PFD and ARFID
ARFID was generated as a mental health diagnosis to describe children with feeding problems and related nutritional risk or deficiency without coincident body image problems, as seen in anorexia. PFD is a multidisciplinary diagnosis that includes feeding dysfunction in any one or several of the four domains, medical, nutrition, feeding skill, or psychosocial. PFD also may be applied to children with ARFID, as ARFID may be considered PFD when psychosocial and/or nutritional dysfunction is present in the absence of skill and/or medical dysfunction. When ARFID is diagnosed in young children, the standard of care should involve a detailed workup that considers the four domains of PFD to ensure that skill and/or medical factors are not contributing to the child’s feeding struggles.
“If a patient has a diagnosis of ARFID, it may be worth reassessing from the pediatric feeding disorder (PFD) perspective to see if the cause of feeding difficulties might include a medical or skill dysfunction, and not be purely behavioral.” -Dr. Richard Noel, Feeding Matters Volunteer Medical Director
View diagnostic criteria for PFD and ARFID
These 6 questions have been shown to accurately identify and differentiate PFD from typical feeding development in children 0-4 years of age.1 2
Looking for support with your child's feeding?
Whether your child has PFD, ARFID, or both, Feeding Matters is here to help. View our family support resources and let us take your feeding journey with you.
1. Barkmeier-Kraemer JM, Linn C, Thompson HL, Byrd RS, Steinfeld MB, Hoffman RG, Silverman AH. Preliminary Study of a Caregiver-based Infant and Child Feeding and Swallowing Screening Tool. JPGN 2017; 64: 979-983.
2. Silverman AH, Berline KS, Linn C, Pederson J, Schiedermayer, Barkmeier-Karamer JM. Psychometric Properties of the Infant and Child Feeding Questionnaire. J Pediatr 2020.
3. Bryant‐Waugh, R., Micali, N., Cooke, L., Lawson, E. A., Eddy, K. T., & Thomas, J. J. (2019). Development of the Pica, ARFID, and Rumination Disorder Interview, a multi‐informant, semi‐structured interview of feeding disorders across the lifespan: A pilot study for ages 10–22. International Journal of Eating Disorders. 52(4):378-387)