Evaluating the Use of Telepractice for Bottle-Feeding Assessments

There is currently limited evidence supporting the use of telepractice to conduct bottle-feeding assessments. This study aimed to investigate the inter-rater reliability of bottle-feeding assessments conducted via synchronous telepractice (real-time videoconferencing). Secondary aims were to investigate parent and clinician satisfaction. Bottle-feeding skills of 30 children (aged 1 month–2 years) were simultaneously assessed by a telepractice SP (T-SP) at a remote location and an in-person SP (IP-SP) at the family home. A purpose-designed assessment form was used to evaluate: (1) developmental level (screen only), (2) state, color, and respiration, (3) oral motor skills, (4), infant oral reflexes, (5) tongue tie (screen only), (6) non-nutritive suck, (7) bottle-feeding, (8) overall feeding skills and (9) recommendations. Results of the T-SP and IP-SP assessments were compared using agreement statistics. Parents reported perceptions of telepractice pre and post session, and also rated post-session satisfaction. The telepractice SP completed a satisfaction questionnaire post-appointment. The majority of assessment components (45/53, 85%) met the agreement criteria (≥80% exact agreement). Difficulties were noted for the assessment of palate integrity, gagging during non-nutritive suck assessment, and 6 components of the tongue tie screen. Parent and clinician satisfaction was high; SPs reported that they would offer telepractice services to 93% of families again in the future. Overall, the results demonstrated that most components of a bottle-feeding assessment could be reliably completed via synchronous telepractice in family homes. However, further research is required to improve the reliability of some intra-oral assessment components.

Sensory Based Feeding Intervention for Toddlers With Food Refusal: A Randomized Controlled Trial

Objective To investigate the effect of sensory-based feeding treatment for toddlers with food refusal compared with only providing nutrition education.Methods Thirty-two toddlers with food refusal were randomly assigned to an intervention group or the control group. Toddlers in the intervention group received the sensory-based feeding intervention and the duration was for 1 hour for 5 days per week for 4 weeks, and then 1 hour, once a week for 8 weeks. Subjects in both the intervention and control groups received nutritional education once every 4 weeks for 12 weeks. The participants were evaluated at their entry into the study and 12 weeks later based on height, weight, behavior at mealtime using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), and sensory processing ability using the Infant/Toddler Sensory Profile.Results Sixteen toddlers were included in each group. Two subjects in the intervention group and four toddlers in the control group were excluded from the final analysis. Significant improvements in child or parent subscales of the BPFAS were observed in the intervention group. In contrast, there were no significant improvements in any BPFAS scores in the control group.Conclusion Sensory-based feeding intervention was effective for improving mealtime behavior in toddlers with food refusal. Therefore, a sensory-based feeding intervention could be considered as an intervention approach to address feeding disorders in toddlers.

Parent Education Class for Children With Feeding Difficulties

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to determine the feasibility and effectiveness of a multidisciplinary educational class for parents in improving child feeding behaviors and reducing caregiver distress associated with feeding difficulties. This class has proven to be effective in educating parents about the intricate and dynamic nature of feeding per positive responses on Behavioral Pediatrics Feeding Assessment Scale, Parent Mealtime Action Scale, and parent survey. Primary Author and Speaker: Adina P. Schwartz Additional Authors and Speakers: Judy Hopkins

Feeding Problems in Typically Developing Young Children, a Population-Based Study

Feeding problems have been estimated to occur in approximately 25–45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents’ feelings about their child’s feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement.

Comparison of feeding behavior problems of hostel and non-hostel living children with ASD in Dhaka

Backgrounds The purpose of this study was to determine the distribution and differences of nutritional status and feeding behavior problems between the school going children with autism spectrum disorder (ASD) who are living either at school hostel or at home with parents of the urban lower-middle-class population in Dhaka city, Bangladesh. Methods This is a cross-sectional study where the children with ASD were randomly selected from 4 schools for children with special needs in Dhaka, Bangladesh. Written consent was taken from the parents of the children. Anthropometric and other nutrition referral data were taken directly from the children during school time. Demographic, parity and behavioral pediatrics feeding assessment scale (BPFAS) module have been interviewed through structured questionnaires from the parents. The referral scores have been applied to measure and compare the mean BPFAS scores. Results 93 children have participated in this study (mean age 10.21 years). It was observed that BPFAS scores for >10 years of age are higher in overall both groups of children (p = <0.05). Parents from joint or bigger families reported higher feeding problems of their child living at home (p = <0.05). Significant difference found in BPFAS score according to the number of siblings in the homegroup (52.0 vs. 81.8; p = <0.01). Mean BPFAS score was higher in the hostel group if the children's parents were highly educated (p = <0.05). No association found in feeding assessment and socio-economic status as we found the SES were quite similar in both groups. Conclusions In this preliminary data, we found that feeding behavior problems reported by parents are less in the hostel living children and also lower in comparatively higher aged children. This study is important for researchers and policymakers as it opens windows to think and do more research about the importance and impact of hostel disciplines and in-home family bonding for the healthy growth of children with ASD. Key messages Higher aged children are have less feeding problem in general. Keeping children with ASD at home in touch of family members have positive impact on their feeding problems and overall nutrition.

Eating Behavior of Children and Feeding Attitudes of Mothers

Aim: Nutritional problem is one of the most common behavioral problems in children. This study was carried out as a descriptive study in order to determine the eating behavior problems of infants and children and to determine the mothers' feelings, thoughts and approaches about feeding process. Method: The population of the study consisted of mothers of children aged 9-72 months who applied to the children's outpatient clinics of a state hospital between April and June 2019; and the sample consisted of 217 mothers who agreed to participate in the study and met the selection criteria. Data were collected using the “Mother-Child Information Form”, “Behavioral Pediatric Feeding Assessment Scale” and “Mother’s Attitudes Towards the Feeding Process Scale”. Number, percentage distribution, mean and Pearson correlation analysis were used to evaluate the data. Results: The total score of the mothers from the Behavioral Pediatric Feeding Assessment Scale was 84.16±16.10; and the total score of the Mother’s Attitudes Towards the Feeding Process Scale was 75.20±17.49. It was found that there was a statistically significant relationship between the mean Behavioral Pediatric Feeding Assessment Scalescore of the mothers and the mean Mother’s Attitudes Towards the Feeding Process Scale score. Conclusion: The results of the study indicated that children have moderately problematic eating behavior and feeding habits. On the other hand, it shows that mothers have moderate problems related to their attitudes towards feeding process. It was also concluded that, as children's eating behavior problems increased, mothers' negative attitudes towards feeding process also increased. Keywords: mothers, feeding, attitude, child, feeding behavior