Pediatric Feeding Disorders Inpatient Program
Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD 21205
Director:
| Program Director: Charles Gulotta, Ph.D. Medical Director: Anil Darbari, M.D. | Kennedy Krieger Feeding Disorders Program Featured on CNN |
The Pediatric Feeding Disorders Inpatient Program offers a unique, comprehensive and interdisciplinary program providing evaluation and treatment of individuals with impairment of oral intake or appetite who require 24-hour nursing, medical supervision or fluid intake.
Inpatient services are recommended for children with severe feeding difficulties (e.g., failure-to-thrive, vomiting, G-tube dependence, total food refusal) so that close medical assessments, nutritional monitoring, oral motor assessments, and intense behavioral interventions can be conducted.
Each discipline conducts a variety of assessments to determine the child's course of treatment. For example, medical work-ups may be required to rule-out or begin medical treatments for possible physiological etiologies of the feeding problem. Behavioral psychology will assess the severity and type of the child’s food refusal or selectivity, observe meals, and begin to evaluate treatment options based on the information gathered. An occupational therapist and/or speech pathologist may need to assess the child's oral motor abilities to determine whether or not the feeding difficulty is related to neurological deficits or oral motor dysfunction. A nutritionist may need to evaluate the nutritional and caloric requirements for catch-up growth. Finally, social work may need to assist the family in dealing with psychosocial issues and/or identify and obtain other community resources.
During the first week of a child's inpatient admission, a steering meeting is held during which the team discusses each member's evaluation results and discusses potential goals for admission. Immediately following this meeting, a parent/caregiver conference is held where all participating disciplines present to review and finalize goals with the parent/caregivers. Throughout the child's admission, the team and parent/caregivers work together with each discipline coordinating therapies to meet the child's admission goals. Typical admission goals include (but are not limited to):
Almost all children with feeding disorders display inappropriate mealtime behavior that interferes with food consumption, regardless of the disorder's etiology. Therefore, a major focus of the program for most children is on the behavioral assessment and treatment of feeding problems. The pediatric feeding disorders program has a long and successful history of applying the principles and procedures of applied behavior analysis to the assessment of feeding disorders. Throughout the child's admission, individualized behavioral assessments are conducted for a number of reasons: (a) to identify the appropriate behavioral treatment procedures; (b) to assess the efficacy of ongoing treatment; and (c) to determine the components of treatment necessary to maintain treatment gains. Throughout the child's admission, the interdisciplinary team meets regularly to continually review and adjust the child's treatment as necessary to meet admission goals.
Prior to discharge, a parent/caregiver meeting is held to review with the parent/caregiver the outcomes of treatment and plans for follow-up care. Typically children receiving behavioral treatment during the admission will receive follow-up services from behavioral psychology for two years post-treatment, with continued adjustment and monitoring of home treatment protocols to ensure the child's continued improvement at home. Other disciplines will also provide follow-up services, usually through Feeding and Swallowing Clinic visits or in conjunction with the behavioral psychology follow-up.
Inpatient services are recommended for children with severe feeding difficulties (e.g., failure-to-thrive, vomiting, G-tube dependence, total food refusal) so that close medical assessments, nutritional monitoring, oral motor assessments, and intense behavioral interventions can be conducted.
Each discipline conducts a variety of assessments to determine the child's course of treatment. For example, medical work-ups may be required to rule-out or begin medical treatments for possible physiological etiologies of the feeding problem. Behavioral psychology will assess the severity and type of the child’s food refusal or selectivity, observe meals, and begin to evaluate treatment options based on the information gathered. An occupational therapist and/or speech pathologist may need to assess the child's oral motor abilities to determine whether or not the feeding difficulty is related to neurological deficits or oral motor dysfunction. A nutritionist may need to evaluate the nutritional and caloric requirements for catch-up growth. Finally, social work may need to assist the family in dealing with psychosocial issues and/or identify and obtain other community resources.
During the first week of a child's inpatient admission, a steering meeting is held during which the team discusses each member's evaluation results and discusses potential goals for admission. Immediately following this meeting, a parent/caregiver conference is held where all participating disciplines present to review and finalize goals with the parent/caregivers. Throughout the child's admission, the team and parent/caregivers work together with each discipline coordinating therapies to meet the child's admission goals. Typical admission goals include (but are not limited to):
- Increase weight
- Increase PO intake
- Increase food texture/types of food consumed
- Decrease G-tube/bottle dependence
- Decrease mealtime inappropriate behaviors
- Increase Self Feeding
- Assessment of and reduction of mealtime emesis (vomiting)
Almost all children with feeding disorders display inappropriate mealtime behavior that interferes with food consumption, regardless of the disorder's etiology. Therefore, a major focus of the program for most children is on the behavioral assessment and treatment of feeding problems. The pediatric feeding disorders program has a long and successful history of applying the principles and procedures of applied behavior analysis to the assessment of feeding disorders. Throughout the child's admission, individualized behavioral assessments are conducted for a number of reasons: (a) to identify the appropriate behavioral treatment procedures; (b) to assess the efficacy of ongoing treatment; and (c) to determine the components of treatment necessary to maintain treatment gains. Throughout the child's admission, the interdisciplinary team meets regularly to continually review and adjust the child's treatment as necessary to meet admission goals.
Prior to discharge, a parent/caregiver meeting is held to review with the parent/caregiver the outcomes of treatment and plans for follow-up care. Typically children receiving behavioral treatment during the admission will receive follow-up services from behavioral psychology for two years post-treatment, with continued adjustment and monitoring of home treatment protocols to ensure the child's continued improvement at home. Other disciplines will also provide follow-up services, usually through Feeding and Swallowing Clinic visits or in conjunction with the behavioral psychology follow-up.
Contacts:
To make a referral or request an initial evaluation:
Contact our Care Management Office
Toll-Free Referral: (888) 554-2080
Local Referral: (443) 923-9400
To make a referral or request for an international patient:
For additional assistance related to visas, travel and translation services appointments for international patients are scheduled through our affiliate
Johns Hopkins International
Contact our Care Management Office
Toll-Free Referral: (888) 554-2080
Local Referral: (443) 923-9400
To make a referral or request for an international patient:
For additional assistance related to visas, travel and translation services appointments for international patients are scheduled through our affiliate
Johns Hopkins International
·Behavioral Psychology Outpatient Programs
·Day Feeding Program
·Feeding Disorders Clinic
·Nutrition Outpatient Program
·Occupational Therapy Clinic
·Pediatric Feeding Disorders Continuum
·Speech and Language Outpatient Clinic
·Day Feeding Program
·Feeding Disorders Clinic
·Nutrition Outpatient Program
·Occupational Therapy Clinic
·Pediatric Feeding Disorders Continuum
·Speech and Language Outpatient Clinic
The Resource Finder: A Project of Kennedy Krieger Institute
Dysphagia Resource Center
(www.dysphagia.com)
Outpatient Programs l Inpatient Programs l Community Programs l
Continuums l Genetic Laboratories l Clinical Disciplines/Depts.
Dysphagia Resource Center
(www.dysphagia.com)
Continuums l Genetic Laboratories l Clinical Disciplines/Depts.