The Multidisciplinary Feeding Program at Children’s Healthcare of Atlanta is designed for children with chronic and severe disruptions in their relationship with food. Many of the children we treat struggle to gain weight because they eat too little or no food at all during meals or because they rely on formula from a bottle or through a tube. Other children may consume enough calories but will eat only a few types of food. They often reject one or more food groups, like fruits and vegetables.
How do I know if my child needs to be seen in the Multidisciplinary Feeding Program?
Common signs and symptoms of a feeding disorder may include:
- Poor weight gain, weight loss or faltering growth
- Dependence on formula delivered by bottle or feeding tube
- Frequent mealtime tantrums
- Refusing to eat
- Distress and anxiety when trying new foods that interferes with social functioning
- Inability to tolerate different textures
- Extreme food selectivity or pickiness (eating fewer than 12 foods, rejecting one or more food groups)
- Significant nutritional deficiency
Children who experience this level of feeding difficulty often meet diagnostic criteria for avoidant or restrictive food intake disorder, a type of eating or feeding disturbance frequently treated in our program.
Why should my child be seen in the Multidisciplinary Feeding Program?
Avoiding and/or restricting food intake can negatively affect a child’s physical, social and psychological well-being.
The Multidisciplinary Feeding Program at Children’s offers many levels of service to address each child’s unique feeding needs.
This is where children are seen during their first visit in our program. Types of evaluations offered through our Assessment Clinic may include:
- Medical screening: Involves a medical history and physical exam to determine conditions that may contribute to feeding difficulties. Further testing, evaluation or medical referrals may be recommended.
- Behavioral evaluation: Involves a detailed clinical interview of past and current feeding behaviors and practices and a formal meal observation with preferred and nonpreferred foods, and makes recommendations for family eating patterns.
- Nutrition assessment: Involves a clinical interview to review growth trends, current and past food intake, and health history, including GI concerns like gastroesophageal reflux or constipation. The nutrition evaluation also includes a detailed analysis of a three-day food intake record.
- Oral-motor skill assessment: Involves a review of feeding history, current feeding practices, feeding therapies and swallow safety. This assessment also includes conducting a clinical observation of a meal, completing a formal nonnutritive, oral-motor evaluation, assessing oral hypersensitivity and determining oral-motor developmental skill level. Recommendations for improving or enhancing nonnutritive and nutritive oral-motor skills, appropriate foods and liquids for safe feeding, seating suggestions, and further medical recommendations, like a swallow study, are provided.
Medical, psychological, nutritional and oral-motor services are offered on an outpatient basis with coordination of care from different providers as needed. The Outpatient Clinic serves children with feeding disorders who can be treated by less-intensive therapy (one hour, once a week or with one discipline) or children who graduated from the Day Treatment Program but may still need additional assistance.
Day Treatment Program
Children treated in this intensive program receive daily therapy. Typical treatment days include four structured meals, during which implementation is overseen by our multidisciplinary team. During the intervention, children receive ongoing medical monitoring and a physical examination. In addition, families are provided with weekly nutritional consultation, individual oral-motor or sensory therapy and parental support, and counseling.
1. High volumes
- We care for more than 1,000 children each year.
2. Patient satisfaction
- Parents gave high ratings for program satisfaction (4.9 out of 5), program effectiveness (4.3 out of 5) and treatment acceptability (4.6 out of 5).
3. Proven outcomes
- Approximately 85 percent or more of goals set by parents and the treatment team are reached at the completion of the Day Treatment Program.
- Patients eat an average of only three foods upon admission, but they leave eating 19 foods, including at least four fruits, four vegetables, four starches and four proteins.
- More than half of our new patients have feeding tubes, and 70 percent of those patients are completely tube dependent. By discharge, 80 percent of patients need the feeding tube for less than half of their calories.
- On average, tube feedings are reduced from 92 percent of a patient’s daily calories upon admission to 36 percent upon completion of the Day Treatment Program.
Our multidisciplinary team includes psychologists, dietitians, physicians, nurse practitioners, speech-language pathologists, occupational therapists and social workers who collaborate to deliver state-of-the-art clinical care.
Our pediatric gastroenterologist and nurse practitioner assess medical needs to initiate feeding intervention and provide ongoing oversight during intervention.
- Barbara McElhanon, MD, Medical Director, Multidisciplinary Feeding Program
- Bonnie Minter, APRN, CPNP
Our psychologists structure meals to promote intake of new foods and conduct caregiver training to support parents with implementing treatment in the home setting.
- Kristina Patel, PsyD, BCBA
- Kaitlin Proctor, PhD
- William Sharp, PhD, Director, Multidisciplinary Feeding Program
- Kathryn Stubbs, PhD, Psychology Manager, Center for Advanced Pediatrics
- Valerie Volkert, PhD, Psychology Manager, Marcus Autism Center
- Addam Wawrzonek, PhD, BCBA
- Emily Edwards, PsyD
- Kristin Hathaway, PhD, BCBA
Our dietitians monitor growth and nutritional intake to promote balanced nutrition, appropriate growth and tolerance of new foods.
- Rashelle Berry, MPH, MS, RD, LD
- Corinne Jacobs, MS, RDN, LD
- Emily Klc, MS, RDN, LD, CNSC
- Caitlin Waddle, MS, RDN
- Lydia White, MS, RDN, CNSC, LD
- Ivanna Betancourt, MS, RDN, LD
- Ana Kucelin, MS, MEd, RDN, LD
Our speech-language pathologists and occupational therapists focus on oral sensitivity, building oral-motor coordination (specifically coordination for chewing) and the introduction of new food textures for children with difficulty chewing.
Our social worker provides parent support and care coordination to connect families with resources, such as transportation and lodging. She also assists with transition planning.
Our pediatric multidisciplinary feeding clinics are offered at the locations listed below. Outpatient behavioral psychology and nutrition services are available in locations throughout metro Atlanta. Contact us for more information.
Center for Advanced Pediatrics
1400 Tullie Road NE
Atlanta, GA 30329
Children's at Forsyth
The Collection at Forsyth
410 Peachtree Parkway
Cumming, GA 30041-7407
Marcus Autism Center
1920 Briarcliff Road
Atlanta, GA 30329