What We Treat

The Multidisciplinary Feeding Program is designed for children with chronic and severe disruptions in their relationship with food. Many children with feeding disorders struggle to gain weight from eating little or no food during meals or relying on formula by bottle or through a tube. Other children consume enough calories, but will only eat a narrow range of foods. They often reject one or more food groups like fruits and vegetables. Avoiding and/or restricting food intake can negatively affect a child’s physical, social and psychological wellbeing. Common signs and symptoms of a feeding disorder include:

  • Poor weight gain, weight loss or faltering growth
  • Dependence on formula delivered by bottle or feeding tube
  • Frequent mealtime tantrums
  • Refusing to eat
  • Distress and anxiety when trying new foods that interferes with social functioning
  • Inability to tolerate different textures
  • Extreme food selectivity or pickiness (eating fewer than 12 foods, rejecting one or more food group)
  • Significant nutritional deficiency

Children who experience this level of feeding difficulty often meet diagnostic criteria for avoidant/restrictive food intake disorder, a type of eating or feeding disturbance frequently treated in our program.

Services We Offer

Our multidisciplinary team includes psychologists, dietitians, physicians, nurse practitioners, speech-language pathologists, occupational therapists and social workers who collaborate to deliver state-of-the-art clinical care.

Specialties

Treatment by our team of specialists includes:

Medicine: Pediatric gastroenterologists and pediatric nurse practitioners assess medical needs to initiate feeding intervention and provide ongoing oversight during intervention.

Nutrition: Dietitians monitor growth and nutritional intake to promote balanced nutrition, appropriate growth and tolerance of new foods.

Skill: Speech-language pathologists and occupational therapists focus on oral sensitivity, building oral-motor coordination (specifically coordination for chewing) and the introduction of new food textures for children with difficulty chewing.

Behavior: Psychologists structure meals to promote intake of new foods and conduct caregiver training to support parents with implementing treatment in the home setting.

Social work: Social workers provide parent support and care coordination to connect families with resources, such as transportation and lodging, and assist with transition planning.

 

Programs

The Multidisciplinary Feeding Program offers many levels of service to address each child’s unique feeding needs.

Assessment clinic: This is where patients will be seen during their first visit to the program. Types of evaluations offered include: 

  • Medical screening: Involves a medical history and physical exam to determine conditions that may contribute to feeding difficulties. Further testing, evaluation or medical referrals may be recommended. 
  • Behavioral evaluation: Involves a detailed clinical interview of past and current feeding behaviors and practices, a formal meal observation with preferred and non-preferred food(s), and makes recommendations for family eating patterns.
  • Nutrition assessment: Involves a clinical interview to review growth trends, current and past food intake, and health history including gastrointestinal concerns, such as gastroesophageal reflux or constipation. The nutrition evaluation also includes detailed analysis of a three-day food intake record.
  • Oral-motor skill assessment: Involves a review of feeding history, current feeding practices, feeding therapies and swallow safety. This assessment also includes conducting a clinical observation of a meal, completing a formal non-nutritive oral-motor evaluation, assessing oral hypersensitivity, and determining oral-motor developmental skill level. Recommendations for improving or enhancing non-nutritive and nutritive oral-motor skill, appropriate foods and liquids for safe feeding, seating suggestions, and further medical recommendations, such as a swallow study, are provided.

Outpatient treatment clinics: Medical, psychology, nutrition, and oral-motor services are offered on an outpatient basis with coordination of care from different providers as needed. The outpatient clinic serves children with feeding disorders who can be treated by less intensive therapy (one hour, once a week or with one discipline) or children who graduated from the Day Treatment Program needing additional assistance.

Intensive Day Treatment Program: Patients in this program receive daily therapy. Typical treatment days include four structured meals, during which implementation is overseen by the multidisciplinary team. During the intervention, patients receive ongoing medical monitoring and a physical examination. In addition, families are provided with weekly nutritional consultation, individual oral motor/sensory therapy and parental support and counseling. 

Outcomes and Patient Successes

Our program sees more than 1,000 patients each year. Program highlights and successes include:

  • 85% or more of goals set by parents and the treatment team are reached at the completion of the Day Treatment Program.
  • Parents gave high ratings for program satisfaction (4.9 out of 5), program effectiveness (4.3 out of 5) and treatment acceptability (4.6 out of 5).
  • Patients eat an average of only three foods upon admission, but they leave eating 19 foods, including at least four fruits, four vegetables, four starches and four proteins.
  • More than half of new patients have feeding tubes, and 70% of those patients are completely tube-dependent. By discharge, 80% of patients need the feeding tube for less than half of their calories.
  • On average, tube feedings are reduced from 92 percent of a patient’s daily calories upon admission to 36 percent by completion of the Day Treatment Program.

Meet the Team

Leadership team

  • William Sharp, PhD, Director, Multidisciplinary Feeding Program
  • Barbara McElhanon, MD, Medical Director, Multidisciplinary Feeding Program
  • Kathryn Stubbs, PhD, Psychology Manager, Center for Advanced Pediatrics
  • Valerie Volkert, PhD, Psychology Manager, Marcus Autism Center
  • Rashelle Berry, MPH, MS, RD, LD, Nutrition Program Manager
  • Michelle Cole-Clark, MEd, CCC/SLP, Oral-Motor Skill Clinical Supervisor

Medicine

Behavior

Nutrition

  • Rashelle Berry, MPH, MS, RD, LD
  • Nikki Smith, MS, RD
  • Kelsey Smith, MS, RD
  • Caitlin Waddle, MS, RDN
  • Lydia White, MS, RDN, CNSC, LD

Skill

  • Michele Cole Clark, MEd, CCC/SLP
  • Paige Roberts, OTR/L
  • Reianna Cotton-Carr, CCC/SLP

Care coordination

  • Katrice Crank, MS

Locations

Comprehensive Multidisciplinary Clinics:

Satellite Services:

Outpatient behavioral psychology and nutrition services available at locations throughout metro Atlanta. Contact us for details. 

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