Dr. Kay Toomey – Picky Eaters vs Problem Feeders vs Avoidant

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 Dr. Kay Toomey – Picky Eaters vs Problem Feeders vs Avoidant

Prevalence Problem

• Picky Essen
• Problem Feeding
• ARFID

Complexities of Eating/Feeding

• 7 areas of human activity
• How children learn to eat

How to complete a comprehensive Feeding Assessment

• Medical/organs
• Oral-motor skills
• Sensory-motor skills
• Motor and postural skills
• Nutrition
• Learning/cognition
• Environment

Differential Diagnoses Criteria, Research, and Limitations

Picky Essen

• Tolerance to new foods
• Reduced variety or range of foods you will eat
• A lot of times, he or she eats a different menu than the rest of his family

Problem Feeding

• Restricted selection or limited variety
• Refuses entire food textures
• Crying and “falls apart” If presented with new foods

ARFID

• Allow a restricted diet to accommodate sensory features
• Food refusal can be linked to fear or aversive behavior-Experiences based on the Internet
• Extreme pickiness, distractible, and forgetful

Align Therapy w/ Diagnosis – Treatment Approaches

• Systematic desensitization
• Flooding/escape extinction
• Eating disorders

Case Studies: When Assessments Go Well, and When They Don’t

Picky eating –

• Case 1 = 2 ½ year old male with limited number of accepted foods he will eat, variable eating from one day to next, issues staying at the table
• Case 2 = 2 ½ year old female with restricted food range, over reliance on liquids for calories and swallowing assistance
• Case 3 = 9 Year, 8-Month-Old male lacking in healthy proteins and vegetables.

Problem feeding –

• Case 1 = 3 years, 10-Month-An old woman with a G-Tube, 26 weeks gestation. Complex medical history
• 2.25-Year-Congenital Rubella in an old woman, poor weight gain, restricted food choices, episodes de gagging and coughing and episodes refusing to eat

ARFID –

• Case 1 = 15-Year-Old male with chronic illness “chok-y” sensational weight loss and hospitalization in an Eating Disorders Program
• Case 2 = 13-year-An old male with difficulty eating at school.

Practical Feeding Strategies For Pediatric Feeding Disorder

Routines & environmental support

Matching foods to a child’s skillset

Reinforcement

Management of maladaptive behaviors

When to refer

Red Flags

Picky Eater vs Problem Feeder criteria

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Description:

A child with a pediatric feeding disorder makes it difficult or impossible to eat, drink or digest food properly, which can often lead to problems in their development and health.

These children have a limited intake, which is a reflection of concerns like:

• Food aversions
• Inattentiveness to eating or cooking
• Avoidance based solely on the sensory characteristics of food
• Fear of choking, or other adverse consequences
• These are serious medical and psychological problems.
  • Severe malnutrition
  • Growth failure
  • Psychosocial functioning is being markedly affected

Dr. Kay Toomey, who has over 30 years of clinical experience assessing and treating children with a wide range of feeding challenges, will show you clear guidelines to utilize the appropriate therapy approach.

Learn practical therapeutic interventions to use with children from each diagnostic group and ways to improve family meal routines and increase children’s intake of more nutritious foods.

• Identify physical, motor, sensory, oral-To properly assess feeding issues, it is important to take into account motor, environmental, nutritional, and behavioral factors.
• Delineate differential criteria for determining a child’s diagnosis as a typical eater, picky eater, problem feeder or a child with ARFID.
• Find out when you should refer to a specialist to receive additional treatment