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Parent-Mediated Responsive Feeding Therapy for Tube Weaning in Children with Neurodevelopmental Conditions: A
Wafaa Alduraidi1, Lauren Foster1, Heidi Moreland2
1Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, Kansas, USA.
Insights
Responsive Feeding Therapy (RFT) shows promise for weaning children with neurodevelopmental conditions off gastrostomy (G-tube) dependence. Two of three children achieved full tube weaning, with all showing improved feeding skills and oral-motor abilities.
Area of Science:
- Pediatric Gastroenterology
- Developmental Pediatrics
- Behavioral Therapy
Background:
- Children with neurodevelopmental conditions often exhibit gastrostomy (G-tube) dependence.
- Longstanding G-tube dependence can impede oral feeding skill development.
Purpose of the Study:
- To evaluate the effectiveness of parent-mediated Responsive Feeding Therapy (RFT) in young children with neurodevelopmental conditions and G-tube dependence.
- To compare outcomes across different RFT delivery modalities.
Main Methods:
- A retrospective case series of three children (18-30 months) with complete G-tube dependence (12-24 months).
- Individualized RFT over six months, including intensive caregiver coaching (in-person, virtual, hybrid) and follow-up virtual coaching.
- Outcome measures included tube dependence, feeding behaviors, oral-motor skills, and parental stress.
Main Results:
- Two children with neuromotor conditions achieved complete tube weaning within three months.
- One child with a growth disorder reduced G-tube dependence by 50% and improved feeding skills.
- All participants demonstrated significant oral-motor and behavioral feeding improvements, though parental stress levels increased.
Conclusions:
- Parent-mediated RFT is a promising intervention for G-tube-dependent children with neurodevelopmental conditions.
- In-person and hybrid RFT delivery facilitated complete tube weaning in neuromotor conditions.
- Virtual RFT delivery led to partial weaning and skill acquisition in a child with a growth disorder, highlighting modality-specific outcomes.
Aims:
To compare outcomes of parent-mediated Responsive Feeding Therapy (RFT) in three young children with neurodevelopmental conditions and longstanding gastrostomy tube (G-tube) dependence.
Methods:
This retrospective comparative case series examined three children (aged 18, 21, and 30 months) with complete G-tube dependence (12-24 months duration) and neurodevelopmental diagnoses. Each received individualized RFT over six months, including hunger induction, a 10-day intensive phase with caregiver coaching (3-5 daily sessions) delivered via in-person, virtual, or hybrid modalities, and a follow-up phase consisting of virtual coaching (average 17 sessions). Outcomes included tube dependence, feeding behaviors, oral-motor skills, and parental stress.
Results:
Two children with neuromotor conditions achieved complete tube weaning by three months. One child with a growth disorder reduced tube dependence to 50% while acquiring feeding skills. All children achieved significant oral-motor and behavioral improvements. Parent stress scores were elevated and increased across all cases.
Conclusions:
RFT demonstrates promise for tube-dependent children with neurodevelopmental conditions. Complete weaning was achieved in children with neuromotor disorders through in-person and hybrid delivery, while virtual delivery for a child with a growth disorder resulted in partial weaning. Universal improvements in feeding behaviors were observed; elevated parental stress likely reflects increased responsibility inherent to parent-mediated feeding interventions.
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