Pediatric Feeding Disorder in Early Intervention: Expanding Access, Improving Outcomes, and Prioritizing Responsive Feeding

Abstract

Purpose: Pediatric feeding disorder (PFD), like many childhood medical conditions, is likely to negatively impact a child's growth and development, daily learning opportunities, and family functioning. Parents who have children with a diagnosis of PFD may not yet know the most effective way to feed their children and often experience negative emotions surrounding mealtimes. These families may receive therapy services through early intervention (EI) programs. In many states, there are barriers that limit access to programs and provision of high-quality care for this population. These barriers include the lack of an approved single feeding-related diagnosis that renders a child automatically eligible, lack of approved stand-alone feeding-specific testing tools with which to determine eligibility, lack of educational and clinical experience requirements for providers, and considerable variation in service provision. Method: This clinical focus article reviews the definition of PFD, the multifaceted needs of families and children in EI, support for use of responsive feeding in treatment of PFD, alignment of responsive feeding strategies with EI principles, and barriers limiting access to consistent, high-quality EI services for children with PFD. Several changes to EI programs are proposed to address these barriers. Conclusions: Use of PFD as an automatically qualifying diagnosis for EI programs and use of approved stand-alone feeding-specific assessment tools could establish more consistent and specific eligibility standards for this population, likely expanding early access to support and improving outcomes. EI provider clinical experience and training requirements would likely lead to more consistent and high-quality, evidence-based service provision. Required training should include the use of methods such as routines-based intervention, parent coaching, and anticipatory guidance to support implementation of responsive feeding practices during mealtime routines.