Feeding Skill and Behavior Changes in Children With Complex Feeding Disorders Following Therapy in an Intensive Multidisciplinary Feeding Program

Abstract

Purpose: This study aims to measure and describe changes in oral feeding skills and mealtime behaviors observed in children with complex feeding disorders and/or feeding tube dependence after participation in an intensive multidisciplinary feeding program. This is the first study to use a standardized tool to report feeding outcomes after patients received intensive feeding therapy using a combination of therapeutic strategies. Method: This was a prospective observational study examining the treatment outcomes of 34 patients (range: 13 months to 6.5 years) admitted into the Intensive Multidisciplinary Feeding Program using the Pediatric Eating Assessment Tool (PediEAT). Eighteen patients were tube dependent; 16 patients were oral feeders. All patients received 19 days of intensive feeding intervention. The PediEAT was completed by patient's caregiver at admission and discharge from the feeding program. Caregiver and patient demographics were also collected. Results: Statistical analysis of scores at admission (prescore) and at discharge (postscore) revealed significant improvements in PediEAT total scores and across all subscales for all patients. The largest degree of change was noted in the Problematic Mealtime Behaviors subscale. Patients who were oral feeders also demonstrated significant improvements in the Oral Processing subscale in addition to Problematic Mealtime Behaviors subscale. Tube-dependent patients presented with a large degree of change in the Selective Restrictive Eating subscale and in the Problematic Mealtime Behaviors subscale. Conclusions: This study demonstrates that the use of an individualized approach using a combination of therapeutic strategies results in statistically significant improvements in multiple feeding domains as measured by a validated tool after participating in an intensive multidisciplinary feeding program. Improvement in a child's ability to manage advanced textures and consistencies can have a significant impact on their willingness to engage in mealtimes. It is important to measure and report on their skills, in addition to behavioral responses and intake.