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Cox, S. Y.1; Fraker, C.2; Walbert, L.2; Fishbein, M.1

Journal of Pediatric Gastroenterology and Nutrition: June 2004 - Volume 39 - Issue - p S51
ABSTRACTS: Oral Presentation Abstracts

1Department of Pediatrics, SIU School of Medicine,2Department of Pediatric Rehabilitation, St John’s Hospital, Springfield, United States

Submitted by:

Introduction: Extreme food selectivity, defined as an inappropriate limitation of food acceptance based on age and developmental stage, is present in a subset of children with eating aversion. Standard treatment for extreme food selectivity is labor intensive and often includes hospitalization. Recently, “food chaining” has been introduced at this institution as a systematic method for the treatment of children with extreme food selectivity. Food chaining is an individualized, non-threatening, home-based feeding program designed to expand food repertoire by emphasizing similar features (taste, temperature, and texture) between accepted and targeted food items (ie. modified potato preparations enable progression from french fries to chicken pot pie). The efficacy of this technique is being investigated.

Methods: Ten children (5M, 5F), ages 1 to 14, diagnosed with extreme food selectivity between September 2001 and June 2003 were enrolled in a food chaining program for three months. Rating scales were utilized to monitor acceptance of modified food items. Interventions were provided through direct contact, telemedicine, telephone contact, voice mail, electronic mail and videotaping. The modality and duration of therapeutic sessions were based upon the needs and responses of the child and caretakers. Accepted food items were recorded at enrollment and 3 mo later and analyzed by paired t-test.

Results: Children underwent therapeutic sessions 0.5 to 2 hr/wk. Food chaining led to an expanded diet in all cases (p <0.05). There were no treatment failures. The modality and duration of therapeutic sessions was variable.

Table 1

Table 1

Conclusion: Food chaining is an efficacious method to treat extreme food selectivity and may be utilized in children regardless of age and medical background.

© 2004 Lippincott Williams & Wilkins, Inc.