Evidence-Based Feeding Intervention Improves Outcomes

Evidence-Based Feeding Intervention Improves Outcomes

After participating in this multidisciplinary treatment model, 7 in 10 patients no longer needed a feeding tube.

Without access to effective treatment, children who are food avoidant may experience growth delays, decreased cognitive ability and compromised immune function. To help overcome these medical and developmental complications, William Sharp, Ph.D., a psychologist and director of the Multidisciplinary Feeding Program at Children’s Healthcare of Atlanta, recently completed a five-year retrospective analysis of an intensive multidisciplinary intervention for children with avoidant-restrictive food intake disorder (ARFID). After this intervention, 7 in 10 patients no longer needed a feeding tube.

“This model represents one of the first standardized approaches to treatment that may be replicated to allow children greater access to evidenced-based feeding intervention,” says Sharp, who also serves as an associate professor in the Emory University School of Medicine Department of Pediatrics.

ARFID is a feeding disorder complicated by medical, developmental, behavioral and oral-motor skill concerns. Child temperament, pain or discomfort with feeding, negative experiences with feeding or negative experiences related to the mouth may all contribute to the development of a feeding disorder. ARFID affects about 5% of children in the U.S., but few clinics specialize in its treatment.

“The lack of intervention guidelines outlining the steps and procedures involved in advancing oral intake represents a major hurdle for opening more clinics to treat this pediatric population,” Sharp says. “Treatment manuals represent an important and necessary prerequisite to replicate and evaluate treatment access settings.”

Developed over the past 12 years, the Multidisciplinary Feeding Program’s intensive treatment model combines daily behavioral intervention and parent training with nutrition therapy, oral-motor therapy and medical oversight.

The retrospective study evaluating the program, “Intensive Multidisciplinary Intervention for Young Children With Feeding Tube Dependence and Chronic Food Refusal: An Electronic Health Record Review,” was published in the Journal of Pediatrics. The analysis included 81 patients ages 10 months to 19 years who relied exclusively on a feeding tube for most nutrition and whose previous treatments were unsuccessful. They received four meals each day over five days a week for two months or more. At discharge, their oral nutrition intake increased by 70% and food refusal decreased by 68%. At follow-up appointments, 72% of patients were completely weaned from their feeding tube.

“This level of daily service combined with our treatment methodology allows for an accelerated rate of recovery,” Sharp says. “Now, we aim to package the intervention model and test it on a larger scale in new treatment settings.”

This article was originally produced and published by Children's Healthcare of Atlanta.

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