Cleveland Clinic Children's Outcomes
Cleveland Clinic Children's Hospital for Rehabilitation
Severe Food Restriction Group
2023
Data were collected on all patients treated in the Pediatric Feeding Disorders Program for 2018 through 2023.
Patients needed to meet criteria for one of two treatment groups:
Severe food restriction (consumes limited number of foods/food groups at the time of initial evaluation)
Inadequate oral feeding skills to manage developmentally appropriate volumes of solids and/or liquids
Progress for the first two treatment groups was measured in several ways:
- Level of refusal behavior:
a. Mild – saying no, ignoring the food on the plate
b. Moderate – batting at the spoon, whining, turning away, refusing to open mouth
c. Severe – tantrums, being combative, intentional vomiting
- Level of oral motor difficulty based on the following behaviors: gagging, pocketing, expelling/anterior spillage of bites or liquid, or the inability to demonstrate an appropriate rotary chewing pattern
a. Mild – only one of the above noted behaviors is present
b. Moderate – two of the above noted behaviors is present
c. Severe – 3-4 of the above noted behaviors is present
- Number of foods added to the diet over the course of treatment
Children seen in the Feeding Program ranged in age from 10 months to 13 years at the time of initial evaluation.
All patients received treatment from an interdisciplinary team that included practitioners from Psychology, Occupational Therapy, Speech Therapy, and Nutrition. The data collected focused on the general outpatient treatment group. Data were measured at the initiation of treatment, follow-up, and discharge.
Improvement in Refusal Behavior for Restrictor Group
2023
Improvement in Oral Skills for Restrictor Group
2023
An Increase in the Number of Foods in the Diet at Follow-Up
2023
76% of patients demonstrated no oral skill impairment at the time of discharge. In addition, 86% of patients demonstrated mild to no refusal behavior at discharge. This would indicate that levels of resistance at accepting new foods decreased through the course of treatment to allow the patient to expand their diet and develop appropriate oral skills with behavioral intervention.
By the initial follow-up, 76% of patients had added foods to their repertoire. At the time of discharge, 95% patients increased their food repertoire and 67% of those patients discharged added at least 21 foods.