Psychological Treatment for Pediatric Feeding Disorder (PFD) and Avoidant/Restrictive Food Intake Disorder (ARFID)

To produce a consensus statement on the psychological treatment of feeding/eating aversions seen in pediatric feeding disorder (PFD) and avoidant/restrictive food intake disorder (ARFID), diagnoses that share common symptoms and psychological mechanisms but have historically been addressed separately in the literature.

To help bridge the gaps between ARFID and PFD treatment and research, we convened a group of experts to clarify and describe the psychological interventions for treating learned food avoidance. The current manuscript summarizes the conclusions of the meeting.

The primary outcome of the consensus process was a description of a common core approach to psychological intervention across the two fields: Exposure to food and the feeding/eating experience with the goal of increasing the volume and variety of food and fluid consumed. Although our consensus process identified some differences in the mode of delivery and incorporation of specific treatment elements, the consensus panel agreed that these differences are related to three primary factors: the severity of clinical impairment, age and developmental status of the patient, and the specific feeding and eating behaviors targeted, rather than to the ARFID/PFD diagnostic distinction.

Building on the consensus statement, we discuss other considerations in preparing for and delivering exposure-based treatment, including multidisciplinary assessment, readiness for treatment, and systemic factors that influence access and engagement.