Journal of Pediatric Psychiatry, Vol 24, 193-214, Copyright © 1999 by Society of Pediatric Psychology
ME Kerwin
OBJECTIVE: To identify treatment studies for severe pediatric feeding
problems that meet the modified methodological criteria of the Task Force
on Promotion and Dissemination of Psychological Procedures (1995). METHODS:
Articles in peer-reviewed medical and psychological journals (1970-1997)
reporting psychosocial or behavioral intervention studies targeting an
identified oral feeding problem in children were selected. Methodologically
rigorous studies were identified and treatments were classified as well
established, probably efficacious, or promising interventions according to
specified criteria. RESULTS: Effective interventions for children with
severe feeding problems are contingency management treatments that include
positive reinforcement of appropriate feeding responses and ignoring or
guiding inappropriate responses. Promising interventions include positive
reinforcement for acceptance and not removing the spoon for refusal and
swallow induction training. CONCLUSIONS: Because only studies of behavioral
interventions met methodological criteria, well-controlled intervention
studies are needed across a variety of theoretical perspectives.
Empirically supported treatments for feeding problems exist; it is now time
to turn to questions about for whom they are appropriate, and when, and
why.
ARTICLE
Empirically supported treatments in pediatric psychology: severe feeding problems
Department of Psychology, Rowan University, Glassboro, New Jersey 08028, USA. kerwin@rowan.edu
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