Posted by: Indonesian Children | August 28, 2009

Classifying Complex Pediatric Feeding Disorders

Classifying Complex Pediatric Feeding Disorders

Burklow, Kathleen A.; Phelps, Anne N.; Schultz, Janet R.; McConnell, Keith; Rudolph, Colin

Journal of Pediatric Gastroenterology & Nutrition:
August 1998 – Volume 27 – Issue 2 – pp 143-147
Original Articles

Abstract

Background: This study defines the multiple characteristics associated with complex pediatric feeding problems and determines the relative frequency of each classification in a population referred to an interdisciplinary feeding team.

Methods: The written reports from team evaluations on 103 children (64 males, 39 females; age range 4 months to 17 years) were reviewed. Prematurity and/or presence of developmental delay was coded. Identified factors related to current feeding problems were coded according to five categories: structural abnormalities, neurological conditions, behavioral issues, cardiorespiratory problems, metabolic dysfunction.

Cited Here… Interrater reliability for the classification coding was 88%. Thirty-eight percent of the children had a history of prematurity and 74% were reported to have evidence of developmental delay. The following five categories or combinations were coded most frequently: structural-neurological-behavioral(30%), neurological-behavioral (27%), behavioral (12%), structural-behavioral(9%), and structural-neurological (8%). Overall, behavioral issues were coded more often (85%) than neurological conditions (73%), structural abnormalities(57%), cardiorespiratory problems (7%), or metabolic dysfunction (5%).

Conclusions: Data analysis using this classification system revealed that the majority of children in this sample had a behavioral component to their complex feeding problem, regardless of concurrent physical factors. These findings suggest that complex pediatric feeding problems are biobehavioral conditions in which biological and behavioral aspects mutually interact, and both need to be addressed to achieve normal feeding.

REFERENCES

1. Rudolph C. Feeding disorders in infants and children.J Pediatr 1994;125:116-24.
2. Stevenson RD. Feeding and nutrition in children with developmental disabilities. Pediatr Ann 1995;24(5):255-60.
3. Beautrais AL, Fergusson DM, Shannon FT. Family life events and behavioral problems in preschool-aged children.Pediatrics 1982;70:774-9.
4. Forsyth BW, Leventhal JM, McCarthy PJ. Mothers’ perceptions of feeding and crying behaviors. Am J Dis Child 1985;139:269-72.
5. Linscheid T. Eating problems in children. In: Walker CE, Roberts MC, editors. Handbook of Clinical Child Psychology. New York: John Wiley & Sons, 1992;451-73.
6. Palmer S, Horn S. Feeding problems in children. In: Palmer S, Ekvall S, eds. Pediatric Nutrition in Developmental Disorders. Springfield, IL: Thomas, 1978:95-100.
7. Perske R, Clifton A, McClean BM, Stein JI, eds.Mealtimes for Severely and Profoundly Handicapped Persons: New Concepts and Attitudes. Baltimore: University Park Press, 1977.
8. Palmer S, Thompson RJ, Linscheid TR. Applied behavior analysis in the treatment of childhood feeding problems. Dev Med Child Neurol 1975;17:333-9.
9. Woolston JL. Eating and Growth Disorders in Infants and Children. Dev Clin Psychol Psychiatry 1991;24:1-85.
10. Frank DA, Zeisel SA. Failure to thrive. Pediatr Clin North Am 1988;35:1187-206.
11. Babbitt RL, Hoch TA, Coe DA, et al. Behavioral assessment and treatment of pediatric feeding disorders: A review and program description. J Dev Behav Pediatr 1994;15:278-91.
12. Budd KS, McGraw TE, Farbisz R, et al. Psychosocial concomitants of children’s feeding disorders. J Pediatr Psychol 1992;17:81-94.
13. Iwata BA, Riordan MM, Wohl MG, Finney JW. Pediatric feeding disorders. Behavioral analysis and treatment. In: Accardo PJ, ed.Failure to Thrive in Infants and Early Childhood: A Multidisciplinary Team Approach. Baltimore: University Park Press, 1982:297-325.
14. Bithoney WG, Dubowitz H. Organic concomitants of nonorganic failure to thrive: Implications for research. In: Drotar D, ed.New directions in failure to thrive: Implications for research and practice. New York: Plenum, 1985:47-68.
15. Linscheid TR, Budd KS, Rasnake LK. Pediatric feeding disorders. In: Roberts MC, ed. Handbook of Pediatric Psychology. 2nd ed. New York: Guilford Press, 1995:501-15.
16. Homer C, Ludwig S. Categorization of etiology of failure to thrive. Am J Dis Child 1981;135:848-51.
17. Woolston JL. Eating disorders in infancy and early childhood. J Am Acad Child Psychiatry 1983;22:114-21.
18. Woolston JL, Forsyth B. Obesity of infancy and early childhood: a diagnostic schema. In: Lahey BB, Kazdin AE, eds. Advances in Clinical Child Psychology. New York: Plenum, 1989;12:179-92.
19. Willbarger P, Willbarger JL. Sensory Defensiveness in Children Aged 2-12: An Intervention Guide for Parents and Other Caretakers. Santa Barbara, CA: Avanti Educational Programs, 1991:1-21.
20. Wolf L, Glass R. Feeding and Swallowing Disorders in Infancy. Tucson, Arizona: Therapy Skill Builders 1992:1-475.
21. Agras WS, Berkowitz RI, Hammer LC, Kraemer HC. Relationships between the eating behaviors of parents and their 18-month old children: A laboratory study. J Eating Disorders 1988;7:461-8.
22. Chatoor I, Conley C, Dickson L. Food refusal after an incident of choking: A posttraumatic eating disorder. J Am Acad Child Adolesc Psychiatry 1988;27(1):105-10.
23. Drotar D, Eckerle D. The family environment in nonorganic failure to thrive. J Pediatr Psychol 1989;14:245-57.
24. Ginsberg A. Feeding disorders in the developmentally disabled population. In: Russo DC, Kedesdy JH, eds. Behavioral Medicine With The Developmentally Disabled. New York: Plenum Press, 1988:21-41.
25. Illingworth R, Lister J. The critical or sensitive period with reference to certain feeding problems in infants and children.J Pediatr 1964;65:839-848.
26. Pugliese MT, Weyman-Daum M, Moses N, Lifshitz F. Parental health beliefs as a cause of nonorganic failure to thrive. Pediatrics 1987;80:175-82.
27. Sanders MR, Patel RK, LeGrice B, Shepherd RW. Children with persistent feeding difficulties: An observational analysis of the feeding interactions of problem and nonproblem eaters. Health Psychol 1993;12:64-73.
28. Singer L. When a sick child won’t-or can’t-eat.Contemp Pediatr 1990:60-76.
29. SAS/STAT User’s Guide. Cary, NC: SAS Institute, Inc. Ver. 6, vol. 1, 1990.
30. O’Brien S, Repp AC, Williams GE, Christophersen ER. Pediatric feeding disorders. Behav Modif 1991;15:394-418.
Keywords:

Biobehavioral; Interdisciplinary team; Pediatric feeding disorders

 

Supported by

PICKY EATERS CLINIC

KLINIK KHUSUS KESULITAN MAKAN PADA ANAK

JL TAMAN BENDUNGAN ASAHAN 5 JAKARTA PUSAT, JAKARTA INDONESIA 10210

PHONE :62 (021) 70081995 – 5703646

Email : judarwanto@gmail.com

https://mypickyeaters.wordpress.com/

 

Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com,

 

Copyright © 2009, Picky Eaters Clinic Information Education Network. All rights reserved.


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