Child & Family Development Child & Family Development

November 13, 2017

Multidisciplinary Feeding Clinic at C&FD

blog_feeding_clinic.jpg

Child and Family Development is pleased to expand our services to include: Multidisciplinary Feeding Evaluations & Clinic Services 

This specialty clinic offers both multidisciplinary evaluations and treatment services for children, ages 4-16 years old, with feeding disorders and/or extreme picky eating. This service is appropriate for children or adolescents who have been formally diagnosed with Avoidance/Restrictive Food Intake Disorder (AFRID).

This clinic occurs at our Pineville office with an expert diagnostic team including: 

‚Ä¢ psychologists and counselors 
• occupational therapists
‚Ä¢ speech therapists  

Feeding problems are characterized by:

• A restricted range or variety of foods, usually less than 20 items
• Resistance to adding new foods
• Refusal of categories of food textures, temperatures or appearance
• Long feeding/ meal times (more than 30 minutes)
• Frequent gagging or vomiting
• Taking a few bites and then refusing more food
 

The Sequential Oral Sensory Feeding Approach‚Ñ¢ (SOS) model will work to expand children‚Äôs food repertoire, improve oral motor skills, and develop socially acceptable feeding behaviors. It is designed to help increase a child‚Äôs comfort with eating both in the home and community. The focus of treatment will be on food exploration in a comfortable and sensory supportive environment and will also include a parent education component. Many of our speech therapists and occupational therapists have specialty training in both the sensory and motor aspects of a feeding or swallowing problem. Treatment for feeding disorders can help a child become a functional eater. Treatment strategies include work on oral sensory awareness, motor execution and motor planning tasks, social modeling, structured meal and snack times, positive reinforcement and home programming. These services are designed to provide parents with the training they need to target their child‚Äôs eating strategies outside of the clinic and produce positive outcomes. 

EVALUATIONS: The evaluation would include an examination of the structures and movements in the mouth, observation of feeding behaviors, observations of the influences of respiration and posture, and informal assessment of nutrition. Food and drink trials are often included in an assessment. Review of medical history form and other records which are shared prior to first appointment. Standardized behavioral questionnaires are provided for parents and teaching/daycare staff to gain information on skills in the home/school settings and to identify any psychological symptoms which warrant specific treatment (e.g., anxiety). Consultative time is an essential portion of this specialty service and is an out of pocket expense.

• Intake 1-hour diagnostic interview with psychologist for parents only
• Testing Session: 1 ½ hour evaluation with both speech therapist and occupational therapist. This allows comprehensive observation of skills and represents a best-practice approach to evaluation services for feeding therapy.
• Interpretive Parent Conference (IPC): 1 hour appointment with parents and members of the diagnostic team during which parents are able to thoroughly understand their child’s development and feeding therapy plan. A written report includes findings, diagnostic impressions and recommendations.

Estimated evaluation cost: $2,381.00 (partially billable to insurance); may be billable to insurance ($1,205.00) and out-of-pocket only ($270.00). 

FEEDING CLINIC SERVICES: The clinic starts with a parent interview with a psychologist or counselor to review the child’s medical history and gather detailed information about the child’s feeding history, mealtime environment, and related behaviors. A behavioral questionnaire is provided to parents and teachers/childcare providers to gather information from both settings. The feeding clinic provides a 12 week structured curriculum to provide parents with all of the skills and knowledge they need to continue to produce positive outcomes after the clinic ends.

The clinic services are a 2-pronged approach that provides individualized intervention. Parents meet with psychologists and counselors without their children present to learn detailed strategies that work to change their child’s behaviors and approach to food (approximately 8 sessions). Parents and children also participate in several joint sessions to learn effective interventions to learn coping strategies and reduce anxiety (approximately 4 sessions).

Children work 1:1 with a feeding therapist using the (SOS) model with a focus on safe food exploration in a comfortable and sensory supportive environment. This evidence-based program includes a comprehensive parent education component, and parents are expected to participate on all feeding sessions in order to understand their child’s feeding behavior and effective management interventions.

A parent only summary session is provided at the end of the 12 week course with both feeding therapist and psychologist/counselor to review progress and provide a specific plan for next steps.

Both rehabilitation and psychological treatment is billable to insurance. Psychologists and counselors are in-network with Aetna and BCBS. Deductibles and copays apply. An out of pocket charge is included in the registration for services which covers consultative time for treatment team members to meet to discuss each case in detail.

Estimated clinic services cost: billable to insurance ‚Äì 12 weekly therapy sessions for both psychology and rehab services and self-pay only – $ 336.00

Read more about the C&FD multidisciplinary feeding clinic here