with FD resolution, principal components analysis (PCA) was used to identify new synthetic variables that were then used in a logistics analysis. Moreover, clinical differences between T1 and T0 were compared with a t test.
Results:
Two third of the cases (66.7%) resolved the FD, while one third (33.3%) did not. Children who had the FD resolved displayed at T0 significant differences in clinical features with respect to those who did not. Specifically, the FD subtype Feeding Disorder of Caregiver-Infant Reciprocity was strongly associated with resolution, while the subtype Infantile Anorexia was not. In addition, the component depicting "Anxious-Depressed", "Mood" and "Isolation" problems was independently associated with a significantly higher probability of resolution, similar to children having FD other than anorexia.
Conclusions:
FD in preschoolers are associated with problems in emotional development and in the relationship with parents. These difficulties tend to accentuate if the disorder persists. The study suggests the need to investigate the maintaining factors of FD in preschool age.
Level Of Evidence:
Level IV: Evidence obtained from multiple time series with and without the intervention.
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