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Classifying complex pediatric feeding disorders
K A Burklow1, A N Phelps, J R Schultz
1Division of Psychology, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Insights
Complex pediatric feeding problems often involve behavioral issues, interacting with biological factors. Addressing both is key for successful feeding outcomes in children.
Area of Science:
- Pediatric Medicine
- Developmental Pediatrics
- Behavioral Science
Background:
- Complex pediatric feeding problems present multifaceted challenges.
- Understanding the classification and frequency of these issues is crucial for effective intervention.
Purpose of the Study:
- To define characteristics of complex pediatric feeding problems.
- To determine the relative frequency of classifications in children referred to an interdisciplinary feeding team.
Main Methods:
- Reviewed 103 children's evaluation reports (4 months–17 years).
- Coded factors: prematurity, developmental delay, structural abnormalities, neurological conditions, behavioral issues, cardiorespiratory problems, metabolic dysfunction.
Main Results:
- Behavioral issues were most frequent (85%), followed by neurological (73%) and structural (57%).
- Common combinations included structural-neurological-behavioral (30%) and neurological-behavioral (27%).
- 38% had prematurity history; 74% showed developmental delay.
Conclusions:
- The majority of children had a behavioral component in their feeding problems.
- Complex pediatric feeding issues are biobehavioral, requiring integrated treatment.
- Both biological and behavioral aspects must be addressed for normal feeding.
Background:
This study defines the multiple characteristics associated with complex pediatric feeding problems and determines the relative frequency of each classification in a population referred to an interdisciplinary feeding team.
Methods:
The written reports from team evaluations on 103 children (64 males, 39 females; age range 4 months to 17 years) were reviewed. Prematurity and/or presence of developmental delay was coded. Identified factors related to current feeding problems were coded according to five categories: structural abnormalities, neurological conditions, behavioral issues, cardiorespiratory problems, metabolic dysfunction.
Results:
Interrater reliability for the classification coding was 88%. Thirty-eight percent of the children had a history of pre- maturity and 74% were reported to have evidence of developmental delay. The following five categories or combinations were coded most frequently: structural-neurological-behavioral (30%), neurological-behavioral (27%), behavioral (12%), structural-behavioral (9%), and structural-neurological (8%). Overall, behavioral issues were coded more often (85%) than neurological conditions (73%), structural abnormalities (57%), cardiorespiratory problems (7%), or metabolic dysfunction (5%).
Conclusions:
Data analysis using this classification system revealed that the majority of children in this sample had a behavioral component to their complex feeding problem, regardless of concurrent physical factors. These findings suggest that complex pediatric feeding problems are biobehavioral conditions in which biological and behavioral aspects mutually interact, and both need to be addressed to achieve normal feeding.