The proposed presentation will focus on psychosocial evaluation and psychosocial evidence-based treatment approaches for pediatric feeding disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), among children ages 2-18. This presentation will inform psychosocial providers on tailoring assessment and treatment based on developmental level and identification of meaningful caregiver and family-specific treatment targets. We will present the most recent literature on evidence-based assessment and intervention across developmental stages and the role of caregivers and families in feeding concerns and treatment. Case examples from our own outpatient practices, which are embedded in two multidisciplinary programs at Boston Children’s Hospital (The Growth and Nutrition Program which serves children up to age 7, and the ARFID Program for patients ages 7 and up) will be included. Assessment for Pediatric Feeding Disorders: We will discuss the specific role of psychosocial evaluation within a multidisciplinary context for managing pediatric feeding disorders. We will review validated patient and caregiver questionnaires used within our clinics across different age groups to aid in assessment and conceptualization. Specifically, recommendations for assessing caregiver and family roles in the presenting feeding problems will be reviewed. Psychosocial Intervention within Pediatric Feeding Disorders: The proposed presentation will cover evidence-based treatment components that are applicable across all developmental stages, including collaborative family-centered goal-setting, implementing structured meal times, decreasing mealtime stress, and promoting adaptive mealtime behaviors. Next, we will cover specific treatment applications for younger children and their caregivers, including parent management training, behavioral techniques to increase or decrease behaviors corresponding with feeding goals, addressing caregiver stress, and improving interrelated aspects of the child’s daily routine such as sleep. In older children, we will present maintaining mechanisms of ARFID including food selectivity/sensory sensitivity, low hunger/motivation, and fear of aversive consequences (e.g., choking, gagging, abdominal pain). We will cover treatment protocols based on the most recent literature for each maintaining mechanisms, and will present specific examples of cognitive behavioral treatment strategies targeting each of these maintaining mechanisms. Finally, we will highlight caregiver and family-centered treatment targets when working with older child and adolescents with ARFID and examine similarities and differences in comparison to treating younger children.
By the end of this session, attendees will be able to:
- Evaluate feeding behaviors including those consistent with ARFID across developmental stages
- Identify similarities and differences in the application of psychological treatment strategies for feeding difficulties across developmental stages.
- Understand the specific role of caregiver and/or family in changing these behaviors
Ryan Davidson, PhD
Ryan Davidson, PhD is a licensed clinical psychologist in the Growth and Nutrition Program within the Department of Gastroenterology and Nutrition at Boston Children’s Hospital and in Instructor in Psychology at Harvard Medical School. Dr. Davidson completed her PhD in Clinical Psychology at the University of Arizona and completed her predoctoral internship in pediatric psychology and post-doctoral fellowship on the Psychiatry Consultation Service at Boston Children’s Hospital. Dr. Davidson’s clinical and research interests include working with families as they navigate complex systems and psychosocial stressors including medical and pediatric settings. In her work with the Growth and Nutrition Program, she works within the multidisciplinary team to identify psychosocial factors which may exacerbate feeding difficulties in young children, assists in developing behavioral plans to improve feeding outcomes, and works with families to implement behavioral management strategies.
Financial Disclosures: Receives a salary from the Department of Gastroenterology and Nutrition at Boston Children’s Hospital
Non-financial Disclosures: Serves as the behavioral medicine specialist for the Growth and Nutrition Program at Boston Children’s Hospital
Julia Carmody, PhD
Julia Carmody, PhD is a licensed clinical psychologist in the Department of Gastroenterology and Nutrition at Boston Children’s Hospital, with a faculty appointment at Harvard Medical School. Dr. Carmody earned her doctorate in Clinical and Health Psychology at the University of Florida. Dr. Carmody specializes in treating children and adolescents with Avoidant/Restrictive Food Intake Disorder. She serves as the Attending Psychologist for the multidisciplinary ARFID outpatient program at Boston Children’s Hospital. Dr. Carmody’s research is focused on improving ARFID assessment and treatment, with a focus on the role of caregivers and the family system.
Financial Disclosures: Receives a salary from the Department of Gastroenterology and Nutrition at Boston Children’s Hospital; has a faculty appointment at Harvard Medical School
Non-financial Disclosures: Serves as the attending Psychologist for the ARFID Program at Boston Children’s Hospital