Over the past three decades, the Department of Behavioral Psychology, in conjunction with an interdisciplinary team, has provided services to children with feeding disorders along a continuum of care including interdisciplinary intake evaluations, outpatient services, and intensive services (daily outpatient, day treatment, and inpatient).

The medical and behavioral diagnoses of children referred to the program’s continuum vary widely, including children whose mealtime behavior is a result of one or more environmental, anatomical, and physiological variables. Goals commonly targeted during treatment include increasing the variety of foods accepted, increasing the volume consumed, decreasing tube dependence, advancing food textures, increasing mealtime independence, improving feeding skills, and reducing inappropriate mealtime behavior (e.g., disruptive behavior, gagging, aggressive behavior, out-of-seat behavior). The Pediatric Feeding Disorders Continuum provides doctoral and post-doctoral training as part of Kennedy Krieger Institute’s APA-accredited training program.

For all fellowship opportunities, there is a strong emphasis on post-doctoral fellows gaining experience with different levels of services, with in-person and telehealth modalities, and with interdisciplinary collaboration. Additionally, post-doctoral fellows are strongly encouraged to contribute to program development through involvement with ongoing or independent research and/or clinical program evaluation.

Core clinical opportunities of fellowship include:

Conducting Interdisciplinary Intake Evaluations one to two afternoons per week provides the post-doctoral fellow opportunities to diagnose feeding disorders and provide service recommendations in collaboration with an interdisciplinary team.

The Pediatric Feeding Disorders Outpatient Services offers the opportunity for post-doctoral fellows to assess and treat children with less severe feeding issues in an outpatient setting. Specifically, caregivers and the child attend one hour appointments on a weekly or biweekly basis to address specific skill deficits and problem behavior in meals. Caregivers are trained to implement specific strategies to address the feeding-related concerns.

The Pediatric Feeding Disorders Intensive Services offers the opportunity for post-doctoral fellows to clinically manage intensive cases by providing supervision and oversight of one or more patients within a 6-8 week intensive program. Specifically, the post-doctoral fellow will initially serve as a co-supervisor (along with faculty) of intensive cases with the expectation that the post-doctoral fellow will supervise more independently as they gain experience and confidence in the role of supervisor. The fellow will assume the clinical responsibility for team collaboration with interdisciplinary team members and caregivers throughout the intensive admission.

Postdoctoral fellows in the Pediatric Feeding Disorders Clinic also have the option to complete a minor rotation in the Pediatric Developmental Disabilities Clinic. Fellows completing this minor rotation will receive training one day per week throughout the year focused on the behavioral assessment and intervention for toddlers, children and adolescents with diagnosed or suspected neurodevelopmental disorders who also have challenging behaviors. They will assume the role as primary therapists for their clients and families. Based on initial and ongoing assessment, they will develop function-based interventions to decrease problem behavior and increase appropriate replacement behavior. Throughout, family barriers to treatment are assessed and methods to overcome obstacles are utilized. Common behaviors targeted and disorders treated include tantrums, aggression, elopement, toileting skill deficits, sleep concerns, anxiety, selective mutism, obsessive-compulsive disorder and cognitive inflexibility. Fellows will learn to use interventions, such as behavioral parent training, modified cognitive behavioral therapy, elements of the SPACE program (i.e., decreasing parental accommodation), and components of ACT as appropriate for their clients.