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| Treatment of Pediatric Feeding Disorders: Outcome Measures of Different Programs Around the Country |
| Sunday, May 25, 2008 |
| 9:00 AM–10:20 AM |
| Boulevard A |
| Area: CBM/DDA; Domain: Applied Research |
| Chair: Meeta R. Patel (Clinic 4 Kidz) |
| Discussant: William H. Ahearn (The New England Center for Children) |
| CE Instructor: Meeta R. Patel, Ph.D. |
| Abstract: The purpose of this symposium is to present data from three pediatirc feeding disorders programs. The data will be presented from two hospital-based programs and one home-based program. Data will be presented by the Kennedy Krieger Institute, St. Joseph's Childrens Hospital, and Clinic 4 Kidz. All three programs will discuss their assessment and treatment methods and present data on their outcome measures. |
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| Outcomes of Tube Dependent Children in Kennedy Krieger Institute’s Pediatric Feeding Disorders Program from 2001-2006. |
| RINITA B. LAUD (Louisiana State University/Kennedy Krieger Institute), Charles S. Gulotta (Kennedy Krieger Institute), Peter Girolami (Kennedy Krieger Institute), Danielle N. Dolezal (Kennedy Krieger Institute/Johns Hopkins University School of Medicine), James H. Boscoe (Kennedy Krieger Institute), Elizabeth A. Masler (Kennedy Krieger Institute), Ping Wang (Kennedy Krieger Institute), R. Meredith Elkins (Kennedy Krieger Institute) |
| Abstract: The Kennedy Krieger Institute’s (KKI) Pediatric Feeding Disorders Program (PFDP) was one of the first interdisciplinary programs established to assess and treat pediatric feeding disorders. For children admitted to this program, the etiology of food refusal behaviors varies from behavioral mismanagement to food refusal that is associated with multiple physiological disorders. In the most severe cases, chronic food refusal leads to a dependence on gastrostomy tube feedings in order to sustain a child’s caloric needs. A typical admission to KKI includes comprehensive evaluation and treatment by a team of specialists from various disciplines including a gastroenterologist, behavioral specialist, nutritionist, occupational/speech therapist, and a social worker. Goals for behavioral interventions have included decreasing tube dependence, increasing food and liquid consumption, decreasing food selectivity by texture or type, decreasing inappropriate mealtime behaviors and training parents to maintain the gains made in the program. The purpose of this study is to describe the outcomes of a five-year sample (N=144) of tube dependent children receiving intensive treatment in KKI’s inpatient and day treatment feeding program. Outcomes examined include change in percent tube dependence, weight status, oral intake and mealtime behavior. Additionally, percent of goals met, parent satisfaction ratings, and follow up data are also described. |
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| The Center for Pediatric Feeding and Swallowing Disorders at St. Joseph’s Children’s Hospital: Assessment, Treatment and Outcomes. |
| MERRILL J. BERKOWITZ (St. Joseph's Regional Medical Center), Peggy S. Eicher (St. Joseph's Regional Medical Center) |
| Abstract: The Center for Pediatric Feeding and Swallowing Disorders at St. Joseph’s Children’s Hospital has been providing services to children exhibiting feeding difficulties for the past 7 years. Several disciplines, including behavior analysis, make up the multidisciplinary team providing these services. Several assessment and treatment strategies have been developed in the area of behavior analysis to specifically address pediatric feeding problems (e.g., Piazza et al., 2003). The current presentation will provide information regarding the demographics of the patients seen at the center and their presenting feeding problems and medical diagnoses. Levels of service, common assessment methods and treatment procedures will be also discussed. Outcome measures will be provided for both levels of service. In addition, the center’s current and future research interests will be provided. |
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| Treatment of Pediatric Feeding Disorders: Outcome Measures for an Intensive Home-Based Program. |
| JENNIFER LEIGH KING (Clinic 4 Kidz), Meeta R. Patel (Clinic 4 Kidz), Angela Pruett (Clinic 4 Kidz) |
| Abstract: Pediatric feeding disorders are common in children with autism and other disabilities and may also be evident in typically developing children with a variety of medical issues (e.g., gastroesophageal reflux, food allergies etc.). Some children may be at risk for weight loss and may eventually be placed on gastrostomy (G-) feedings while others may not have advanced with regards to variety and textures of food. Since there are a variety of problems displayed by children with pediatric feeding disorders, it is ideal that treatment be provided by a team of professionals (i.e., pediatric gastroenterologist, occupational/speech therapist, nutritionist, social worker and/or behavior analyst). Typically these services are provided in a clinic/hospital environment; however, more recently a similar model has been used in the home environment. The purpose of this presentation is to give the audience an overview of how intensive treatment can be initiated for children with pediatric feeding disorders in the home environment using an interdisciplinary model. Data will be presented for at least 45 patients who were admitted to the Clinic 4 Kidz Pediatric Feeding Disorders Program. Results indicate that this type of intensive home-based program is effective at decreasing tube dependency, increasing oral intake, increasing variety of foods consumed, and decreasing refusal behaviors in a short period of time. The advantages and disadvantages of a home-based program to treat feeding problems will be discussed. In addition, the need for more published outcome measures will also be discussed as it relates to medical insurance reimbursement. |
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