Children who are GT dependent can be weaned off GT feedings during a 3-week admission using a multidisciplinary feeding model. The therapeutic gains were maintained at 1 year postdischarge.

Summary The present paper describes the successful implementation of a training programme for the parents of a child with moderate learning difficulties presenting with chronic food refusal and provides an example of how professionals can work with families to manage clinical problems in the home. The parents were taught to use the Premack principle to motivate their child in the consumption of previously refused foods. A multiple baseline design across three foods demonstrated the efficacy of the programme and the dietary changes were maintained at the 3‐month follow‐up.

Maintaining therapeutic programmes for people with learning disabilities over long periods of time presents a major challenge to care systems as the limited and slow pace of client behavioural change is often insufficient to sustain staff behaviour. In this study, a 17-year-old young man with profound learning difficulties was successfully supported on a toilet training programme for more than 2 1 2 years. In spite of early setbacks and only limited behavioural change the staff team persisted with the programme. Four factors were identified as supporting staff behaviour with the programme: (1) parental involvement, (2) the therapeutic culture and values of the care system, (3) support from external agencies and (4) positive staff feelings towards the client.

The purpose of this longitudinal observational study was to evaluate the effectiveness of a multidisciplinary inpatient treatment model for feeding disorders by analyzing long-term nutritional and health outcomes 12 months following discharge. Fifty patients completed the study. Average caloric intake by mouth as a percentage of goal for gastrostomy tube (GT)-dependent patients (n = 31) increased from pre-admit, week 1, and week 2 of the inpatient program (30%, 70%, and 84%, respectively), and was sustained from week 3 to 12-month follow-up (85% and 86%, respectively). Eighty-one percentage were discharged without GT support and 65% remained off GT support at 12 months. Oral supplement dependence for non-GT patients (n = 19) decreased from pre-admit, discharge, and 12-month follow-up (51%, 31%, and 19% of caloric intake, respectively). BMI z-scores improved during and after treatment. The present study demonstrated an effective approach for treatment of pediatric feeding disorders, including decreased reliance on oral supplementation and GT dependence.