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

Feeding Matters welcomes all families with children who struggle to eat and the professionals who serve them. Information and support is inclusive of all diagnoses related to feeding difficulties.

View diagnostic criteria for PFD and ARFID



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PFD Resources

ARFID Resources

We are grateful to Jennifer J. Thomas, PhD, FAED for sharing the following ARFID resources.

 

Book Reference: Thomas JJ, Becker, KR, Eddy KT. The Picky Eater’s Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder. Cambridge, UK: Cambridge University Press; 2021.

 

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

PFD Screening Tool

The PARDI-AR-Q is a self-report measure of the symptoms of avoidant restrictive food intake disorder (ARFID), based on the Pica, ARFID, and Rumination Disorder Interview (PARDI).3

ARFID Screening Tool

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.

View Family Support Resources

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)