Chapter 6 - Treatment of Feeding Disorders in Children

Abstract

This chapter focuses on nonorganic and combined organic and nonorganic failure to thrive (FTT) and their diagnosis and treatment. Because assessing and treating the child with failure to thrive is so complex, a multidisciplinary team is needed, consisting of a physician; a mental health professional such as a child psychiatrist, clinical psychologist, or social worker; a speech and language therapist; a nutritionist or pediatric nurse; and an occupational therapist. Infants should receive a comprehensive set of assessments in order to delineate the nature of the child's feeding disorder. Close collaboration between members of the team is essential in order to ensure that the evaluation and treatment process does not fragment treatment services or further disrupt a family under extreme stress. In addition, a primary pediatrician must be involved to monitor weight gain and address any medical complications that may arise. An initial intake interview should be conducted by a mental health professional to identify parental concerns, obtain a complete medical and family history, and document previous treatment approaches. The child's second and third visits should consist of a developmental assessment and feeding observation that includes developmental, sensory, motor, oral–motor, feeding, and language functions. In developing a treatment approach for children with failure to thrive, it is important to identify the emotional conflicts that may be contributing to the feeding disorder. The evaluation process should be followed by a parent conference to discuss the team findings, recommendations for treatment, and setting of goals with the family.