Intervention for feeding difficulties in children with a complex medical history: a randomized clinical trial

Marshall, Jeanne, Hill, Rebecca J., Wallace, Meagan and Dodrill, Pamela (2017) Intervention for feeding difficulties in children with a complex medical history: a randomized clinical trial. Journal of Pediatric Gastroenterology and Nutrition, 66 1: 152-158. doi:10.1097/MPG.0000000000001683

Author Marshall, Jeanne
Hill, Rebecca J.
Wallace, Meagan
Dodrill, Pamela
Title Intervention for feeding difficulties in children with a complex medical history: a randomized clinical trial
Journal name Journal of Pediatric Gastroenterology and Nutrition   Check publisher's open access policy
ISSN 1536-4801
Publication date 2017-07-01
Year available 2018
Sub-type Article (original research)
DOI 10.1097/MPG.0000000000001683
Open Access Status Not yet assessed
Volume 66
Issue 1
Start page 152
End page 158
Total pages 24
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
2715 Gastroenterology
Abstract This study aimed to compare outcomes of different multidisciplinary feeding therapy approaches in children with feeding difficulties.

Children aged 2 to 6 years with feeding difficulties and a medically complex history (MC) were recruited. Children with feeding difficulties and a nonmedically complex history (NMC) were included as a comparison group. Participants attended a clinical assessment, and eligible participants were randomized to receive targeted feeding intervention incorporating either operant conditioning or systematic desensitization. Parents could elect to receive intervention in an intensive (10 sessions in a week) or weekly (10 sessions during 10 weeks) format. Both groups received immersive parent training. A review was completed 3 months post-intervention.

In total, 98 participants were eligible to participate (MC, n = 43; NMC, n = 55). Data from 20 children from the MC group (47%) and 41 children from the NMC group (75%) were included in the final analysis. Clinically significant improvements were observed following both arms of therapy, consistent with previous research. Parents of children in the MC arm were significantly more likely to elect for intensive intervention than weekly (MC = 12/20, 60%; 12/41, 29%; P = 0.02).

Both therapy protocols were considered clinically effective. The difference in attrition rates between the etiological groups suggests primary differences in how service delivery should be managed. Progress for the medically complex child may be slower while medical issues are stabilized, or while the focus for parents shifts to other developmental areas. In planning services for a medically complex group, therefore, it is essential that consideration be given to medical and family needs.
Keyword Pediatrics, perinatology, and child health
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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