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Feeding disorders 2 Presentation Transcript

  • 2. + DIAGNOSTIC CRITERIADiagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR)International Statistical Classifications of Diseases- 10 (ICD-10)  For classification of diseases and health problems on “health and vital records including death certificates and health records.” (WHO, 2012)
  • 3. + DIAGNOSTIC CRITERIADSM-IV-TR, 307.59, Feeding Disorder ofInfancy or Early Childhood: A. Feeding disturbance as manifested by persistent failure to eat adequately with significant failure to gain weight or significant loss of weight over at least 1 month. (Behavenet, 2012)
  • 4. + DIAGNOSTIC CRITERIADSM-IV-TR, 307.59 B. The disturbance is not due to an associated gastrointestinal or other general medical condition (e.g., esophageal reflux). (Behavenet, 2012)
  • 5. + DIAGNOSTIC CRITERIADSM-IV-TR, 307.59 C. The disturbance is not better accounted for by another mental disorder (e.g., Rumination Disorder) or by lack of available food. D. The onset is before age 6 years. (Behavenet, 2012)
  • 6. + DIAGNOSTIC CRITERIADSM 5 Feeding and Eating Disorders“…it is being recommended that the Eating Disorders category be renamed Feeding and Eating Disorders to reflect the proposal for inclusion of feeding disorders…” (American Psychiatric Association, 2012)
  • 7. + DIAGNOSTIC CRITERIAInternational Statistical Classifications of Diseases- 10 (ICD-10)  F98.2 Feeding disorder of infancy and childhood: A feeding disorder of varying manifestations usually specific to infancy and early childhood. (WHO, 2012)
  • 8. + DIAGNOSTIC CRITERIAICD-10 It generally involves food refusal and extreme faddiness in the presence of an adequate food supply, a reasonably competent caregiver, and the absence of organic disease. (WHO, 2012)
  • 9. + DIAGNOSTIC CRITERIAICD-10 There may or may not be associated rumination (repeated regurgitation without nausea or gastrointestinal illness). (WHO, 2012)
  • 10. + CHARACTERISTICSFood refusalInappropriate behaviors during mealtimeFailure to thriveFood Selectivity (Piazza & Carroll-Hernandez, 2004)
  • 11. + CHARACTERISTICSFood Refusal  Refusing food and/or drink  May lead to failure to thrive  Skill deficits: Oral motor behaviors (i.e., chewing) Fine motor behaviors (i.e., self-feeding) (Piazza & Carroll-Hernandez, 2004)
  • 12. + CHARACTERISTICSFailure to thrive  Child loses weight over time Lack of nutrients Unable to take in, retain, or utilize the calories (Piazza & Carroll-Hernandez, 2004)
  • 13. + CHARACTERISTICSInappropriate behaviors during mealtime:  Crying  Screaming  Aggression  Gagging  Vomiting (Gutshall, 2012)
  • 14. + CHARACTERISTICSFood selectivity: Texture (smooth v. crunchy) Type (carbohydrate v. fruits) Presentation (on specific plate or specific location) Brand (Hunt’s ketchup v. Heinz’s ketchup) (Gutshall, 2012)
  • 15. + COMMON TREATMENTSMultidisciplinary Treatment (Team approach): Physician, Speech Language Pathologist (SLP), occupational therapist (OT), physical therapist (PT), and behavioral analystBehavioral Therapy (AKA Contingency Management)Diet Therapy: Gradually increasing nutrient intakeSupplemental feedings: Tube Feeding
  • 16. + COMMON TREATMENTSSupplemental feedings (Tube Feeding):  Gastrostomy tube (G-tube): A tube is inserted through the abdomen and then nutrients are delivered into the stomach 1st year $46,875.55 2nd year $80,959.10 5 years+ $183,209.80  Nasogastric tube (NG-tube): a tube is inserted through the nasal canal and then nutrients are delivered into the stomach  Child becomes dependent (Piazza & Carroll-Hernandez, 2004)
  • 17. + COMMON TREATMENTSBehavioral Therapy  Increased in food consumption and “may be more effective than other strategies”  Decreased in supplemental feedings  2 year+ $48,000  Compared to G-tube, cost savings $135, 209.80 for 5 year+ (Piazza & Carroll-Hernandez, 2004)
  • 18. + Special Considerations for Behavior AnalystsComponents that should be looked at:  Biological  Medical issues: Are there any medical problems? (e.g., food allergies, reflux issues, GI problems, etc.)  Skill deficits  Oral  Motor  Problem behaviors during mealtime  Functional Analysis  Parent education  Educate parents
  • 19. + References American Psychiatric Association. (2012). Retrieved October 31, 2012, from: http://www.dsm5.org/PROPOSEDREVISION/Pages/ FeedingandEatingDisorders.aspx Gutshall, K. (2006). Q&A: Feeding Disorders. Retrieved October 30, 2012, from:http://blog.centerforautism.com/2012/01/11/qa-feeding-disorders/ Piazza CC, Carroll-Hernandez TA. Assessment and treatment of pediatric feeding disorders. In: Tremblay RE, Barr RG, Peters RDeV, eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development; 2004:1-7. Available at: http://www.child- encyclopedia.com/documents/Piazza-Carroll-HernandezANGxp.pdf. Accessed [October 31, 2012].
  • 20. + References Rozantes, M. (2012). Treating Children with Feeding Disorders. Retrieved October 28, 2012, from:http://teamchatterboxes.blogspot.com/2012/07/treating-children-with-feeding.html Unknown. BehaveNet. (1995-2012). Retrieved October 29, 2012, from:http://behavenet.com/node/21491 World Health Organization. (2012). Retrieved October 31, 2012, from:http://www.who.int/en/
  • 21. + Question Whatdo you think about Feeding and Eating Disorders being combined together?