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Peskin A, Barth A, Mansoor E, Farias A, Rothenberg WA, Garcia D, Jent J. Impact of parent child interaction therapy on child eating behaviors. Appetite 2024; 200:107544. [PMID: 38850640 DOI: 10.1016/j.appet.2024.107544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/08/2024] [Accepted: 06/04/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Picky eating commonly co-occurs with disruptive behaviors in young children. While feeding interventions exist, it remains unknown whether unmodified behavioral parent training (BPT) improves maladaptive child eating. As coercive feeding practices may exacerbate picky eating, BPT could ameliorate associated behaviors by increasing authoritative parenting. METHODS Caregiver-child dyads (N = 194, ages 2-8) received 18 weeks of Parent-Child Interaction Therapy (PCIT). Caregivers completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) at pre-, mid-, and post-treatment. The BPFAS overall picky eating frequency and number of problems was examined, as well as the subscale of mealtime misbehaviors, and overall caregiver feeding practices. RESULTS From pre-to post-treatment, reductions occurred in frequency/problems scales across overall BPFAS child behaviors. Mealtime misbehaviors significantly declined at all checkpoints - early skill acquisition may drive this early change, whereas changes in frequency/problem scales occurred after mid-treatment, suggesting later skill acquisition may be driving these changes. On the coercive caregiver feeding subscale, multivariate regression identified a significant race by time interaction (p = .02) - multiracial caregivers improved while others showed no difference. CONCLUSION Standard PCIT, not adapted for feeding concerns, decreased maladaptive child eating behaviors across all caregivers and coercive feeding practices in multiracial caregivers. Authoritative parenting principles may generalize to eating contexts for certain cultural groups. PCIT shows promise as an early upstream intervention potentially changing trajectories without needed feeding content modifications. Assessment of long-term maintenance is warranted. Coupling with nutrition education could optimize impact.
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Affiliation(s)
- Abigail Peskin
- University of Miami Miller School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL, 33136, USA.
| | - Alex Barth
- University of California San Diego, USA.
| | - Elana Mansoor
- University of Miami Miller School of Medicine, Mailman Center for Child Development, USA.
| | - Alina Farias
- University of Miami Miller School of Medicine, Mailman Center for Child Development, USA.
| | - W Andrew Rothenberg
- University of Miami Miller School of Medicine, Mailman Center for Child Development, USA.
| | - Dainelys Garcia
- University of Miami Miller School of Medicine, Mailman Center for Child Development, USA.
| | - Jason Jent
- University of Miami Miller School of Medicine, Mailman Center for Child Development, USA.
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Tengilimoglu-Metin MM, Kabasakal-Cetin A. Effect of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school age children. Clin Nutr ESPEN 2024; 61:224-229. [PMID: 38777438 DOI: 10.1016/j.clnesp.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND & AIMS Feeding problems in pre-school children are common and negative maternal feeding practices may even worsen the child's problematic eating behavior. Therefore, investigating the effects of maternal eating behaviors and attitudes towards the feeding process on pre-school children's feeding problems may be helpful for preventing feeding problems. This study sought to investigate the effects of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school children. METHODS Mothers of 373 children aged 3-6 were included in this cross-sectional study and data was collected by an online questionnaire including the scales of three-factor eating questionnaire (TFEQ), mother's attitudes towards the feeding process (MATFPS) and behavioral pediatric feeding assessment (BPFAS), as well as demographics and anthropometric measures (height and weight). Spearman's rho test was used to calculate correlation coefficients between the TFEQ, MATFP and BPFA scales. In order to identify independent predictors of child feeding behaviors, a multiple linear regression model was used. RESULTS Results showed that uncontrolled eating subscale was positively (r = 0.160, p < 0.001) and cognitive restriction subscale negatively (r = -0.126, p < 0.05) correlated with MATFP. MATFP was also positively correlated with BPFA (r = 0.368, p < 0.001). Regression analysis indicated that BPFA was significantly predicted by MATFP which was the most important contributor of child feeding problems (β = 0.24, t = 4.88, p < 0.001). CONCLUSIONS This study indicated that maternal eating behaviors were related to maternal attitudes towards the feeding process and, mothers' attitudes were associated with feeding problems of their pre-school children.
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Affiliation(s)
- M Merve Tengilimoglu-Metin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
| | - Arzu Kabasakal-Cetin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
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Hill SA, Nurmatov U, DunnGalvin A, Reese I, Vieira MC, Rommel N, Dupont C, Venter C, Cianferoni A, Walsh J, Yonamine G, Beauregard A, Meyer R, Vazquez-Ortiz M. Feeding difficulties in children with food allergies: An EAACI Task Force Report. Pediatr Allergy Immunol 2024; 35:e14119. [PMID: 38566436 DOI: 10.1111/pai.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
The term "feeding difficulties" refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age-appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically review all the available literature reporting the prevalence of feeding difficulties within food allergic children. We searched eight international electronic databases for all published studies until June 2022. International experts in the field were also contacted for unpublished and ongoing studies. All publications were screened against pre-defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta-analyses, so narrative synthesis of quantitative data was performed. A total of 2059 abstracts were assessed, out of which 21 underwent full-text screening and 10 studies met the study criteria. In these, 12 different terms to define feeding difficulties and 11 diagnostic tools were used. Five papers included data of feeding difficulty prevalence in children with food allergies, ranging from 13.6% to 40%. Higher prevalence was associated with multiple food allergies. The current literature suggests that feeding difficulties are prevalent within food allergic children, particularly those with multiple food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging. Consensus guidelines for the diagnosis and management of feeding difficulties within food allergic children and further research on the development and perpetuation of feeding difficulties are needed to appropriately manage such patients.
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Affiliation(s)
- Sarah-Anne Hill
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ulugbek Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Audrey DunnGalvin
- NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Mario C Vieira
- Center for Pediatric Gastroenterology, Hospital Pequeno Principe, Curitiba, Brazil
| | - Natalie Rommel
- University Hospital Tübingen, Tübingen, Germany
- Therapiezentrum, University Hospital Tübingen, Tübingen, Germany
| | - Christophe Dupont
- Paris Descartes University, Paris, France
- Clinique Marcel Sembat, Ramsay Group, Boulogne Billancourt, France
| | - Carina Venter
- University of Colorado/Children's Hospital Colorado, Denver, Colorado, USA
| | - Antonella Cianferoni
- Allergy and Immunology Division, Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Glauce Yonamine
- Division of Nutrition, Instituto da Criança e do Adolescente, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Alexia Beauregard
- Faculty, Ellyn Satter Institute, Clinical Dietetics Branch Winn Army Community Hospital, Fort Stewart, Georgia, USA
| | - Rosan Meyer
- Imperial College London, London, UK
- University of Winchester, Winchester, UK
- University of KU Leuven, Leuven, Belgium
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Wan AWL, Chung KKH, Li JB, Xu SS, Chan DKC. An assessment tool for the international healthy eating report card for preschool-aged children: a cross-cultural validation across Australia, Hong Kong, Singapore, and the United States. Front Nutr 2024; 11:1340007. [PMID: 38562489 PMCID: PMC10982429 DOI: 10.3389/fnut.2024.1340007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aimed to develop and validate a globally applicable assessment tool of the 43-item International Healthy Eating Report Card Scale (IHERCS) which was designed to assess preschool-aged children's eating behaviours and family home food environments (FHFEs) across different cultural settings. In particular, we examined the factor structure, internal consistency and measurement invariance of the IHERCS across four cultural samples, including Australia, Hong Kong, Singapore, and the US. Convergent and discriminant validity were then conducted. Methods In this cross-cultural study, a total of 2059 parent-child dyads from these four regions were recruited, and the parents were asked to complete the IHERCS. An exploratory structural equational modelling approach was employed to examine two higher-order factor models of children's eating behaviours and FHFEs in the IHERCS and its cross-cultural measurement invariance. Results The findings demonstrated robust factor structures of the scales of children's eating behaviours and FHFEs in the IHERCS (i.e., CFI and TLI > 0.90; RMSEA and SRMR < 0.08) and an acceptable level of internal consistency (i.e., Cronbach's α = 0.55-0.84). Full configural invariance and metric invariance were established across the four cultural contexts, but full scalar invariance was not achieved. Partial scalar invariance was found only in the scale of FHFEs. The convergent validity and discriminant validity were supported. Conclusion Overall, the current findings provided preliminary support for the construct validity and measurement invariance of the IHERCS. It provides a reliable, valid and comprehensive assessment of eating behaviours and FHFEs among children in different cultural settings.
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Affiliation(s)
| | | | | | | | - Derwin King Chung Chan
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
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Kemer SN, Serel-Arslan S. A comparative analysis of oropharyngeal functions in preterm and term children with cerebral palsy. Early Hum Dev 2024; 190:105964. [PMID: 38325005 DOI: 10.1016/j.earlhumdev.2024.105964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
This study aims to compare term and preterm children with Cerebral Palsy (CP) in terms of their oropharyngeal functions. A total of 50 children with CP participated in the study, and were divided into two groups according to their birth history including preterm group (gestational age below 37 weeks; 60 % female; mean age = 6.86 ± 4.35 years) and term group (gestational age between 37 and 41 weeks; 60 % female; mean age = 6.48 ± 4.86 years). Chewing and swallowing functions were evaluated in terms of oropharyngeal functions. Chewing evaluation was performed by using the Karaduman Chewing Performance Scale (KCPS) and the Turkish version of the Mastication Observation and Evaluation Instrument (T-MOE). The pediatric version of the Eating Assessment Tool (PEDI-EAT-10) was used to evaluate swallowing performance of children. In addition, the Behavioral Pediatric Feeding Assessment Scale (BPFAS) was used to assess feeding behaviors of children. There were significant differences between groups in terms of KCPS (p = 0.03), T-MOE (p = 0.01), and PEDI-EAT-10 scores (p = 0.04). There was a significant difference between groups in terms of the parental frequency score from the BPFAS (p = 0.04). Oropharyngeal functions of preterm children with CP were more adversely affected than term children with CP. Clinicians working with children with CP should be aware of the risks of preterm birth on oropharyngeal functions, and take precautions for oropharyngeal dysfunction in the early period in preterm children with CP.
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Affiliation(s)
- Seda Nur Kemer
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkiye; Ondokuz Mayıs University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Samsun, Turkiye.
| | - Selen Serel-Arslan
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkiye
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Kefford J, Marshall J, Packer RL, Ward EC. Feeding Characteristics in Children With Food Allergies: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:132-148. [PMID: 38040005 DOI: 10.1044/2023_jslhr-23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Food allergy (FA) affects approximately 8% of children and may be immunoglobulin E (IgE)-mediated or non-IgE-mediated. It is recognized clinically that children with both subtypes of FA may present with features of pediatric feeding disorder (PFD); however, there is currently a limited detail of presenting characteristics. OBJECTIVE The objective of this study was to synthesize the current evidence regarding the feeding characteristics of children with FA, with a focus on the feeding skills and psychosocial domains of PFD. METHOD This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Papers published between 2001 and 2022 describing feeding characteristics in the feeding skills and psychosocial domains in children with FA/history of FA were included. Papers that focused solely on characteristics from the medical or nutritional domains were excluded. Descriptive information regarding demographics, methodology, allergy profile and history, and the characteristics of PFD observed was extracted using a preconceived data extraction form. RESULTS Overall, 40 papers contained descriptions of feeding characteristics of children with non-IgE-mediated FA (n = 22) and IgE-mediated FA (n = 11), while four were nonspecific. In the psychosocial domain, food refusal/aversion, anxiety with eating, and poor intake were the most frequently reported, regardless of FA subtype. Less information was reported regarding feeding skills, although slowness in eating, immature diet, and delays in oral sensory-motor skills were described. CONCLUSIONS Children with FA/history of FA may present with a range of characteristics that map across the feeding skill and psychosocial domains of PFD. Systematic research is needed to fully describe the feeding characteristics of children with FA. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24562732.
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Affiliation(s)
- Jennifer Kefford
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Northern Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Jeanne Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia
| | - Rebecca L Packer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Queensland, Australia
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Özen G, Güneş B, Yalçın S, Yalçın SS. Mother-child pairs' eating and feeding behaviours in two different nutritional status from two distinct provinces. BMC Pediatr 2024; 24:25. [PMID: 38191315 PMCID: PMC10773149 DOI: 10.1186/s12887-023-04481-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Nutrition plays a crucial role for the bio-psycho-social growth and development of children. Mother-child pairs' eating-feeding problems can be hypothesized to relate to the child's nutritional status and living area. Our focus was to assess maternal attitudes and children's eating habits in thin and normal-weight children across two cities characterized by distinct socioeconomic and demographic profiles: Ankara and Şanlıurfa. This double case-control study included the mothers whose children are aged between 2 and 7 years old in both cities. Figure Rating Scale, Child Feeding Questionnaire and Behavioral Pediatrics Feeding Assessment Scale were filled by mothers of children. The mothers of thin children were concerned more about the weight of their children, felt more responsible for feeding their children, and use of pressured them to eat more frequently compared to normal-weight children's mothers in both cities. In Ankara, the duration of breastfeeding is longer, using formula is rarer and starting complementary food on time is more common, mother had higher scores on perceived responsibility, perceived child weight, and concern about child weight subscales; lower score on the restriction subscale compared to Şanlıurfa. Mothers of both thin and normal weight children in Şanlıurfa rated their children as weaker compared to those in Ankara. In conclusion, child eating behaviors and parental feeding practices were associated with the weight of children depending on demographic and sociocultural differences. Implementing customized, location-specific preventive educational initiatives on child feeding will not only foster behavioral changes but also yield valuable insights for shaping future interventions.
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Affiliation(s)
- Gülsüm Özen
- Ankara Ataturk Sanatoryum Training and Research Hospital, Keçioren, Ankara, Turkey
| | - Bülent Güneş
- Child Health and Disease Service, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Suzan Yalçın
- Department of Food Hygiene and Technology, Selcuk University Faculty of Veterinary Medicine, Konya, Turkey
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Gent V, Marshall J, Weir KA, Trembath D. Investigating the impact of autistic children's feeding difficulties on caregivers. Child Care Health Dev 2024; 50:e13218. [PMID: 38265139 DOI: 10.1111/cch.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 01/25/2024]
Abstract
AIM The aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver-reported impact at mealtimes. BACKGROUND Caregivers of children (5-12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2-short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver-reported impact of feeding difficulties (Feeding-Swallowing Impact Survey, FS-IS). RESULTS Seventy-eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver-reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS-IS; U = 257.000, z = -4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS-IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver-reported impact with a moderate effect size (r = 0.49). CONCLUSION Autistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families.
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Affiliation(s)
| | - Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly A Weir
- The Royal Children's Hospital Parkville, Melbourne, Australia
- School of Health Sciences, The University of Melbourne, Parkville, Melbourne, Australia
- School of Health Sciences & Social Work, Griffith University, Southport, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
- CliniKids, Telethon Kids Institute, Subiaco, Australia
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Page SD, Souders MC, Aryal S, Pinto-Martin JA, Deatrick JA. A Comparison of Family Management Between Families of Children With Autism Spectrum Disorder and Families of Children With Down Syndrome. J Pediatr Health Care 2024; 38:61-73. [PMID: 37725028 DOI: 10.1016/j.pedhc.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION This cross-sectional study aimed to (1) compare family management between families of children with autism spectrum disorder (ASD) or Down syndrome and (2) evaluate the contribution of the child (ASD behaviors, feeding difficulties, sleep disturbances), caregiver (mental health) and family (social support) factors to the caregiver's perceived condition management ability and effort. METHOD Eighty-five caregivers (56 ASD, 29 Down syndrome) completed quantitative instruments online. Data analysis included independent samples t-tests and multiple linear regression. RESULTS There were no significant differences in the dimensions of family management between groups. More ASD behaviors were associated with lower condition management ability and higher condition management effort. Lower perceived social support and higher caregiver age were associated with lower condition management ability. DISCUSSION Integrating care into family life may be more challenging when the child has more social differences and behavioral rigidity. Nursing care should include an assessment of family social support.
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Willmott E, Dickinson R, Hall C, Sadikovic K, Wadhera E, Micali N, Trompeter N, Jewell T. A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder (ARFID). Int J Eat Disord 2024; 57:27-61. [PMID: 37876356 DOI: 10.1002/eat.24073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This scoping review identifies and describes psychological interventions for avoidant restrictive food intake disorder (ARFID) and summarizes how outcomes are measured across such interventions. METHOD Five databases (Cochrane, Embase, Medline, PsycInfo, Web of Science) were searched up to December 22, 2022. Studies were included if they reported on psychological interventions for ARFID. Studies were excluded if participants did not have an ARFID diagnosis and if psychological interventions were not delivered or detailed. RESULTS Fifty studies met inclusion criteria; almost half were single-case study designs (23 studies) and most studies reported on psychological interventions for children and adolescents with ARFID (42 studies). Behavioral interventions (16 studies), cognitive-behavioral therapy (10 studies), and family therapy (5 studies), or combinations of these therapeutic approaches (19 studies) were delivered to support patients with ARFID. Many studies lacked validated measures, with outcomes most commonly assessed via physical health metrics such as weight. DISCUSSION This review provides a comprehensive summary of psychological interventions for ARFID since its introduction to the DSM-5. Across a range of psychological interventions and modalities for ARFID, there were common treatment components such as food exposure, psychoeducation, anxiety management, and family involvement. Currently, studies reporting on psychological interventions for ARFID are characterized by small samples and high levels of heterogeneity, including in how outcomes are measured. Based on reviewed studies, we outline suggestions for clinical practice and future research. PUBLIC SIGNIFICANCE Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance or restriction of food due to fear, sensory sensitivities, and/or a lack of interest in food. We reviewed the literature on psychological interventions for ARFID and the outcomes used to measure change. Several psychological interventions have been developed and applied to patients with ARFID. Outcome measurement varies widely and requires further development and greater consensus.
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Affiliation(s)
- Emma Willmott
- Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Rachel Dickinson
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Celine Hall
- Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Kevser Sadikovic
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Emily Wadhera
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services of the Capital Region of Denmark, Eating Disorders Research Unit, Ballerup Psychiatric Centre, Copenhagen, Denmark
| | - Nora Trompeter
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | - Tom Jewell
- Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Hines M, Martens A, Zimmerman E. Infant Bottle-Feeding: A Prospective Study of Infant Physiology and Parental Report Metrics. Compr Child Adolesc Nurs 2023; 46:309-319. [PMID: 37498287 PMCID: PMC10592442 DOI: 10.1080/24694193.2023.2232457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/24/2023] [Indexed: 07/28/2023]
Abstract
The aim of this study was to examine associations between parent reports of bottle-feeding behaviors and infant non-nutritive suck (NNS) on a pacifier as well as oral feeding skills during bottle-feeding. A prospective study was conducted. Full-term infants with no prior diagnosed feeding disorders were recruited at 3-months. Parents reported their infant's bottle-feeding behaviors using the Neonatal Eating Assessment Tool-Bottle-Feeding (NeoEAT-Bottle-Feeding), consisting of five domains: Infant Regulation, Energy and Physiologic Stability, Gastrointestinal Tract Function, Sensory Responsiveness, and Compelling Symptoms of Problematic Feeding. Infant NNS was measured using a custom pacifier, pressure transducer device, which yields the following NNS variables: duration (sec), frequency (Hz), amplitude (cmH20), cycles per burst, cycle amount, and burst amount. The Oral Feeding Skills (OFS) scale was used to measure the initial volume, transfer volume, proficiency, and rate of milk transfer during bottle feeding. Fifty-two infants (58% male) with reported prior bottle experience completed this study. NeoEAT-Bottle-Feeding Total score was significantly positively associated with NNS burst duration and NNS cycles per burst. The NeoEAT-Bottle-Feeding Energy and Physiologic Stability domain was significantly positively correlated with NNS cycles per burst. NeoEAT-Bottle-Feeding Gastrointestinal Tract Function domain score was significantly positively correlated with NNS duration, amplitude, and cycles per burst. There were no significant associations between NeoEAT-Bottle-Feeding domains and the OFS scale. The findings demonstrate that parent reports of problematic feeding at 3 months of age are associated with aspects of infant NNS physiology and not with oral feeding metrics during bottle-feeding. Parent reports of bottle-feeding behaviors, particularly pertaining to gastrointestinal issues, were associated with aspects of infant NNS. These data together will allow for a more nuanced understanding of infant feeding and will be beneficial in determining if infants have a feeding delay.
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Affiliation(s)
- Morgan Hines
- Speech and Neurodevelopment lab, Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Avenue, Boston, MA 02115
| | - Alaina Martens
- Speech and Neurodevelopment lab, Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Avenue, Boston, MA 02115
| | - Emily Zimmerman
- Speech and Neurodevelopment lab, Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Avenue, Boston, MA 02115
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Manikandan B, Gloria J K, Samuel R, Russell PSS. Feeding Difficulties Among Children With Special Needs: A Cross-Sectional Study From India. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:592-599. [PMID: 36377204 DOI: 10.1177/15394492221130971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Deficits in feeding can lead to impairments in occupational performance for children with special needs. This correlational study assessed the relationship between oromotor deficits, behavior problems related to feeding, and caregiver perception of the behavior in children with special needs. We included children with neurodevelopmental disorders (n=79), between 2 and 12 years of chronological age, and their caregivers. Those fulfilling the selection criteria were administered the Behavioral Pediatric Feeding Assessment Scale (BPFAS) and Schedule for Oromotor Assessment (SOMA). More than half the sample had skill deficits and behavioral problems related to feeding. There was a statistically significant correlation of oromotor deficits with specific food consistencies and feeding-related behavior problems. Children with special needs have impaired participation in feeding. Deficits at the body system level are associated with parental and cultural factors, which would have to be mitigated to optimize performance.
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Affiliation(s)
| | | | - Reema Samuel
- Christian Medical College, Vellore, Tamil Nadu, India
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Kuschner ES, Sivathasan S, McQueen E, Berry RC, Pulver SL, Sharp WG, Klaiman C. Screening for Caregiver-Reported Feeding Concerns in Children with Autism Spectrum Disorder in a Tertiary-Care Clinic. J Dev Behav Pediatr 2023; 44:e559-e565. [PMID: 37590189 DOI: 10.1097/dbp.0000000000001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 06/12/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Feeding concerns, primarily food selectivity, are commonly observed in children with autism spectrum disorder (ASD). Prevalence rates suggest that at least half of autistic youth have feeding difficulties. METHODS A retrospective chart review examining records of a large cohort of autistic children (N = 746) referred for ASD evaluation was conducted. Families completed a survey regarding feeding concerns in their children before a diagnostic evaluation. RESULTS Post hoc analyses based on retrospective chart review revealed approximately 30% of caregivers reported significant difficulty feeding their child. Young age, food selectivity, and concerns about weight were associated with increased likelihood of reported feeding difficulties. There was clear overlap between overall feeding difficulties and specific food selectivity; however, 1 in 5 children whose caregivers did not report feeding difficulties endorsed food selectivity. CONCLUSION Findings highlight the need for multipronged approaches to screening to facilitate service prioritization by pediatric providers.
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Affiliation(s)
- Emily S Kuschner
- Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shalini Sivathasan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emma McQueen
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Rashelle C Berry
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
| | - Stormi L Pulver
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - William G Sharp
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Cheryl Klaiman
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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Serel-Arslan S, Elmalı Y, Harmancı Ö, Yılmaz AY. Screening of Swallowing and Feeding-Related Problems in Typically Developing Children. Clin Pediatr (Phila) 2023; 62:1209-1216. [PMID: 36797975 DOI: 10.1177/00099228231154137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The aim of this study was to define swallowing and feeding-related problems among typically developing children aged between 2 and 6 years. The presence of food selectivity, limited appetite, chewing dysfunction, and dysphagia signs was questioned and scored as "absent" or "present" according to parent report. Children were divided into 2 groups: children with swallowing and feeding disorders and children without swallowing and feeding disorders. The Turkish version of the Behavioral Pediatrics Feeding Assessment Scale (T-BPFAS) was used to evaluate feeding behaviors of children, and Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) was used to measure the impact on caregivers. A total of 234 children were included. Food selectivity was defined in 62.4% (n = 146), limited appetite in 26.9% (n = 63), and chewing dysfunction in 7.3% (n = 17). The most common dysphagia-related sign was coughing. There were significant differences between groups in terms of both T-BPFAS and T-FS-IS (P < .001). In conclusion, children with typical development have experienced a wide range of swallowing and feeding-related problems, which have an impact on mothers' perceptions regarding feeding and their quality of life.
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Affiliation(s)
- Selen Serel-Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yağmur Elmalı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özden Harmancı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Abdullah Yiğit Yılmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Memiç İnan C, Özfer Özçelik A. Nutritional Status and Feeding Problems in Pediatric Specific Learning Disability. Clin Pediatr (Phila) 2023; 62:981-990. [PMID: 36609156 DOI: 10.1177/00099228221148601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This cross-sectional study aims to determine the feeding problems and nutritional status of children diagnosed with specific learning disability (SLD), which is one of the neurodevelopmental disorders. Sociodemographic information, anthropometric measurements, and food consumption records of 76 children (38 boys and 38 girls) diagnosed with SLD were obtained by applying a questionnaire. The Behavioral Pediatrics Feeding Assessment Scale was used to determine the feeding problems of children. About 31.6% of children with SLD are overweight and obese. Feeding behavioral problems were found in 39.5% of the children with SLD. Binary logistic regression analysis showed a significantly higher frequency of feeding behavior problems in children with SLD: (1) lower body mass index (adjusted odds ratio [AOR]: 0.841, 95% confidence interval [CI]: 0.722-0.979), (2) lower tri-ponderal mass index (AOR: 0.738, 95% CI: 0.585-0.933), (3) lower upper middle arm circumference (AOR: 0.772, 95% CI: 0.649-0.918),and (4) lower triceps skinfold thickness (TSFT) (AOR: 0.890, 95% CI: 0.808-0.980). In this study, feeding behavior problems are common in children diagnosed with SLD. Therefore, identifying feeding behavior problems in children diagnosed with SLD and developing solutions specific to the problem are important for gaining healthy eating habits throughout life.
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Affiliation(s)
- Cansu Memiç İnan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
| | - Ayşe Özfer Özçelik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Craig F, DE Giacomo A, Operto FF, Margari M, Trabacca A, Margari L. Association between feeding/mealtime behavior problems and internalizing/externalizing problems in autism spectrum disorder, other neurodevelopmental disorders and typically developing children. Minerva Pediatr (Torino) 2023; 75:536-543. [PMID: 30761818 DOI: 10.23736/s2724-5276.19.05371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The aim of current study was to examine the nature and prevalence of feeding problems and mealtime behavior problems in children with autism spectrum disorder (ASD) comparing to children with other neurodevelopmental disorders (NNDs) and TD children. We also investigated the impact of intelligence quotient (IQ) and/or emotional and behavioral problems on feeding and mealtime behavior problems. METHODS Participants completed the following tests: Social Communication Questionnaire (SCQ), Child Behavior Checklist (CBCL), Brief Autism Mealtime Behavior Inventory (BAMBI) and Behavioral Pediatric Feeding Assessment Scale (BPFAS). RESULTS Children with ASD showed more feeding and mealtime behavior problems including food refusal (P<0.001, P<0.001) and limited variety of foods (P=0.014; P=0.018) compared with NDDs and TD children. ASD group showed more problems in mealtime behavior (P=0.034) and parent behaviors (P=0.028) compared to TD group. Internalizing (P=0.003) and externalizing (P=0.008) problems were positively related to parent frustration during mealtime in ASD group. CONCLUSIONS These results suggest that routine screening for feeding and mealtime behavior problems among children with ASD is necessary to prevent dietary inadequacies that may be associated with eating habits.
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Affiliation(s)
- Francesco Craig
- Unit for Severe Disabilities in Developmental Age and Young Adults, IRCCS Eugenio Medea, Brindisi, Italy
| | - Andrea DE Giacomo
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesca F Operto
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Mariella Margari
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Trabacca
- Unit for Severe Disabilities in Developmental Age and Young Adults, IRCCS Eugenio Medea, Brindisi, Italy -
| | - Lucia Margari
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
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Marshall J, Gosa MM, Dodrill P. Patient-Reported Outcome Measures That Describe the Feeding Skills Domain for Pediatric Feeding Disorder: A Clinimetric Review. J Pediatr Gastroenterol Nutr 2023; 77:137-145. [PMID: 37084340 DOI: 10.1097/mpg.0000000000003798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
OBJECTIVES Pediatric feeding disorder (PFD) is defined as "impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction." Patient-reported outcome measures (PROMs) are tools that complement clinical assessment, but many have limited clinimetric data. This review aimed to assess PROMs that reported on the feeding skills domain for PFD in children. METHODS A search strategy across 4 databases was conducted (July 2022). PROMs were included in the review if they described elements of the feeding skills domain of PFD, had criterion/norm-referenced data and/or a standardized assessment procedure, description, or scoring system available, and were applicable to children ≥6 months. PROMs were mapped to the PFD diagnostic domains and aspects of the International Classification of Function (ICF) model. Quality assessment was completed using the COnsensus-based Standards to the selection of health Measurement Instruments methodology. RESULTS Overall, 14 PROMs across 22 papers met inclusion criteria. There was variable methodological quality across the tools, with those more recently developed often receiving better scores, particularly where a more rigorous process for tool development and content validity was reported. Most tools captured ICF aspects of impairment (n = 11, eg, biting/chewing) or activity (n = 13, eg, eating a meal), rather than social participation (n = 3, eg, going to a restaurant). CONCLUSIONS Using PROMs with strong content validity, and including some measure of social participation, is recommended as part of an assessment battery for PFD. Consideration of the caregiver/child perspective is an essential component of family-centered care.
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Affiliation(s)
- Jeanne Marshall
- From the Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Memorie M Gosa
- the Department of Communicative Disorders, The University of Alabama, Tuscaloosa, AL
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Rabaey PA, Barlow K, Jama H, Lehr V. Investigation of Assessment Tools in the Area of Pediatric Feeding Evaluation: A Mixed-Methods Study. Am J Occup Ther 2023; 77:7704205110. [PMID: 37498961 DOI: 10.5014/ajot.2023.050040] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
IMPORTANCE The new diagnostic code for pediatric feeding disorder (PFD) in the International Classification of Diseases, 10th edition, Clinical Modification, requires that occupational therapists and speech-language pathologists (SLPs) use valid and reliable assessment tools that capture the complexity of PFD. OBJECTIVE To determine current assessment tools that clinicians are using across the four domains of PFD: (1) medical factors, (2) nutrition factors, (3) feeding skill factors, and (4) psychosocial factors. A secondary objective was to obtain clinicians' perceptions of the assessment tools. DESIGN A mixed-methods study using survey research and focus groups. SETTING Online survey and virtual focus groups. PARTICIPANTS Occupational therapists and SLPs who identified as clinicians who treat PFDs. RESULTS The survey revealed that 65% of the clinicians (N = 445) used a nonstandardized assessment tool across the four domains of PFD. The focus groups (n = 26) revealed four resulting themes that expanded the survey results: (1) no one assessment tool works, (2) clinicians rely on self-created assessments, (3) it takes a team and collaboration, and (4) there are many issues with the current assessment of PFD. CONCLUSIONS AND RELEVANCE This study reveals the need for clinicians working with children with PFD to use feeding assessment tools with sound psychometric properties. The requirement for occupational therapists and SLPs to evaluate and treat dysphagia and disorders of feeding indicates the need to provide entry-level education on reliable and valid assessment tools that thoroughly evaluate all the domains of PFD. What This Article Adds: This article highlights current assessment tools used by occupational therapists and SLPs treating PFD and the need for more standardized procedures and tools to evaluate children across the four domains of PFD.
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Affiliation(s)
- Paula A Rabaey
- Paula A. Rabaey, PhD, MPH, OTR/L, is Associate Professor, Occupational Therapy, University of Minnesota, Minneapolis;
| | - Kate Barlow
- Kate Barlow, OTD, MS, OTR/L, is Associate Professor, Occupational Therapy, American International College, Springfield, MA
| | - Hibak Jama
- Hibak Jama, is Student, St. Catherine University, St. Paul, MN
| | - Victoria Lehr
- Victoria Lehr, OTD, MS, OTR/L, is Occupational Therapist and Vocational Director, Cutchins Programs for Children and Families, Northhampton, MA
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Samuel R, Manikandan B, Russell PSS. Caregiver experiences of feeding children with developmental disabilities: a qualitative study using interpretative phenomenological analysis from India. BMJ Open 2023; 13:e072714. [PMID: 37316309 DOI: 10.1136/bmjopen-2023-072714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE We aimed to explore caregiver experiences of feeding children with developmental disabilities, in the context of it being influenced by biological, personal and social factors. DESIGN This study applied a qualitative study design through focus group discussions (FGDs), using interpretative phenomenological analysis. Data were analysed using thematic content analysis. SETTING This study was conducted at the Child Psychiatry Unit of a tertiary care centre in South India, between March and November 2020. PARTICIPANTS Seventeen mothers of children with developmental disabilities, who provided written informed consent, participated in four FGDs. RESULTS Three over-arching themes were identified. Feeding experience: (a) a tedious, confusing task; (b) disproportionate onus on mothers; (c) influenced by sociocultural norms. CONCLUSION Feeding can be a stressful activity for both caregiver and child, influenced by family structure and sociocultural belief systems. Considering caregivers' emotional status, facilitatory and hindering environmental factors, and actively exploring strategies to promote the generalisation of strategies learnt into real-life outcomes are essential in tailoring deficit-specific feeding interventions.
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Affiliation(s)
- Reema Samuel
- Department of Psychiatry, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Bhuvaneswari Manikandan
- Department of Psychiatry, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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Mokhlesin M, Ebadi A, Yadegari F, Ghoreishi ZS. Translation and Psychometric Properties of the Persian Version of the Feeding/Swallowing Impact Survey in Iranian Mothers. Folia Phoniatr Logop 2023; 76:22-29. [PMID: 37231856 DOI: 10.1159/000531023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Feeding is an interactive process between a child and a caregiver, and its early and chronic problems can affect the stress and quality of life of parents. Since the health and support of caregivers can affect the child's disability and performance, it is important to consider the impact of feeding and swallowing disorders on caregivers. Hence, the present study aimed to translate and investigate the validity and reliability of the Feeding/Swallowing Impact Survey (FS-IS) in Persian. METHODS This methodological study consisted of two phases: translating the test to Persian (P-FS-IS) and evaluating psychometric properties including face and content validity (through experts' opinions and cognitive interviews), construct validity (by known-group validity and exploratory factor analysis), and reliability of the questionnaire (by internal consistency and test-retest reliability). The present study was performed on 97 Iranian mothers of children with cerebral palsy aged 2-18 years with swallowing impairments. RESULTS Exploratory factor analysis rendered two factors with a cumulative variance of 59.71%. When evaluating known-group validity, the questionnaire scores were significantly different across the groups with different severity of the disorder (F(2, 94) = 57.1, p ≤ 0.001). P-FS-IS had a high internal consistency with Cronbach's alpha of 0.95, and there was an appropriate intra-class correlation coefficient of 0.97 for the total questionnaire. CONCLUSION P-FS-IS has good validity and reliability and is a suitable questionnaire for assessing the impact of pediatric feeding and swallowing disorders on Persian language mothers. This scale can be used in research and clinical settings to evaluate and determine therapeutic goals.
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Affiliation(s)
- Maryam Mokhlesin
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran,
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Sadat Ghoreishi
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Clarke E, Pugh G, van den Heuvel E, Winstanley M, Wood AC, Laughton SJ, Lovell AL. Understanding the patient and family experience of nutrition and dietetic support during childhood cancer treatment. Support Care Cancer 2023; 31:326. [PMID: 37154869 PMCID: PMC10167176 DOI: 10.1007/s00520-023-07787-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/27/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE This study aimed to understand the experience of families caring for a child with cancer in New Zealand (NZ) who received nutrition and dietetic support during cancer treatment and their preferences for the delivery, format, and timing of nutrition information. METHODS Childhood cancer patients and their families (N = 21) participated in a mixed-methods study at a specialist paediatric oncology centre in Auckland, NZ. Before the semi-structured interview, participants completed a questionnaire capturing demographic, disease, and treatment characteristics of their child, their nutrition concerns, and their information needs. Quantitative data were described, and qualitative thematic analysis of the semi-structured interviews was performed using NVivo data analysis software. RESULTS Eighty-six percent of participants indicated they had concerns about their child's nutrition during treatment. The most common concerns were anorexia, vomiting, and weight loss. While many were happy with the quality of the nutrition support received, one-third of the patients wanted more support. Four key themes emerged from the interviews: (1) patients experience significant and distressing nutrition challenges; (2) patients and families have mixed perceptions of EN; (3) there are gaps in the current nutrition support system for inpatients; and (4) a desire for more accessible nutrition support. CONCLUSION Childhood cancer patients and families experience significant and distressing nutrition challenges during treatment. Standardising information given to patients and their families may optimise nutrition support for paediatric oncology patients and reduce the discordance between families and health professionals. Future implementation of a nutrition decision aid in this population is warranted.
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Affiliation(s)
- Emma Clarke
- The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Gemma Pugh
- National Child Cancer Network, Te Aho O Te Kahu Cancer Control Agency, Wellington, New Zealand
| | | | - Mark Winstanley
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Andrew C Wood
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Stephen J Laughton
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Amy L Lovell
- The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand.
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Maffei MF, Chenausky KV, Gill SV, Tager-Flusberg H, Green JR. Oromotor skills in autism spectrum disorder: A scoping review. Autism Res 2023; 16:879-917. [PMID: 37010327 PMCID: PMC10365059 DOI: 10.1002/aur.2923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.
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Affiliation(s)
- Marc F. Maffei
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Karen V. Chenausky
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Neurology Department, Harvard Medical School, Boston, Massachusetts, USA
| | - Simone V. Gill
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, Massachusetts, USA
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Speech and Hearing Biosciences and Technology Program, Harvard University, Cambridge, Massachusetts, USA
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Güngör Ş, Büyükavcı MA, Acıpayam C. Effects of parent- and child-related behavioral feeding problems in early childhood on malnutrition. Arch Pediatr 2023; 30:206-211. [PMID: 36925345 DOI: 10.1016/j.arcped.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/18/2022] [Accepted: 11/11/2022] [Indexed: 03/15/2023]
Abstract
OBJECTIVE Children's responses to food and their caregivers during normal developmental periods are known as feeding behavior. For the healthy development of these behaviors, parent and child relationships must also be healthy. Therefore, we aimed to investigate the effect of behavioral feeding problems on primary malnutrition (PM). METHOD The Behavioral Pediatric Nutrition Assessment Scale (BPFAS) was administered to 300 malnourished and 300 control pediatric patients aged from 9 months to 4 years who were referred to our pediatric gastroenterology outpatient clinic. Pre- and posttreatment data were compared between the two groups. RESULTS There was no statistically significant difference between patients with and without malnutrition in terms of gender and age (p = 0.191, p = 0.128, respectively). Total behavioral frequency (TBF) and total behavioral problem (TBP) scores were significantly higher in the malnutrition group (p < 0.001). In the logistic regression analysis of risk factors that may affect malnutrition we found that a total TBF score of ≥85 increases the risk of developing malnutrition 3.731 times, a child TBF score of ≥62 increases it 2.644 times, and a parental TBF score of ≥21 increases it 4.82 times (p < 0.001). When anthropometric measurements and BPFAS scores of 127 PM patients who received behavioral therapy with enteral products and who attended follow-up were compared with their pretreatment data, there was a significant improvement (p < 0.05). CONCLUSION Our study showed that behavioral feeding problems may increase the risk of PM and that behavioral therapy together with enteral products has a positive effect on treatment. Therefore, in addition to nutritional support in patients with PM, offering behavioral feeding therapy to parents will positively affect both the child's physical development and the relationship between the parents and their child.
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Affiliation(s)
- Şükrü Güngör
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, NecipFazıl City Hospital, Kahramanmaras, Turkey; Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Sütçü İmam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Mehmet Akif Büyükavcı
- Department of Developmental Pediatrics, Inonu University, Medical Faculty, Malatya, Turkey.
| | - Can Acıpayam
- Department of Pediatrics, Sütçü İmam University Faculty of Medicine, Kahramanmaras, Turkey
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Esposito M, Mirizzi P, Fadda R, Pirollo C, Ricciardi O, Mazza M, Valenti M. Food Selectivity in Children with Autism: Guidelines for Assessment and Clinical Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065092. [PMID: 36982001 PMCID: PMC10048794 DOI: 10.3390/ijerph20065092] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 02/06/2023] [Indexed: 05/23/2023]
Abstract
Autisms Spectrum Disorders (ASD) are characterized by core symptoms (social communication and restricted and repetitive behaviors) and related comorbidities, including sensory anomalies, feeding issues, and challenging behaviors. Children with ASD experience significantly more feeding problems than their peers. In fact, parents and clinicians have to manage daily the burden of various dysfunctional behaviors of children at mealtimes (food refusal, limited variety of food, single food intake, or liquid diet). These dysfunctional behaviors at mealtime depend on different factors that are either medical/sensorial or behavioral. Consequently, a correct assessment is necessary in order to program an effective clinical intervention. The aim of this study is to provide clinicians with a guideline regarding food selectivity concerning possible explanations of the phenomenon, along with a direct/indirect assessment gathering detailed and useful information about target feeding behaviors. Finally, a description of evidence-based sensorial and behavioral strategies useful also for parent-mediated intervention is reported addressing food selectivity in children with ASD.
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Affiliation(s)
- Marco Esposito
- Autism Research and Treatment Centre Una Breccia Nel Muro, 00168 Rome, Italy
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy
| | - Paolo Mirizzi
- Department of Education, Psychology, Communication, University of Bari, 70121 Bari, Italy
| | - Roberta Fadda
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09100 Cagliari, Italy
| | - Chiara Pirollo
- Autism Research and Treatment Centre Una Breccia Nel Muro, 00168 Rome, Italy
| | - Orlando Ricciardi
- Autism Research and Treatment Centre Una Breccia Nel Muro, 00168 Rome, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy
- Regional Centre for Autism, Abruzzo Region Health System, 67100 L’Aquila, Italy
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25
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Thompson K, Wallisch A, Nowell S, Meredith J, Boyd B. Short report: The role of oral hypersensitivity in feeding behaviors of young autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1157-1162. [PMID: 36840323 PMCID: PMC10101859 DOI: 10.1177/13623613221135091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
LAY ABSTRACT Feeding problems are common among autistic children and are linked to negative health consequences. Therefore, understanding feeding problems and factors that influence these behaviors is important for developing supports for children and families. While certain sensory processing patterns are commonly associated with feeding problems, less is known about the link between sensory processing and feeding behaviors in autism, as well as how parent behaviors and feelings during mealtime differ based on child sensory preferences. This research examined two groups of young autistic children who were reported to be picky eaters by their parents: those with and those without oral hypersensitivity. Children with oral hypersensitivity had more difficulty with food acceptance and their parents reported more negative feelings around feeding their child. However, the two groups of children (oral hypersensitive and not) did not differ in their medical/oral motor symptoms, mealtime behavior, or parent use of strategies at mealtimes. This research supports the need for personalized treatment strategies based on the child's sensory preferences to support both the child and parent in managing mealtimes.
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Affiliation(s)
| | | | - Sallie Nowell
- The University of North Carolina at Chapel Hill, USA
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26
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Gonynor C, Wang C, Tully C, Monaghan M, Streisand R, Hilliard ME. Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes. J Dev Behav Pediatr 2023; 44:e111-e118. [PMID: 36730036 PMCID: PMC9908816 DOI: 10.1097/dbp.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/04/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Managing young children's mealtime concerns can be challenging after type 1 diabetes (T1D) diagnosis because of developmental factors and diabetes management demands. To identify potential intervention targets, we evaluated medical, psychosocial, and demographic factors in relation to parents' engagement in problem mealtime behaviors (e.g., pressure to eat, restriction). METHOD Parents (N = 157) of young children (age 1-6 years) reported on psychosocial variables (parent fear of hypoglycemia, family functioning, parent problem solving, and parents' problem mealtime behavior frequency and perceptions of being problematic) within 2 months after T1D diagnosis. Hierarchical regression analyses examined associations among psychosocial variables, demographics (child sex, parent race/ethnicity), child continuous glucose monitor (CGM) use, and parents' problem mealtime behaviors. RESULTS Parents of children using CGMs reported parents' mealtime behaviors as more problematic than nonusers, but there were no differences for other medical or demographic variables. Models predicting parents' problem mealtime behavior frequency and problem perceptions that included psychosocial variables, demographic variables, and CGM use led to significant R 2 of 0.14 and 0.16, respectively. CGM use and parent problem solving were significantly associated with parent mealtime behaviors being perceived as more problematic. CONCLUSION Shortly after T1D diagnosis in young children, medical and parent psychosocial factors related to how frequently parents engaged in problem mealtime behaviors and the degree to which parents perceived them as problematic. Other factors may further explain the complexities of mealtime management. Considering parents' problem-solving skills and child treatment regimens may help guide interventions targeting mealtime challenges during the new diagnosis period.
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Affiliation(s)
- Caroline Gonynor
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX
- Texas A&M University, College Station, TX
| | - Christine Wang
- Children's National Hospital, Washington, DC; and
- The George Washington University School of Medicine, Washington, DC
| | - Carrie Tully
- Children's National Hospital, Washington, DC; and
- The George Washington University School of Medicine, Washington, DC
| | - Maureen Monaghan
- Children's National Hospital, Washington, DC; and
- The George Washington University School of Medicine, Washington, DC
| | - Randi Streisand
- Children's National Hospital, Washington, DC; and
- The George Washington University School of Medicine, Washington, DC
| | - Marisa E Hilliard
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX
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27
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Assessment of Feeding Behaviors and Parents' Frustrations of Children with Autism Spectrum Disorder in Lebanon: A Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010117. [PMID: 36670667 PMCID: PMC9856887 DOI: 10.3390/children10010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
Children with autism spectrum disorder (ASD) exhibit restrictive and repetitive behaviors that affect their eating habits. The purpose of this study is to identify the behavioral feeding problems and eating habits among ASD children compared to typically developed (TD) children age/gender-matched controls, along with their parents'/caregivers' strategies for dealing with them. It included 43 ASD children and 43 TD children aged two to eleven years. The analysis was performed based on two valid questionnaires: the Behavior Pediatrics Feeding Assessment Scale (BPFA) and "My Child Eating Habits" (MCEH). The BPFA and MCEH scores conceded three manifestations that fall into food selectivity and problematic mealtime behavior in both groups of children. Compared to TD children, children with ASD exhibited higher BPFA scores, which indicated food-related behavioral and skill-based problems (p = 0.004). Children with ASD were less likely to consume fruits, vegetables, and milk than TD children, which may lead to nutritional deficiencies (p = 0.003, p = 0.003, and p = 0.010, respectively). Parents of ASD children were concerned about their behavioral problems and expressed their intention of an early intervention. These findings highlight the importance of nutritional clinical routines that incorporate the evaluation of the nutritional status and feeding behaviors of ASD children.
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28
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Food Fussiness in Children. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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29
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Muldoon DM, Murphy TM, DeBonis DA. "Tan and Crunchy Is Where We Live": An Interpretative Phenomenological Analysis of Caregivers' Perspectives of Pediatric Feeding Disorder in Children With Developmental Disability. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2675-2687. [PMID: 36251871 DOI: 10.1044/2022_ajslp-22-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The purpose of this study was to examine caregivers' perceptions of feeding disorders in their young child who also had a co-occurring developmental disability (DD). METHOD Using interpretative phenomenological analysis, eight caregivers of children with DD and pediatric feeding disorder (PFD) were interviewed. Interviews were recorded, transcribed, and analyzed for the lived experiences of caregivers. Thematic analysis, member checking, and an audit were completed by three researchers. RESULTS Three themes emerged: Parenting Journey, Emotions and Repercussions, and Winging It. Results indicated caregivers struggled to find appropriate professional help, referenced lack of confidence in the professionals designated to help, and were often ambivalent in approach to the PFD. Indications were that parents were frequently retelling past experiences as they presented the narrative of the feeding disorder and, as such, created narratives that became part of their present and the future experiences when feeding their child. CONCLUSIONS Implications for speech-language pathologists are considered. Particularly, interventions that go beyond the immediate environmental variables of the feeding or mealtime environment are considered, including the application of this analysis to necessary psychological flexibility for caregivers of children with PFD.
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Affiliation(s)
- Deirdre M Muldoon
- The College of Saint Rose, Albany, NY
- Albany Medical Center Hospital, NY
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30
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Branjerdporn N, Benfer K, Crawford E, Ziviani J, Boyd RN, Sakzewski L. Efficacy of early interventions with active parent implementation in low-and-Middle income countries for young children with cerebral palsy to improve child development and parent mental health outcomes: a systematic review. Disabil Rehabil 2022; 44:6969-6983. [PMID: 34647839 DOI: 10.1080/09638288.2021.1989063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To determine the efficacy of interventions with active parent implementation for young children with cerebral palsy (CP) to improve child and parent outcomes in low-middle income countries (LMICs). METHODS Five databases were systematically searched. Randomised or comparison studies evaluating interventions with the training of the parent and/or home practice components to implement with their child with CP (<60 months of age) were included. The modified Downs and Black scale assessed methodological quality. Data were pooled to calculate mean differences and 95% confidence intervals (95% CI). RESULTS Searches yielded 189 unique articles. 11 studies from ten papers of moderate to high quality were included. Parent-implemented general developmental interventions had a small negative effect on gross motor function compared to interventionist-implemented therapy. Parent-implemented upper limb training compared to interventionist-implemented neurodevelopmental therapy had a small positive effect on bimanual hand function. Parent-implemented functional feeding training had a large significant effect on chewing function compared to parent-implemented oral motor exercises. Parent-implemented interventions targeting general child development and feeding had mixed effects on parent stress outcomes. CONCLUSIONS Parent-implemented interventions in LMICs are promising to improve child bimanual hand and chewing function. Further research evaluating the efficacy of parent-implemented interventions to improve parent mental health is needed.Implications for Rehabilitation:Intensive motor training-based interventions with active parent implementation were effective to improve child gross motor, bimanual hand, and chewing function in young children with CP compared to passive, generic interventionist-implemented or health education interventions.Interventions with active parent implementation had mixed results to improve parent mental health, however, this was frequently not assessed. A consistent level of support and training provided to parents may be required to have a positive effect on parent stress.To further understand the feasibility of early interventions with active parent implementation in LMICs, data on adherence to home practice dose and session attendance and a qualitative understanding of contextual and child factors influencing parent implementation is needed.
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Affiliation(s)
- Nataya Branjerdporn
- Faculty of Medicine, The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia
| | - Katherine Benfer
- Faculty of Medicine, The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia
| | - Emma Crawford
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Roslyn N Boyd
- Faculty of Medicine, The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia
| | - Leanne Sakzewski
- Faculty of Medicine, The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia
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31
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Tanner K, Dempster R, Castillo A, Burdo-Hartman W, Halpin E, Rausch J, Stevens J. Randomized trial of a self-administered parenting intervention for selective eating in young children. Eat Behav 2022; 46:101646. [PMID: 35753286 DOI: 10.1016/j.eatbeh.2022.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
Abstract
Selective eating is a common childhood feeding problem associated with family stress and micronutrient deficiencies. While there are empirically-supported behavioral strategies for addressing selective eating, there are significant systems-level barriers to implementing them. The aim of this study was to develop and test a self-administered intervention for parents of children with selective eating. Participants were 156 parents of children with selective eating ages 18 months-6 years who were randomly assigned to either the handout + video condition (8-module video intervention and detailed handout) or handout condition (detailed handout only). Outcome measures were administered pre-intervention and 4 weeks post-intervention. Only 23 % of participants in the handouts plus video condition played more than one video module. Both groups had significant decreases in maladaptive mealtime parenting practices, undesired child mealtime behaviors, and number of foods offered. No significant effect of study condition was found on the outcome measures. Further research is needed to determine how to encourage engagement of parents with self-administered intervention materials.
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Affiliation(s)
- Kelly Tanner
- Nationwide Children's Hospital, Columbus, OH, United States of America.
| | - Rob Dempster
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Anthony Castillo
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | | | - Elizabeth Halpin
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Joseph Rausch
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Jack Stevens
- Nationwide Children's Hospital, Columbus, OH, United States of America; The Ohio State University Department of Pediatrics, Columbus, OH, United States of America
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32
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Koca RB, Huri M. Investigation of the relationship between feeding problems and cognitive functions in premature children. Appetite 2022; 177:106156. [PMID: 35780938 DOI: 10.1016/j.appet.2022.106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 11/02/2022]
Abstract
Children with a history of premature birth may show various problems in feeding, and these problems may continue at school age. It is necessary to examine the role of cognitive functions in children's feeding with more detailed studies.Comparison of feeding problems and cognitive functions of premature and full-term children and examining the relationship between them. The parents of 60 children aged 6-10 completed the The Screening Tool of Feeding Problems, and the cognitive functions of the children were evaluated with the Dynamic Occupational Therapy Cognitive Assessment. Results are compared and correlations betweeen feeding problems and cognitive functions were examıned. Feeding problems of premature children are statistically higher than those born at term; their cognitive functions were statistically weaker (p < 0.001). It was found that feeding problems and cognitive functions were statistically related in premature children (p < 0.05). Feeding problems seen in premature children may be related to their weaker cognitive functions compared to their peers. It is important to evaluate cognitive functions and include them in the intervention in rehabilitation programs to be prepared for premature children with feeding problems.
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Affiliation(s)
- Rukiye Begüm Koca
- Occupational Therapy Department, Ankara Medipol University, Ankara, Turkey.
| | - Meral Huri
- Occupational Therapy Department, Hacettepe University, Ankara, Turkey.
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33
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Grajales Rodríguez A, Moreno P. L, González G. S. Instrumentos de evaluación de la deglución pediátrica: un reporte por fonoaudiólogos en Colombia y Chile. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.73161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La prevalencia de usuarios pediátricos que presentan alteraciones en la deglución/ alimentación ha aumentado significativamente, por lo que realizar un proceso de evaluación sistemático, a usuarios ambulatorios y/u hospitalizados, con el uso de instrumentos estandarizados, puede evitar complicaciones asociadas. El objetivo de esta investigación fue identificar cuáles son las pruebas que conocen y usan los fonoaudiólogos en dos países de habla hispana: Colombia y Chile, para la valoración de la deglución en población pediátrica. Se trata de un estudio observacional de corte transversal, en el que participaron 36 fonoaudiólogos de ambos países, los que contestaron una encuesta de 23 ítems, previamente validada por juicio de expertos. El 55,6% (n=20) señaló que conocía pruebas de screening, el 63,89% (n=23) conocía pruebas de evaluación clínica (no instrumentales o subjetivas), el 100% conocía pruebas instrumentales (objetivas) y sólo el 11% (n=4) conocían pruebas de calidad de vida. Se evidenció de forma general dificultad en la clasificación de las pruebas y un mayor uso de pruebas no estandarizadas, lo que sugiere una necesidad disciplinar en cuanto a la formación sobre instrumentos de medición y evaluación, que permitan la identificación, selección y comprensión analítica de dichos instrumentos.
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34
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Kang YQ, Teo CM, Tan ML, Aw MM, Chan YH, Chong SC. Feeding difficulties in Asian children with autism spectrum disorder. Pediatr Neonatol 2022; 63:48-56. [PMID: 34538733 DOI: 10.1016/j.pedneo.2021.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To characterize the nature and severity of feeding difficulties in Asian young children with Autism Spectrum Disorders (ASD) and identify potential predictors of poorer feeding outcomes. METHODS Cross sectional study of children aged 1-7 years with ASD. Parents completed the following: demographic information, brief autism mealtime behavior inventory, aberrant behavior checklist (ABC), behavioral pediatrics feeding assessment scale (BPFAS) and caregiver feeding style questionnaire. Additional information (medical data, cognitive and developmental assessment results, e.g., Autism Diagnostic Observation Schedule Second Edition, Autism Diagnostic Interview, Revised, Vineland Adaptive Behaviour Scales, etc.) were subsequently obtained from electronic medical records retrospectively by one of the study team members. RESULTS Of the 67 children, 28.4% had feeding difficulties (high BPFAS total frequency score). Caregiver feeding styles were authoritarian (34.8%) or indulgent (39.4%). Child characteristics did not significantly predict for the severity of feeding difficulties. Univariate analysis revealed that authoritarian feeding style (p = 0.001) and ABC hyperactivity score (p = 0.006) were significantly associated with BPFAS severity score. Multivariate analysis revealed that ABC hyperactivity score remained significantly associated with BPFAS severity score after controlling for all other ABC subscale scores. A final regression model including all child characteristics and ABC scores did not reveal any significant predictors of BPFAS total frequency score (R2 = 0.557). CONCLUSION Our findings suggest an association between hyperactivity, authoritarian feeding style and feeding difficulties. Children with ASD who have significant hyperactivity behaviors in the context of parents with an authoritarian feeding style should be actively screened for problematic feeding behaviors.
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Affiliation(s)
- Ying Qi Kang
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Charmaine Min Teo
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Michelle Ln Tan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Marion M Aw
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University, Singapore
| | - Shang Chee Chong
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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35
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Breiner CE, Miller ML, Hormes JM. ARFID Parent Training Protocol: A randomized pilot trial evaluating a brief, parent-training program for avoidant/restrictive food intake disorder. Int J Eat Disord 2021; 54:2229-2235. [PMID: 34779528 DOI: 10.1002/eat.23643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/07/2021] [Accepted: 11/07/2021] [Indexed: 11/07/2022]
Abstract
Evidence-based treatment approaches for avoidant/restrictive food intake disorder (ARFID) remain limited and may be inaccessible to families due to geographic, financial, and/or time constraints. This study aims to establish the acceptability and feasibility of a brief ARFID Parent Training Program (ARFID-PTP), modified from other evidence-based approaches, using a randomized controlled trial design. Participants (n = 30) will be children aged 5-12 who meet diagnostic criteria for ARFID and their parents/guardians. Participants will be randomized to receive treatment immediately or following a 4-week wait (waitlist control). Treatment consists of two, 2-hr virtual treatment sessions with the family and a therapist plus an optional booster session. Primary aims include evaluating the (a) feasibility of ARFID-PTP as indicated by recruitment and retention rates, as well as treatment adherence at home and (b) acceptability as determined by ratings on the Credibility and Expectancy Questionnaire and satisfaction questions. A secondary aim is to assess the preliminary efficacy of ARFID-PTP via changes in scores on the Pica, ARFID, and Rumination Disorder Interview. If results indicate appropriate feasibility and acceptability, the proposed protocol will form the basis for larger scale trials of treatment efficacy in efforts to increase accessibility of evidence-based treatment for ARFID.
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Affiliation(s)
- Courtney E Breiner
- Department of Psychology, University at Albany - State University of New York, Albany, New York, USA
| | - McKenzie L Miller
- Department of Psychology, University at Albany - State University of New York, Albany, New York, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany - State University of New York, Albany, New York, USA
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36
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Kim AR, Kwon JY, Yi SH, Kim EH. Sensory Based Feeding Intervention for Toddlers With Food Refusal: A Randomized Controlled Trial. Ann Rehabil Med 2021; 45:393-400. [PMID: 34743482 PMCID: PMC8572996 DOI: 10.5535/arm.21076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/01/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the effect of sensory-based feeding treatment for toddlers with food refusal compared with only providing nutrition education. METHODS Thirty-two toddlers with food refusal were randomly assigned to an intervention group or the control group. Toddlers in the intervention group received the sensory-based feeding intervention and the duration was for 1 hour for 5 days per week for 4 weeks, and then 1 hour, once a week for 8 weeks. Subjects in both the intervention and control groups received nutritional education once every 4 weeks for 12 weeks. The participants were evaluated at their entry into the study and 12 weeks later based on height, weight, behavior at mealtime using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), and sensory processing ability using the Infant/Toddler Sensory Profile. RESULTS Sixteen toddlers were included in each group. Two subjects in the intervention group and four toddlers in the control group were excluded from the final analysis. Significant improvements in child or parent subscales of the BPFAS were observed in the intervention group. In contrast, there were no significant improvements in any BPFAS scores in the control group. CONCLUSION Sensory-based feeding intervention was effective for improving mealtime behavior in toddlers with food refusal. Therefore, a sensory-based feeding intervention could be considered as an intervention approach to address feeding disorders in toddlers.
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Affiliation(s)
- Ah-Ran Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sook-Hee Yi
- Department of Rehabilitation Medicine, Seoul Rehabilitation Hospital, Seoul, Korea
| | - Eun-Hye Kim
- Department of Occupational Therapy, Seoul Rehabilitation Hospital, Seoul, Korea
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37
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Wilson E, Simione M, Polley L. Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1316-1333. [PMID: 34423521 PMCID: PMC8585681 DOI: 10.1111/1460-6984.12662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Chewing dysfunction can have adverse effects on growth, development and quality of life. There is a lack of evidence-based consensus guidelines for sensorimotor intervention. To address this, we need to understand the current state of the science in clinical sensorimotor interventions for paediatric chewing dysfunction and systematically plan a research agenda and priorities for the field. AIMS The purpose of this scoping review was to examine the extent, range and nature of evidence for oral sensorimotor interventions for paediatric chewing dysfunction. METHODS & PROCEDURES This scoping review entailed five phases that included: identification of the research question; identification of relevant studies; study selection; data charting; and collation, summarization and report of the results. Treatment studies that were peer-reviewed and written in English were included. All studies involved a paediatric population and included an oral sensorimotor and/or chewing intervention. Information regarding study design, population, intervention, comparator, outcome measures and findings were extracted. MAIN CONTRIBUTION Of the 21 studies included in this scoping review, 53% were specific to children with cerebral palsy. All interventions were multi-component in nature and the treatment studies included a range of study designs, but few were controlled trials with comparators. A wide variety of outcomes measures were used within and across studies to determine treatment effectiveness. CONCLUSIONS & IMPLICATIONS The findings suggest that in a small number of studies, sensorimotor interventions provide preliminary evidence for effectiveness in specific populations. These and other treatment protocols must be trialled in additional clinical populations and settings to improve the evidence base for sensorimotor treatment of paediatric chewing dysfunction. This review also serves to help prioritize research agendas and further motivates the need for consensus-based clinical guidelines for paediatric chewing treatment. WHAT THIS PAPER ADDS What is already known on the subject Paediatric feeding disorders are highly prevalent and children often have chewing dysfunction that results in significant negative consequences. We lack evidence-based sensorimotor treatment approaches for chewing dysfunction, which directly impacts the care clinicians can provide children. What this study adds to existing knowledge This scoping review is the first step in examining the literature to understand the current state of the science for oral sensorimotor interventions for paediatric chewing dysfunction. Few randomized controlled studies were identified and a majority included children with cerebral palsy. Most of the interventions were multi-component and included a variety of treatment approaches. What are the potential or actual clinical implications of this work? The results of this scoping review can be used as an initial reference for clinicians selecting treatment approaches for chewing dysfunction. It also serves to help prioritize research agendas and further motivates the need for consensus-based clinical guidelines for paediatric chewing treatment.
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Affiliation(s)
- Erin Wilson
- Speech and Feeding Disorders Laboratory, MGH Institute of Health Professions, Boston, MA, USA
| | - Meg Simione
- Division of General Pediatrics, Mass General Hospital for Children, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Lydia Polley
- Department of Speech Pathology, Akron Children's Hospital, Akron, OH, USA
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Dinkler L, Yasumitsu-Lovell K, Eitoku M, Fujieda M, Suganuma N, Hatakenaka Y, Hadjikhani N, Bryant-Waugh R, Råstam M, Gillberg C. 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. Appetite 2021; 168:105735. [PMID: 34626753 DOI: 10.1016/j.appet.2021.105735] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 01/11/2023]
Abstract
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 (1) to investigate the prevalence of children screening positive for ARFID in a Japanese birth cohort using a newly developed parent-reported screening tool, (2) to estimate the prevalence of children with ARFID experiencing physical versus psychosocial consequences of their eating pattern, and (3) to provide preliminary evidence for the validity of the new screening tool. Data were collected from 3728 4-7-year-old children born between 2011 and 2014 in Kochi prefecture, Japan (response rate was 56.5%); 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, which together provides 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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Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan.
| | - Kahoko Yasumitsu-Lovell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan
| | - Yuhei Hatakenaka
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Faculty of Humanities and Sociologies, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan
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Ozturk S, Ozsin Ozler C, Serel Arslan S, Demir N, Olmez MS, Uzamis Tekcicek M. Orofacial functions and oral health: An analysis on children aged 5-8 years old. J Texture Stud 2021; 53:31-40. [PMID: 34482536 DOI: 10.1111/jtxs.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study is to assess the orofacial function performance and oral health status of healthy children as well as their potential correlations. In this descriptive study, the oral functions of four hundred systemically healthy children who applied for the pediatric dentistry clinic were evaluated. Three scales, namely Karaduman Chewing Performance Scale (KCPS), Pediatric version of the Eating Assessment Tool (PEDI-EAT-10), and Nordic Orofacial Test Screening (NOT-S) protocol, are used to collect the data. These children's carious lesions were evaluated by using the decayed, missing, filled tooth/surface (DMFT/S, dmft/s) indices, the International Caries Detection and the Assessment-II System (ICDAS-II). In total, 400 (6.5 years [78.02 months]) children were participated in the study. Their KCPS scores indicate that 58.0% of the children were at level 0 and 35.8% were at level 1. The results of the KCPS levels and the DMFT, dmft, DT, dt, MT, mt (as =0 and ≥1) were found to be statistically significant; p = .044, p = .009, p = .008, p = .000, p = .032, and p = .003, respectively. The total PEDI-EAT-10 score of 13.4% of the children was found to be 3 or higher, suggesting that they experience a problem in swallowing. According to the NOT-S, the most affected domains were "habits" (51.0%), "facial expression" (49.3%), and "chewing and swallowing" (45.3%). Among healthy children without a defined problem in swallowing and orofacial functions, the oral health status may affect orofacial functions. Decayed (particularly, extensive caries existence) or missing tooth may have critical importance for adequate chewing in children. Especially in the presence of so many decayed or missing teeth, evaluating the orofacial functions through different scales may considerably contribute to early diagnosis of functional problems.
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Affiliation(s)
- Seyma Ozturk
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Cansu Ozsin Ozler
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Numan Demir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merih Seval Olmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Meryem Uzamis Tekcicek
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Gronski MP. Occupational Therapy Interventions to Support Feeding and Toileting in Children From Birth to Age 5 Years. Am J Occup Ther 2021. [DOI: 10.5014/ajot.2021.049194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Program. In this Evidence Connection article, I describe a case report of a young child receiving early intervention services and outline the occupational therapy evaluation and intervention processes for supporting this child’s activities of daily living in the home and early childhood education setting. Findings from the systematic reviews on this topic were published in the March/April 2020 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Early Childhood: Birth–5 Years. Each article in this series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.
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Affiliation(s)
- Meredith P. Gronski
- Meredith P. Gronski, OTD, OTR/L, CLA, is Program Director, Methodist University, Fayetteville, NC;
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Ross CF, Surette VA, Bernhard CB, Smith-Simpson S, Lee J, Russell CG, Keast R. Development and application of specific questions to classify a child as food texture sensitive. J Texture Stud 2021; 53:3-17. [PMID: 34435671 DOI: 10.1111/jtxs.12627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
Understanding food texture sensitivity in children is important in guiding food selection. The objective of this work was to develop a short questionnaire that could be completed by parents in nonclinical settings to provide a categorization for food texture sensitivity in children. This study evaluated the distribution of children as texture sensitive (TS) or non-texture sensitive (NTS) and the predictive validity of these questions to explain rejection of specific food textures. Three sets of survey data were examined, including data from a home-use test (HUT) in children with and without Down syndrome (DS), and lingual tactile sensitivity measured by grating orientation task (GOT). From three parent-completed surveys, the use of the questionnaire yielded a similar distribution of children in the TS category (16-22%) as previously reported. TS children (4-36 months) were more likely to reject specific food textures, including chewy, hard, lumpy, and "tough meat" (p < .05). A higher percentage of children with a diagnosis of DS were TS (36.9%). Children who were TS showed increased negative behaviors to foods and ate less than NTS children. In older children (5-12 years), TS children were fussier than NTS children (p < .001). Lingual tactile sensitivity was not significantly different by TS/NTS categorization (p = .458). This study demonstrated that the use of these five questions specific to food texture provides a useful tool in categorizing a child as TS/NTS, with this information being useful in selecting preferred food textures. Future studies involving these TS questions should perform psychometric assessments and measures of criterion validity using other questionnaires.
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Affiliation(s)
- Carolyn F Ross
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Victoria A Surette
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Charles B Bernhard
- School of Food Science, Washington State University, Pullman, Washington, USA
| | | | - Jookyeong Lee
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Catherine G Russell
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Russell Keast
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Adams SN, Verachia R, Coutts K. Mealtime challenges and food selectivity in children with autism spectrum disorder in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1954794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Raeesa Verachia
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Kim Coutts
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Caldwell AR, Krause EK. Mealtime behaviours of young children with sensory food aversions: An observational study. Aust Occup Ther J 2021; 68:336-344. [PMID: 33955028 PMCID: PMC8363574 DOI: 10.1111/1440-1630.12732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Children with sensory food aversions (SFAs) are at risk for nutritional problems and occupational dysfunction during daily meals. To facilitate optimal occupational performance for children with SFAs, it is critical that clinicians understand child behaviour and caregiver strategy use to manage child behaviour during meals. The purpose of this paper is to examine the reliability of a novel coding scheme, the Behavioural Mealtime Coding System (BMCS) and identify associations among child acceptance of preferred and targeted foods, child food exploration and caregiver use of strategies to manage child behaviour. METHODS Twenty-one children (aged 18-60 months) with SFAs and their caregivers were recruited using a convenience sample. An observational video coding system was developed to code mealtime behaviour in 63 typical mealtime videos recorded by caregivers in the home environment. Inter-rater reliability, descriptive statistics and bivariate correlations were calculated. RESULTS The BMCS demonstrated excellent inter-rater reliability (ICC = .95). Child bites of targeted foods were associated with mealtime duration (rs = .51, p = .02) and events of the child licking food (rs = .57, p = .007). Caregiver use of threats was positively associated with child age (rs = .48, p = .03) and negatively associated with caregiver education level (rs = -.49, p = .03). CONCLUSION For children with SFAs, increasing mealtime duration by embedding positive activities to encourage food exploration may improve acceptance of healthy targeted foods. Future research is needed to better understand the complex relationships among caregiver strategy use, mealtime duration and child mealtime behaviour.
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Affiliation(s)
- Angela R Caldwell
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elise K Krause
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1505-1519. [PMID: 33653157 PMCID: PMC8323334 DOI: 10.1177/1362361321995631] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
LAY ABSTRACT Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms "feeding" and "eating" problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use "eating problems" when behaviors involve preoccupation with food, eating, or body image, and "feeding problems" when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child's treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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Affiliation(s)
- Jessica Baraskewich
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Kristin M von Ranson
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Adam McCrimmon
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Carly A McMorris
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare (Basel) 2021; 9:healthcare9060741. [PMID: 34204179 PMCID: PMC8234215 DOI: 10.3390/healthcare9060741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece;
| | - Stavroula Beropouli
- Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
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Sdravou K, Fotoulaki M, Emmanouilidou-Fotoulaki E, Andreoulakis E, Makris G, Sotiriadou F, Printza A. Feeding Problems in Typically Developing Young Children, a Population-Based Study. CHILDREN-BASEL 2021; 8:children8050388. [PMID: 34068336 PMCID: PMC8153308 DOI: 10.3390/children8050388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Feeding problems have been estimated to occur in approximately 25–45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents’ feelings about their child’s feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Elias Andreoulakis
- Adult Psychiatric Unit, Hellenic Centre for Mental Health and Research, Department of Thessaloniki, 36 Kaftatzoglou Str., 55337 Thessaloniki, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Fotini Sotiriadou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 54636 Thessaloniki, Greece
- Correspondence:
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Ercan N, Tel Adıgüzel K. Effect of early childhood cow's milk elimination diet on eating behaviours, nutrition and growth status at age 2-6 years. J Hum Nutr Diet 2021; 35:300-309. [PMID: 33974304 DOI: 10.1111/jhn.12914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The present study aimed to investigate the eating behaviour, nutritional status and growth of Caucasian children in ages 2-6 years who had a diet because of cow's milk protein allergy (CMA) [immunoglobulin (Ig)E-mediated and/or non-IgE-mediated] in early childhood. METHODS In this cross-sectional, case-control study, the cow's milk elimination (CME) group comprised children aged 0-2 years who were receiving a CME diet because of CMA, as confirmed by an oral food challenge test, and had reintroduced cow's milk for at least ≥ 3 months. The control group never had a restricted diet. Eating behaviour and children's growth was assessed. A 3-day food record was taken to determine the macronutrient and micronutrient intake of the children. Data on the children's socio-demographic, infant nutrition and family allergy history were collected from their medical records and face-to-face interviews with mothers. RESULTS In total, 62 children with a median age of 32 months were recruited for the study. The total scores of food avoidance and satiety responsiveness in the CME group (n:31) were higher than in the controls (n = 31) (p = 0.036 and 0.006, respectively). Weight-for-age and height-for-age are statistically lower in the CME group than in the control group (p < 0.001). A significant difference between groups in terms of dairy intake was recorded (p = 0.011). In the CME group, the current frequency of adequate energy, vitamin B1, folic acid, vitamin C and calcium intake was significantly lower than in the control group (p < 0.05). CONCLUSIONS Dietary interventions because of CMA at age 0-2 years can affect children's nutritional habits and parental-reported assessment of children's eating behaviours, resulting in growth restriction with insufficient micro/macronutrients and/or dairy products at the age of 2-6 years.
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Affiliation(s)
- Nazli Ercan
- Department of Child Health and Diseases, Pediatric Immunology and Allergy, Gülhane Education and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Kübra Tel Adıgüzel
- Department of Nutrition and Dietetics, Gülhane Faculty of Health Sciences, University of Health Sciences Turkey, Ankara, Turkey
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Tully C, Clary L, Monaghan M, Levy W, Hilliard ME, Streisand R. Implementation and Preliminary Feasibility of an Individualized, Supportive Approach to Behavioral Care for Parents of Young Children Newly Diagnosed With Type 1 Diabetes. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:293-308. [PMID: 34025105 PMCID: PMC8136148 DOI: 10.1016/j.cbpra.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There are significant stressors related to parenting a young child with newly diagnosed type 1 diabetes (T1D). Despite these challenges, there are not yet clearly defined interventions to help promote psychological health and adherence for families with young children with T1D. First STEPS is a tailored stepped care design intervention to positively impact parents' emotional functioning and children's glycemic control in young children newly diagnosed with T1D. The First STEPS intervention is derived from a combination of Cognitive Behavioral Theory and Social Cognitive Theory to support family adjustment to T1D, promote parental mastery over T1D tasks, increase coping skills to manage stressors associated with T1D, and build on the strengths of families newly diagnosed with T1D to help them achieve positive health and wellbeing outcomes. We present details about the intervention and describe two pilot participants as case studies. Results indicated that the treatment and delivery model were acceptable to the pilot participants, as evidenced by treatment completion and satisfaction ratings. Future directions for this work include testing the efficacy of this new treatment in a randomized controlled trial.
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Affiliation(s)
- Carrie Tully
- Children's National Health System and George Washington University
| | - Lauren Clary
- Children's National Health System and George Washington University
| | - Maureen Monaghan
- Children's National Health System and George Washington University
| | - Wendy Levy
- Texas Children's Hospital and Baylor College of Medicine
| | | | - Randi Streisand
- Children's National Health System and George Washington University
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Surette VA, Bernhard CB, Smith-Simpson S, Ross CF. Development of a home-use method for the evaluation of food products by children with and without Down syndrome. J Texture Stud 2021; 52:424-446. [PMID: 33856694 DOI: 10.1111/jtxs.12601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/29/2022]
Abstract
This article describes the development of a method to evaluate the acceptance of different snack food textures by children with food texture sensitivities, including children with and without Down syndrome (DS). An in-home use test (HUT) was developed to reflect recent taste study and allow greater recruitment. In this study, parents with children (ages 11-60 months) with DS (CWDS) and without (typically developing, CTD) were recruited and based on responses to several questions, children were categorized as food texture sensitive (TS) or nontexture sensitive (NTS). In total, 111 CWDS (49 TS and 62 NTS) and 107 CTD (42 TS and 65 NTS) participated. To select the food products for assessment, a trained panel profiled commercially available infant and toddler solid snack foods (n = 41), from which 16 products were selected and sorted into four flavor groupings. For the HUT, participating children evaluated each food product once per day for 6 days. Parents recorded their children's reactions to each food product; a panel of trained coders coded each video for verbal and nonverbal behaviors using a novel coding scheme. Parent prompts were also coded. Several challenges were experienced during this study, including poor-quality videos, and standardization of the home environment during the feeding sessions. However, the high degree of successful completion of the HUT (96%) was attributed to the high motivation of the parents involved, as well as the close interaction between the experimenters and the participants on an individual family level.
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Affiliation(s)
- Victoria A Surette
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Charles B Bernhard
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Sarah Smith-Simpson
- Sensory and Consumer Insights, Nestlé Nutrition, Gerber Products Company, Fremont, Michigan, USA
| | - Carolyn F Ross
- School of Food Science, Washington State University, Pullman, Washington, USA
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50
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Gal E, Gal-Mishael R, Vissoker RE, Hedley D, Bury SM, Stolar O. Eating Challenges in Children with Autism Spectrum Disorder: Development and Validation of the "Aut-Eat" Questionnaire (AEQ). J Autism Dev Disord 2021; 52:811-822. [PMID: 33792802 DOI: 10.1007/s10803-021-04978-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The Aut-Eat Questionnaire (AEQ) provides a novel and comprehensive assessment of eating problems and patterns in children with ASD. To establish the internal consistency and discriminant validity of the AEQ, parents of children with ASD (n = 105, Mage = 40.85, SD = 15.67 months) or typical development (TD; n = 98, Mage = 50.33, SD = 16.50 months) completed the AEQ. Questionnaire construction, content validity, factor analysis, internal consistency and discriminant validity are reported. The AEQ was reliable with high internal consistency in most domains. Significant differences were found between groups in all domains. The AEQ is a reliable and valid tool and may help to characterize eating difficulties in this population.
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Affiliation(s)
- Eynat Gal
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel.
| | - Rotem Gal-Mishael
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Roni Enten Vissoker
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Simon M Bury
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Orit Stolar
- Shamir Medical Center, Department of Pediatrics, Autism Center, Zerifin, Israel
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