Behavioral Management of Feeding Disorders of Childhood

Abstract

Feeding disorders, characterized by suboptimal intake and/or lack of age-appropriate eating habits, are common and may be seen in up to 45% of children. Feeding disorders are a significant concern to both the affected families and to the providers who treat them. Fortunately, there are well-established behavioral treatments which have been shown to be highly efficacious. This article provides an overview of behavioral assessment and treatment of pediatric feeding disorders, provides guidance in treatment planning, and provides information which may be useful in considering if additional psychological consultation may be beneficial.

Feeding disorders in children: modern approaches to diagnosis and management

“…Сенсорная интеграция, или десенситизация, заключается в постепенном введении новых текстур и видов пищи [37]. При поведенческой терапии используются различные техники для восстановления приемлемости пищи и нивелирования дезадаптивного отказа от еды [37,38]. Две наиболее полезные поведенческие техники -постепенная замена любимого продукта нелюбимой пищей со сходными характеристиками и постепенное изменение объема или консистенции предлагаемой пищи [37,39].…”

“…Дети со сниженным аппетитом редко проявляют интерес к еде, быстро насыщаются [40] и обычно употребляют недостаточное количество пищи для поддержания нормального роста и развития [8,38]. Низкий аппетит встречается реже, чем избирательность в пище и составляет около 25% от нарушений пищевого поведения, наблюдаемых на амбулаторном приеме [15].…”

Infant Feeding and Clinical Problems

“…Although various treatment approaches for feeding disorders have been reported, evidence of the efficacy of these treatments is limited due to a lack of any systematic evaluation of specific and clearly described interventions (Hay et al 2014). Behavioral management (e.g., stable nutrition intake and regular mealtimes, without distractions, such as television or cell phone, with a pleasant neutral attitude during mealtime), parental psychoeducation to correctly recognize the infant's cues during mealtime, parent-infant interactive guidance aimed at improving the caregiver's feeding styles (e.g., controlling, indulgent, or neglectful) are the most commonly described approaches which can be applied to feeding disorders in infants (Chatoor 2009;Kerzner et al 2015;Luiselli 2000;Silverman 2015). In addition, several methods of intervention that address tactile sensitivity and support the infant's need to have a sense of control with attention to appropriate nutrition in infancy have been reported (Angell 2010).…”

Evaluación Y Manejo De Dificultades De Succión-Deglución en Recién Nacidos Y Lactantes Sin Compromiso Neuromuscular

“…Puede provocar compromiso nutricional. La dificultad alimentaria, puede desarrollarse de manera primaria o puede instalarse asociada al uso exclusivo y prolongado de alguna vía alternativa de alimentación (15).…”