Intensive, Manual‐based Intervention for Pediatric Feeding Disorders: Results From a Randomized Pilot Trial
Abstract
Objectives: The aim of this pilot study was to investigate feasibility and preliminary efficacy of an intensive, manual‐based behavioral feeding intervention for children with chronic food refusal and dependence on enteral feeding or oral nutritional formula supplementation. Methods: Twenty children ages 13 to 72 months (12 boys and 8 girls) meeting criteria for avoidant/restrictive food intake disorder were randomly assigned to receive treatment for 5 consecutive days in a day treatment program (n = 10) or waitlist (n = 10). A team of trained therapists implemented treatment under the guidance of a multidisciplinary team. Parent training was delivered to support generalization of treatment gains. We tracked parental attrition and attendance, as well as therapist fidelity. Primary outcome measures were bite acceptance, disruptions, and grams consumed during meals. Results: Caregivers reported high satisfaction and acceptability of the intervention. Three participants (1 intervention; 2 waitlist) dropped out of the study before endpoint. Of the expected 140 treatment meals for the intervention group, 137 (97.8%) were actually attended. The intervention group showed significantly greater improvements (P < 0.05) on all primary outcome measures (d = 1.03–2.11) compared with waitlist (d = −1.13–0.24). A 1‐month follow‐up suggested stability in treatment gains. Conclusions: Results from this pilot study corroborate evidence from single‐subject and nonrandomized studies on the positive effects of behavioral intervention. Findings support the feasibility and preliminary efficacy of this manual‐based approach to intervention. These results warrant a large‐scale randomized trial to test the safety and efficacy of this intervention.
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Many people with ARFID experience somatic, interoceptive, or sensory sensations as aversive and act to suppress them.
“Early medical conditions and/or somatic symptoms such as abdominal pain may lead some with ARFID to experience somatic sensations as aversive.”
From Feeling and body investigators (FBI): ARFID division—An acceptance-based interoceptive exposure treatment for children with ARFID (2019) · cites this paper as Sharp et al., 2016
In a pilot treatment study of children with ARFID, 60% had gastroesophageal reflux, where eating is followed by pain.
“in a pilot treatment study for children with ARFID, 60% had gastroesophogeal reflux, a condition whereby pain follows eating (Sharp et al., 2016).”
From Feeling and body investigators (FBI): ARFID division—An acceptance-based interoceptive exposure treatment for children with ARFID (2019) · cites this paper as Sharp et al., 2016
Several case studies have demonstrated the success of core ARFID treatments, particularly behavioural interventions, in a non-autistic population.
“several case studies have demonstrated the success of core ARFID treatments, particularly behavioural interventions, in a non-autistic population, [87][88][89]”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [89]
There are promising psychosocial treatments for ARFID in children and adolescents.
“There are currently a number of promising psychosocial treatments for ARFID in children and adolescents (e.g., Dumont, Jansen, Kroes, de Haan, & Mulkens, 2019); Lock, Sadeh-Sharvit, & L’Insalata, 2019; Sharp et al., 2016; Thomas et al., in press).”
From Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder (2021) · cites this paper as Sharp et al., 2016
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Behandeling met gedragstherapie of toegepaste gedragsanalyse bij kinderen van één tot zes jaar
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- Authors
- Sharp, W. G., Stubbs, K. H., Adams, H., Wells, B. M., Lesack, R. S., Criado, K. K., Simon, E. L., McCracken, C. E., West, L. L., & Scahill, L. D.
- Affiliations
- Emory University (US)
- Marcus Autism Center Atlanta GA
- Georgia Institute of Technology (US)
- Corresponding author
- Sharp, William G.
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2016-04
- Volume
- 62
- Issue
- 4
- Pages
- 658-663
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2323571464
- Semantic Scholar
- 158e0a3d34daec642f2889568ab1c3ac77e5b05b
- Cited by
- 102
- References
- 16
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 16 · 2023: 12 · 2022: 9 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 10 · 2017: 5 · 2016: 2
- FWCI
- 4.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- pediatric feeding disorders, avoidant/restrictive food intake disorder, food refusal, meal ingestion, parent training, intervention fidelity, feasibility
- MeSH terms
- Diet, Healthy, Behavior Therapy, Child Behavior, Child, Preschool, Combined Modality Therapy, Feasibility Studies, Female, Follow-Up Studies, Food Preferences, Georgia, Humans, Infant, Male, Manuals as Topic, Parents, Patient Acceptance of Health Care, Patient Care Team, Patient Compliance, Pilot Projects, Practice Guidelines as Topic, Feeding and Eating Disorders of Childhood, Meals
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