Intensive Multidisciplinary Intervention for Young Children with Feeding Tube Dependence and Chronic Food Refusal: An Electronic Health Record Review

Sharp, William G.; Volkert, Valerie M.; Stubbs, Kathryn H.; Berry, Rashelle C.; Clark, Michele Cole; Bettermann, Erika; Luevano, Carla; McElhanon, Barbara O.; Scahill, Lawrence

doi:10.1016/j.jpeds.2020.04.034

Cited by 36 publications

(36 citation statements)

References 16 publications

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“…Also studies from child and adolescent eating disorder programs, which are inherently female-based, found higher rates of males in patients with ARFID than in patients with anorexia nervosa (Fisher et al, 2014; Forman et al, 2014; Nicely, Lane-Loney, Masciulli, Hollenbeak, & Ornstein, 2014; Norris et al, 2014). Some studies of children referred to hospital-based pediatric feeding disorder programs even found boys to be in the majority (Sharp et al, 2020; Williams et al, 2015). The relatively much higher proportion of males in ARFID as compared with anorexia nervosa might be explained by two reasons.…”

Section: Discussionmentioning

confidence: 99%

Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children

Dinkler

Yasumitsu‐Lovell

Eitoku

et al. 2021

Preprint

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The prevalence of Avoidant/Restrictive Food Intake Disorder (ARFID) in the general child population is still largely unknown and validated screening instruments are lacking. The aims of this study were to investigate the prevalence of children screening positive for ARFID in a Japanese birth cohort using a newly developed parent-reported screening tool, and to provide preliminary evidence for the validity of the new screening tool. Data were collected from 3,728 4-7-year-old children born in Kochi prefecture (response rate was 56.5%), Japan, between 2011 and 2014; a sub-sample of the Japan Environment and Children's Study (JECS). Parents completed a questionnaire including the ARFID screener and several other measures to assess convergent validity. The point prevalence of children screening positive for ARFID was 1.3%; half of them met criteria for ARFID based on psychosocial impairment alone, while the other half met diagnostic criteria relating to physical impairment (and additional psychosocial impairment in many cases). Sensory sensitivity to food characteristics (63%) and/or lack of interest in eating (51%) were the most prevalent drivers of food avoidance. Children screening positive for ARFID were lighter in weight and shorter in height, they showed more problem behaviors related to mealtimes and nutritional intake, and they were more often selective eaters and more responsive to satiety, providing preliminary support for the validity of the new screening tool. This is the largest screening study to date of ARFID in children up to 7 years. Future studies should examine the diagnostic validity of the new ARFID screener using clinically ascertained cases. Further research on ARFID prevalence in the general population is needed.

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Section: Discussionmentioning

confidence: 99%

Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children

Dinkler

Yasumitsu‐Lovell

Eitoku

et al. 2021

Preprint

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“…14 A systematic review of these practices found an average 70% success rate for a full wean from enteral feeding and a 74% increase in oral consumption of foods. 8 Early intervention and increase of oral food consumption can help prevent or reduce the negative impacts of poor nutrition on childhood growth and development, and therefore should be a high priority for pediatricians working with children with 3q29Del.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, 3q29Del is comorbid with several other neurodevelopmental and medical disorders which are associated with pediatric feeding concerns, including intellectual disability, developmental delay, and various gastrointestinal conditions. 5,6,7,8 More information is needed on the prevalence of pediatric feeding concerns within specific subgroups and how they relate to the greater 3q29Del population.…”

Section: Future Directionsmentioning

confidence: 99%

“…12,13 Indeed, it is well-established that there is a higher incidence of feeding disorders among individuals with ASD and GDD, as well as children with predisposing medical conditions (e.g., congenital or acquired respiratory, cardiac, and gastrointestinal [GI] problems). 5,6,7,8 Children with ARFID and food selectivity most often present with comorbid developmental conditions including ASD and/or DD; 7,11 children with ARFID and formula or feeding tube dependence most often present with complex medical histories. 8,12…”

Section: Introductionmentioning

confidence: 99%

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Symptoms of pediatric feeding disorders among individuals with 3q29 deletion syndrome

Wawrzonek

Burrell

Sharp

et al. 2020

Preprint

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Objective: To evaluate symptoms of pediatric feeding disorders in a sample of individuals with 3q29 Deletion Syndrome. Previous research has found that individuals with 3q29 deletion syndrome (3q29Del) may experience elevated feeding concerns in early childhood; however, the specificity of these feeding concerns in this pediatric population is not well understood. Methods: We compared individuals with 3q29Del (n = 60) to matched controls (n = 59) using an 11-item survey that assessed commonly reported symptoms associated with pediatric feeding disorders. An exploratory analysis also examined individuals with 3q29Del with and without a comorbid autism spectrum disorder (ASD) diagnosis. Results: Caregivers of 3q29Del cases reported higher incidences of feeding concerns on all 11 items included in the survey. This included statistically significant differences in food refusal behaviors, rejection of one or more food group, and a history of failure to thrive. Parents of children with comorbid autism were more likely to report concerns regarding rejection of one or more food group compared to children with 3q29Del without autism. Conclusions: Results suggest individuals with 3q29Del experience increased symptoms of pediatric feeding disorders. Future research should include a more thorough multidisciplinary evaluation to further document the severity and identify optimal remediation strategies.

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“…Relatedly, the timing of transition from an nasogastric tube to a gastrostomy is variable, as is guidance on when is optimal to do so 32 . Evidence of what constitutes high‐quality care across the tube‐feeding lifecycle is urgently needed, recognising the importance of multidisciplinary and interdisciplinary approaches that actively include parents and caregivers as experts in the lived experience of caring for children who tube feed 28,41 …”

Section: Prioritiesmentioning

confidence: 99%

Paediatric tube‐feeding: An agenda for care improvement and research

Hopwood

Moraby

Gowans

et al. 2020

J Paediatrics Child Health

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This article presents an agenda to improve the care and wellbeing of children with paediatric feeding disorder who require tube feeding (PFD‐T). PFD‐T requires urgent attention in practice and research. Priorities include: routine collection of PFD‐T data in health‐care records; addressing the tube‐feeding lifecycle; and reducing the severity and duration of disruption caused by PFD‐T where possible. This work should be underpinned by principles of involving, respecting and connecting families.

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Intensive Multidisciplinary Intervention for Young Children with Feeding Tube Dependence and Chronic Food Refusal: An Electronic Health Record Review

Cited by 36 publications

References 16 publications

Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children

Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children

Symptoms of pediatric feeding disorders among individuals with 3q29 deletion syndrome

Paediatric tube‐feeding: An agenda for care improvement and research

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