Cleveland Clinic Children's Outcomes

Data were collected on all patients treated in the Pediatric Feeding Disorders Program for 2018 through 2022.

Patients needed to meet criteria for one of three treatment groups:

1. Severe food restriction (consumes limited number of foods/food groups at the time of initial evaluation)

2. Inadequate oral feeding skills to manage developmentally appropriate volumes of solids and/or liquids

3. Diagnosis of ARFID (Avoidant Restrictive Food Intake Disorder) in patients 9 and older who meet DSM-V diagnostic criteria including persistent failure to meet appropriate nutritional and/or energy needs.

Progress for the first two treatment groups was measured in several ways:

1. 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

1. 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

1. Number of foods added to the diet over the course of treatment

Children seen in the Feeding Program ranged in age from 11 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.