ATLANTA (June 26, 2020) – Without access to effective treatment, children who continually refuse to eat may experience growth delays, decreased cognitive ability and compromised immune function. To help overcome these medical and developmental complications, William Sharp, PhD, Psychologist and Director of the Multidisciplinary Feeding Program at Children’s Healthcare of Atlanta, recently completed a five-year retrospective analysis of an intensive multidisciplinary intervention for children with Avoidant-Restrictive Food Intake Disorder (ARFID). After this intervention, seven in 10 patients no longer needed a feeding tube.
“This model represents one of the first standardized approaches to treatment that may be replicated to allow children greater access to evidenced-based feeding intervention,” said Dr. Sharp, who also serves as Associate Professor for the Emory University School of Medicine Department of Pediatrics.
ARFID is a feeding disorder complicated by medical, developmental, behavioral and oral-motor skill concerns. Child temperament, pain or discomfort with feeding, negative experiences with feeding or negative experiences related to the mouth may all contribute to the development of a feeding disorder. ARFID affects about 5% of children in the US, but few clinics specialize in its treatment.
“The lack of intervention guidelines outlining the steps and procedures involved in advancing oral intake represents a major hurdle for opening more clinics to treat this pediatric population,” said Dr. Sharp. “Treatment manuals represent an important and necessary prerequisite to replicate and evaluate treatment access settings.”
Developed over the past 12 years, the Feeding Program’s intensive multidisciplinary treatment model combines daily behavioral intervention and parent training with nutrition therapy, oral-motor therapy and medical oversight. The retrospective study evaluating the program, “Intensive Multidisciplinary Intervention for Young Children with Feeding Tube Dependence and Chronic Food Refusal: An Electronic Health Record Review,” was published in the Journal of Pediatrics. The analysis included 81 patients ages 10 months to 19 years who relied exclusively on a feeding tube for most nutrition and whose previous treatments were unsuccessful. They received four meals per day over five days a week for two months or more. At discharge, their oral nutrition intake increased by 70% and food refusal decreased 68%. At follow up, 72% of patients were completely weaned from their feeding tube.
“This level of daily service combined with our treatment methodology allows for an accelerated rate of recovery,” said Dr. Sharp. “Now, we aim to package the intervention model and test it on a larger scale in new treatment settings.”
Based on the success of the model, the Feeding Program is increasing access to care at Children’s to meet a significant unmet need in Georgia. In addition to its location at the Marcus Autism Center, the program has increased capacity by more than 200% after expanding to offer services at the Children’s Healthcare of Atlanta Center for Advanced Pediatrics.