Ashley Francis

10/22/14
Background and long-term goals: The Feeding Program is located at VCU Childrens Hospital in Richmond,
VA. The Program is an 8-10 week clinical setting facilitated by a team of feeding specialists that include a
Dietitian, Nurse Practitioner, Pediatrician, Psychologist, Speech Therapist, and Occupational Therapist. This
team works to improve feeding issues that children (from infancy to age 21) may experience such as failure to
thrive, food or swallowing phobias, food selectivity, inability to chew or swallow, mealtime behavior problems,
nasogastric or gastronomy tubes, recurrent vomiting, and refusal to eat or drink. These behaviors can be caused
by mental, physical, or behavioral developmental disabilities and may have negative impacts on growth and
health. The Feeding Program aims to improve feeding, nutritional/health outcomes, and growth and/or weight
gain/maintenance as applicable per patient through an intensive feeding curriculum.
Intermediate goals and assumptions: While multidisciplinary feeding clinics are a relatively new intervention
model, research has proven that they are statistically effective. Couriel et. al concluded that a multidisciplinary
feeding approach for children significantly reduced the stress associated with feeding. Substantial
improvements in quality of life were also found (Couriel et al, 1993). Specifically regarding children with
developmental disabilities, research has proven patients gained significant increases in energy intake and skin
fold thickness two years post intervention (Schwarz et al., 2001). Additionally, hospital admissions were
reduced.
Interventions and logic: Patients who are referred to the program through partner providers will undergo a
baseline behavioral feeding assessment. This will allow clinicians to establish a problem and etiology statement
for each patient so that appropriate interventions and goals may be created and tailored for each patient. Patients
will then attend three feeding sessions each day for 8-10 weeks (as selected by clinicians) so that clinicians can
begin practicing mealtime interventions with patients. Weekly meetings will be scheduled with the caregiver
and a primary therapist so that the team can review the childs progress and establish a date of discharge as it
aligns with the tailored goal. Additionally, family training sessions will complete the intervention process.
Family members/caregivers will be able to observe feeding therapy sessions from outside treatment room and
then practice interventions themselves (with therapists) once feeding techniques have been established.

Ashley Francis
10/22/14
Couriel, J. M., Bisset, R., Miller, R., Thomas, A., & Clarke, M. (1993). Assessment of feeding problems in
neurodevelopmental handicap: A team approach. Archives of Disease in Childhood, 69(5), 609-613.
doi:10.1136/adc.69.5.609
Schwarz, S. M., Corredor, J., Fisher-Medina, J., Cohen, J., & Rabinowitz, S. (2001). Diagnosis and treatment of
feeding disorders in children with developmental disabilities. Pediatrics, 108(3), 671-676.
doi:10.1542/peds.108.3.671