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Question & Answer --> FAQ's
Who gets feeding issues?
Feeding issues affect approximately 25-40% of children, from newborns to adolescents. Approximately 80% of children with developmental disabilities have a feeding problem. Feeding and swallowing problems are symptoms often associated with complex medical diagnoses. The mission of the Center for Pediatric Feeding and Swallowing is to provide a collaborative medical, motor, and learning-based approach to children with complex feeding and swallowing difficulties.
Causes
- Feeding and swallowing problems occur in children for a variety of reasons:
- Birth and genetic defects
- Gastrointestinal defects
- Infection/inflammation
- Food allergies
- Vomiting
- Pain
- Injury, surgery, cancer
- Trauma
- Premature births
- Fatigue
- Dysphagia
- Developmental disabilities
- Ineffective therapeutic interventions
- Naso- or gastrointestinal tubes
- Failure to thrive
- Environmental issues
- Prolonged subsistence on one food
Questions Commonly Asked By Caregivers
We are always glad to answer any of your questions or direct you to a
person who can. The information in this handbook is designed to answer
many of the most commonly asked questions.
Do we use force-feeding?
No. Force-feeding, defined as placing food into the child's mouth without
giving the child the clear opportunity to accept food independently or
with instruction, is never used. We always attempt to use the techniques
that are the least intrusive in meeting our treatment goals. All of our
treatment plans include a positive reinforcement component (such as praise
or toy play), and they may also include other techniques, which do not
allow children to end a meal by crying or turning away.
What is the typical length of stay?
A typical day treatment admission lasts from four to five weeks. The length
of stay is primarily based on the patient's progress in the program. Other
factors, such as medical condition and insurance continuance, can sometimes
affect the length of the admission. Children stay in Day Treatment all
day, unless another appointment has been previously scheduled. Please
make your child's primary therapist aware of any such appointments well
ahead of time.
How are treatment decisions made?
Our Feeding Therapists collect objective data during each session. We
review these data daily to evaluate the children's progress. All of our
treatment decisions are data based and decided by the entire team.
Will my child have a daily schedule?
A typical day, including meals, therapies, and other activities, will
look something like this:
9:00 Meal
9:30 - 11:00 Other Therapy / Playroom
11:00 Meal
11:30 - 1:30 Other Therapy / Playroom
1:30 Meal
2:00 - 3:30 Other Therapy / Playroom
3:30 Meal
It is important to remember that each child's schedule is determined by health, medical, and feeding needs. Schedules will vary according to the needs of each individual child.
Why is Baseline Assessment important?
Baseline is used to measure the level of the child's feeding behavior
before we start treatment. The data we gather during baseline are used
to determine the effectiveness of our treatment. Baseline data are also
used to determine which behavioral treatment we will use. The amount of
baseline data we take depends entirely on the child's performance. Remember
that baseline is the yardstick against which we measure the effectiveness
of our treatment. In addition, baseline data help us choose the "best-fit"
treatment for your child.
Can other caregivers come in to observe and receive training?
Yes! We are certainly willing to help train as many of your child's caregivers
as possible. If there is another person(s), such as a therapist, teacher,
babysitter, or other relative who routinely feeds your child and whom
you would like to have trained, please discuss this with your child's
primary therapist.
Why does my spouse (or mother, babysitter, therapist, etc.) need to
be trained?
We have found that consistency is very important in our feeding program.
It is preferable to have all care providers using the same feeding protocol
so that the child can learn what is expected during the meal. It is also
important that other caregivers be trained to feed in case you are unable
to feed for whatever reason.
Will my child be eating like other children when he/she leaves the
center?
Depending on the severity of your child's feeding issues, your child
may not be eating like other children upon discharge. Although the long-term
goal is almost always to have your child eating like other children, this
process may take some time.
What happens if my child gets sick at home and refuses to eat?
Before discharge, we will review techniques for you to use when your child
is ill. If your child does get sick at home, please call ahead of time
and inform your therapist after consulting with your child's pediatrician.
We will then be able to advise you on feeding them
What are my right's as a Patient?
Parents' Rights Regarding Treatment
- Parents will be involved to the maximum extent possible in determining their children's menus (e.g., parents will have input as to foods that are/are not culturally appropriate). It should be noted that doctor's orders pertaining to allergy-safe diets will always be followed.
- Parents will be given a full range of possible/feasible treatment options and outcomes.
- Parents' input in making decisions concerning treatment will be given the fullest consideration. Parents may elect to choose a less intrusive treatment, which may result in slower progress.
- When discussing treatment options and recommendations, the staff
will attempt the following:
a) The staff will explain the rationale for recommendations.
b) When applicable, the staff will demonstrate the recommendations.
c) The staff will attempt to identify parental concerns.
d) The staff will attempt to address any concerns identified.
e) The staff and the team will attempt to provide alternative recommendations and propose compromises when feasible.
f) The staff and caregivers will agree upon a specific time period over which to evaluate change. - Parent recommendations cannot be implemented when they are deemed:
-- dangerous
-- contraindicated by past experience
-- unethical
-- unfeasible
-- ineffective
e.g., treatment without any reinforcement
mealtimes at odd hours (e.g., middle of night)
excessive punishment (corporal punishment)
excessive rate of treatment changes
developmentally inappropriate
Confidentiality
Over the course of a child's admission here at the Center for Pediatric
Feeding and Swallowing, parents may find themselves inadvertently exposed
to information concerning other patients in our program. In situations
such as these, we ask caregivers to keep this information confidential.
Information about patients themselves, or their families must remain confidential
in all instances, and should not be discussed with anyone, including staff.
A particular area of concern is observing a patient other than your child during a feeding session. Unless you have obtained the permission from a parent or guardian of a patient in the program please do not observe any meals other than your own child's. If you have any questions relating to confidentiality, please speak to either your therapist or to a senior staff member.
Important Contact Phone Numbers
Front Desk (973) 754-4300