Single Provider vs. Multidisciplinary Team Approaches in Pediatric Feeding Disorders

Objective(s): -To define and compare single service vs. multidisciplinary intervention approaches.
-To report on outcomes relevant to single service vs. multidisciplinary service in the treatment of ARFID.
-To distinguish between feeding and swallowing disorders and eating disorders.

Data Sources: Databases: PubMed, CINAHL, Global Health, Cochrane
Indexing terminology: ARFID, ARFID and co-morbidities, Autism, multidisciplinary feeding, feeding and swallowing disorder, oral aversion, picky eating, selective eating, feeding therapy, feeding program, outpatient therapy, day program, rehabilitation, institutionalized care, team approach, Diagnostic and Statistical Manual of Mental Disorders-5, DSM-V).

Study Selection: Information was collected from articles retrieved from the above mentioned databases. Single subject case reviews were limited. The focus was on discriminating between feeding and swallowing disorders and eating disorders in the context of ARFID (Avoidant Restrictive Food Intake Disorder), as well as, finding results related to patient safety and outcomes when intervention was offered using a team vs, single service approach. Settings included were: single service outpatient, day program, and hospitalization/institutionalization.

Data Extraction: Completed reviewed with guidelines that included research published since 2013 relevant to first publishing of ARFID in DSM-V. Article selection and data extraction was relevant to the pediatric population with range of early childhood through early adulthood. Data collection excluded adults.

Data Synthesis: Qualitative research and data analysis completed resulted in widening the scope of understanding Pediatric Feeding Disorder (PFD) and its commonly known co-occurring diagnoses and ARFID. Specifically, a focus on feeding concerns associated with Autism Spectrum Disorder (ASD) and Avoidant/Restrictive Food Intake Disorder (ARFID). We highlight the SLP’s role in differential diagnosis, referral processes and treatment. We include a literature review comparing single service and multidisciplinary approaches as intervention methods for PFD and the impact on habilitation/rehabilitation.

Conclusions: We were able to identify risks involved in the diagnosis of ARFID and the limited availability of evidence based methods for intervention include: incorrect identification resulting in delays in intervention, poor management of care, lack of parental/caregiver education, extension of costly services impacting resources for finances and time for parents/caregivers, dietary diversity, vitamin and mineral deficiency impacting growth and well-being, social acceptance and engagement, and texture advancement. Findings were strongly indicative of multidisciplinary approach along with parental/caregiver education as being the methods with most comprehensive success positively impacting response to treatment and outcomes.

Author(s) Disclosures: The authors do not have any relevant disclosures at this time.