Sandra Maestro1, Olivia Curzio2, Sara Calderoni1,3, Virginia Silvestri1, Claudia Intorcia1, Claudia Roversi1, Cecilia Simi1, Valentina Lorenzoni4. 1. Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128, Calambrone, Italy. 2. Department of Biomedical sciences, Unit of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology of the National Research Council IFC-CNR, Via G. Moruzzi, 1, 56124, Pisa, Italy. olivia.curzio@ifc.cnr.it. 3. Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy. 4. Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà n. 33, 56127, Pisa, Italy.
Abstract
PURPOSE: To provide a description about a cohort of preschoolers with feeding disorders (FD) recruited from the therapeutic nursery "Cerco Asilo" of a tertiary care University Hospital, and to evaluate the short-term clinical outcome after 6 months of multidisciplinary treatment. METHODS: The present inception cohort study was based on an observational longitudinal research design comparing families who underwent the multidisciplinary treatment and those who did not. 42 children (47.6% female; 52.4% males-mean age 36.7 months, SD 17.2, range 2.3-65 months) underwent FD assessment according to the DC-0-3R diagnostic criteria (T0). At the end of the assessment, 62% of families with FD children agreed to be included in the family-based treatment. Both treated and untreated children with FD underwent a follow-up clinical evaluation after 6 months (T1) from baseline. Comparison of clinical features at T0 between groups of subjects resolving or not the FD was performed. To evaluate baseline factors associated with FD resolution, principal components analysis (PCA) was used to identify new synthetic variables that were then used in a logistics analysis. Moreover, clinical differences between T1 and T0 were compared with a t test. RESULTS: Two third of the cases (66.7%) resolved the FD, while one third (33.3%) did not. Children who had the FD resolved displayed at T0 significant differences in clinical features with respect to those who did not. Specifically, the FD subtype Feeding Disorder of Caregiver-Infant Reciprocity was strongly associated with resolution, while the subtype Infantile Anorexia was not. In addition, the component depicting "Anxious-Depressed", "Mood" and "Isolation" problems was independently associated with a significantly higher probability of resolution, similar to children having FD other than anorexia. CONCLUSIONS: FD in preschoolers are associated with problems in emotional development and in the relationship with parents. These difficulties tend to accentuate if the disorder persists. The study suggests the need to investigate the maintaining factors of FD in preschool age. LEVEL OF EVIDENCE: Level IV: Evidence obtained from multiple time series with and without the intervention.
PURPOSE: To provide a description about a cohort of preschoolers with feeding disorders (FD) recruited from the therapeutic nursery "Cerco Asilo" of a tertiary care University Hospital, and to evaluate the short-term clinical outcome after 6 months of multidisciplinary treatment. METHODS: The present inception cohort study was based on an observational longitudinal research design comparing families who underwent the multidisciplinary treatment and those who did not. 42 children (47.6% female; 52.4% males-mean age 36.7 months, SD 17.2, range 2.3-65 months) underwent FD assessment according to the DC-0-3R diagnostic criteria (T0). At the end of the assessment, 62% of families with FD children agreed to be included in the family-based treatment. Both treated and untreated children with FD underwent a follow-up clinical evaluation after 6 months (T1) from baseline. Comparison of clinical features at T0 between groups of subjects resolving or not the FD was performed. To evaluate baseline factors associated with FD resolution, principal components analysis (PCA) was used to identify new synthetic variables that were then used in a logistics analysis. Moreover, clinical differences between T1 and T0 were compared with a t test. RESULTS: Two third of the cases (66.7%) resolved the FD, while one third (33.3%) did not. Children who had the FD resolved displayed at T0 significant differences in clinical features with respect to those who did not. Specifically, the FD subtype Feeding Disorder of Caregiver-Infant Reciprocity was strongly associated with resolution, while the subtype Infantile Anorexia was not. In addition, the component depicting "Anxious-Depressed", "Mood" and "Isolation" problems was independently associated with a significantly higher probability of resolution, similar to children having FD other than anorexia. CONCLUSIONS: FD in preschoolers are associated with problems in emotional development and in the relationship with parents. These difficulties tend to accentuate if the disorder persists. The study suggests the need to investigate the maintaining factors of FD in preschool age. LEVEL OF EVIDENCE: Level IV: Evidence obtained from multiple time series with and without the intervention.
Authors: W Hobart Davies; Ellyn Satter; Kristoffer S Berlin; Amy F Sato; Alan H Silverman; Elizabeth A Fischer; Joan C Arvedson; Colin D Rudolph Journal: J Fam Psychol Date: 2006-09
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Authors: Praveen S Goday; Susanna Y Huh; Alan Silverman; Colleen T Lukens; Pamela Dodrill; Sherri S Cohen; Amy L Delaney; Mary B Feuling; Richard J Noel; Erika Gisel; Amy Kenzer; Daniel B Kessler; Olaf Kraus de Camargo; Joy Browne; James A Phalen Journal: J Pediatr Gastroenterol Nutr Date: 2019-01 Impact factor: 2.839