Pediatric Feeding Disorders

Abstract

Feeding problems occur in children who have normal development, who have failure to thrive, and who have developmental disabilities. This article focuses on the latter two groups. The characteristics and developmental concerns include family characteristics, parent-child interactions, cognitive development, and oral-motor development. The evaluation process for children with feeding problems should include an interdisciplinary approach with a medical, nutritional, occupational therapy, and behavioral evaluation. The behavioral treatments include the Premack principle, time-out plus reinforcement, and negative reinforcement. Future research should focus on the parent-child interaction process in both mealtime and nonmealtime situations, along with demonstrating parents' and teachers' ability to implement mealtime treatment protocols.

Psychological Treatment of Food Refusal in Young Children

“…The standard behavioural management techniques include modelling, shaping, reinforcement, extinction and time out (Babbitt et al, 1994;O'Brien et al, 1991;Siegel, 1988). Their use within the area of management of feeding problems requires sensitive and creative use together with additional therapeutic techniques.…”

A Practical Approach to Classifying and Managing Feeding Difficulties

“…[5][6][7] Classifications of these disorders dating back to the 1980s tend to reflect the discipline of the authors and often lack an agreedupon nomenclature. [8][9][10][11] Those from the pediatric medical community generally focus on well-defined organic conditions, but do not emphasize a systematic approach to behavioral issues. 8,9 Classifications from the psychiatric field 12 focus more on behavioral problems, whose diagnostic labels are necessarily "constructs," (ie, models devised on the basis of clinical observation, subject to variability, but nonetheless affording opportunity to institute appropriate therapy).…”

Behavioral Management of Feeding Disorders of Childhood

“…Families should avoid offering a strongly preferred activity after the meal without a clear exit criterion [10] as this may result in a child attempting to hasten the meal resulting in poor intake. Exit criterions make use of the Premack principle [39] in which individuals will perform less desirable activities to earn a more desirable activity (e.g. after you have eaten your vegetables, we will go to the park).…”