Does your child spit out food, turn his head, swat at the spoon, throw food and cry or scream during mealtime?  Do you ever wonder if other parents encounter the same difficulties during mealtime?  If you answered "yes" to both, you're not alone. For children with developmental or intellectual disabilities, they face a variety of challenges in their life.  Pediatric food refusal happens to be one of the most common types of problems these children face (Kerwin, 1999). 

To qualify for a formal feeding disorder diagnosis, a child must refuse or be unable to eat a sufficient amount or variety of food that results in the child losing weight or failing to gain weight or meet their nutritional needs (Shore & Piazza, 1997).  A child with a feeding disorder may refuse to consume solid foods entirely or may be food selective in which only certain types or textures of foods will be accepted (i.e., smooth textures like pudding, yogurt, applesauce or mashed potatoes are rejected or only crunchy, brown peanut butter flavored cookies, granola bars and pretzels are consumed).  In other cases, children may display food selectivity based upon the presentation of the food, such as consuming plain white rice only but rejecting white rice if combined with vegetables, sauces, herbs or wild rice.  A peanut butter sandwich might be consumed but only if the peanut butter and jelly are each distributed on their own piece of bread without the pieces touching on the plate.  Over time, the variety of foods a child will consume shrinks and/or the list of rules about how certain foods must be presented in order to accept them grows, resulting in further weight loss and nutritional deterioration for the child. 

While approximately 25% of typically developing children experience a feeding disorder, the rates are as high as 80% for children with developmental disabilities.  Thus, this is a common problem challenging caregiver.  Pediatric food refusal is classified into one of three categories:  organic (medical), non-organic (behavioral) or mixed .  The research indicates that children who engage in food refusal of the non-organic or mixed type engage in refusal because often the demand to consume the foods is withdrawn.  This results in an increase in refusal or other problem behaviors in the future during mealtimes (Woods, Borrero, Laud and Borrero, 2010)

If you are concerned with your child's nutrition or if your child is displaying some of the symptoms described above, your child should be evaluated by a medical professional (i.e., pediatrician) to determine if your child's nutrition is deficient and the cause.  Your child's doctor will determine if a referral to other professionals, such as a speech pathologist, registered dietitian or OT, is necessary.  If medical variables have been ruled out and it is determined the problem is behavioral in nature, a Board Certified Behavior Analyst with specialized training in using Applied Behavior Analysis (ABA) can work with your child to increase acceptance of a wider array of foods and liquids.  At Alliant Behavioral Pediatrics, we treat mild to moderate cases of pediatric food selectivity that are not organic (medical) in nature.  Contact us at info@alliantbehavioral.com so we can determine if we can assist you in your child's needs.  Listed below are other recognized, qualified professionals specializing in the treatment of pediatric feeding disorders.   


RESOURCES
University of Nebraska Medical Center:  Munroe-Meyer Institute
Dr. Cathleen Piazza

http://www.unmc.edu/mmi/pfdclinic.htm
http://www.unmc.edu/mmi/cathleenpiazzaphd.htm

The Marcus Autism Center-Pediatric Feeding Disorders Program
Dr. David Jaquess

http://www.marcus.org/default.aspx?id=37

University of MN:  Pediatric Feeding Clinic
http://www.uofmchildrenshospital.org/Specialties/Rehabilitation/Programs/index.htm


REFERENCES
Woods, J., Borrero, J., Laud, R., & Borrero, C.  (2010).  Descriptive analyses of pediatric food refusal:  The structure of parental attention.  Behavior Modification, 34(1), p. 35-56.

Kerwin, M. (1999).  Empirically supported treatment in pediatric psychology:  Severe feeding problems.  Journal of Pediatric Psychology, 24, 193-214.

Shore, B, & Piazza, C.  (1997).  Pediatric feeding disorders.  In E.A. Konarski, J.E. Favell, & J.E. Favell (Eds.), Manual for the assessment and treatment of the behavior disorder of people with mental retardation (pp. 65-89).  New York:  Guilford.

 
 
For anyone that holds a supervisory level, management position in an organization, this is a must read on how to be an even more effective and successful leader by avoiding these five mistakes. 

http://www.forbes.com/sites/alexknapp/2012/02/13/five-leadership-mistakes-of-the-galactic-empire/
 
 
This article is making headlines in the state of MN currently.  Follow the link for the full article.

http://www.startribune.com/lifestyle/wellness/139556798.html

 
 
BLUE CROSS TO DROP FUNDING FOR EARLY INTENSIVE BEHAVIORAL INTERVENTION

This recent article from the Pioneer Press gives you a sense of what could be happening and how important it is to contact your own legislator.

"Blues rein in autism care coverage. Insurer plans to begin dropping costly intensive therapy; advocates fear state program at risk, too"By Christopher Snowbeck, Pioneer Press, St. Paul, Minn.McClatchy-Tribune Information ServicesDec. 20--Blue Cross and Blue Shield of Minnesota will begin dropping coverage in most cases for a costlytherapy for autistic children as early as Jan. 1 -- a change that has patient advocates worried about losingcoverage through a key state program, too.The Eagan-based health insurer said Monday that the coverage change will be phased in over next year andaffect about 200 children who have been receiving a treatment known as early intensive behavioralintervention. The treatment cost averages about $80,000 per year.Autism is one of four developmental disabilities grouped under the heading of Autism Spectrum Disorders,which can cause significant social, communication and behavioral changes. The federal government estimatesthat an average of one in 110 children in the United States have one of the disorders.Blue Cross is changing its coverage policy to match that of other health plans as well as the stateDepartment of Human Services, said Pam Lux, a spokeswoman for the insurer.That's bad news, patient advocates said, because Blue Cross has been one of the few health plans to providecoverage of the intensive therapy, which in some cases involves 40 hours per week of treatment.But the insurer's reference to the Department of Human Services also is concerning, advocates said, becausethe state has been a key source of coverage for families that don't have Blue Cross coverage."We're concerned that this is a harbinger of something on the horizon -- that the state is going to say: 'This is not a covered service,' " said Amy Esler, a psychologist at the autism spectrum disorders clinic at the University of Minnesota.But Patrice Vick, a spokeswoman with the Department of Human Services, said Monday: "We're not makingany changes in our coverage of autism services."The state does not offer blanket coverage for the therapy, advocates said, but patients get access to theservices as part of what the state calls "skills training."The state's public health insurance programs provide access to the intensive behavioral therapy for about 300to 500 children, estimated Amy Dawson, an attorney with the Autism Advocacy and Law Center inMinneapolis.

EVENT PURPOSE:
The purpose of this event is to learn how anyone can contribute to the needed advocacy efforts during this legislative session. From 9:00-10:30am there will be presenters detailing what the issues are, how to identify your legislators, what to talk with them about and how we can work together to secure the necessary funding for services related to children with autism. From 10:30-12:00 we will assist you in meeting with your legislators. Detailed below are two links to use to identify who your legislators are based on your home address. If possible, please contact your legislators in advance to schedule a meeting with them on 02/28/12 directly following our event.http://www.autismvotes.org/c.frKNI3PCImE/b.3932687/k.F652/Find_My_Legislators/siteapps/advocacy/search.aspxhttp://www.gis.leg.mn/OpenLayers/districts/

Your action is needed to secure continued coverage for Early Intensive Behavior Intervention (EIBI). Throughout the 2012 Legislative Session we need to rally and advocate together to prevent cuts in coverage and to secure coverage for the treatment that children with autism deserve. This event is open to all concerned individuals including parents, friends, providers, staff and physicians. We have invited a number of legislators to attend as well.

LOCATION:
Minnesota Judicial Center
25 Rev. Dr. Martin Luther king Jr. Blvd.
St. Paul, MN 55155

For directions and parking information from the Minnesota Judicial Center's website: http://www.mncourts.gov/?page=CourtHouseProfile&ID=40090

Most of the public ramps have metered parking available so bringing quarters is recommended.

Please rsvp your attendance to Sheri Radoux at sheri182002@yahoo.com or to Kristy Oldham at koldham@lovaas.com.
 
 
Dear Parents,

Researchers at Penn State University are initiating an exciting new research project and would like your help. We are trying to recruit parents whose children with autism spectrum disorder (ASD) are between 8 and 12 years old to complete a survey about the video game behaviors of their children.

Participation in this study will involve completing a 10-15 minute survey about whether or not your child with ASD plays video games. If your child does play video games the survey will ask you to answer questions about the ways your child engages with this media and how you feel about this activity as a leisure pursuit. If your child does not play video games the questions on the survey will follow-up on the types of activities that your child does engage in during leisure time. The information gathered will be used to determine how preferred activities, like video gaming, may be used to promote improvement of social and educational outcomes for children with ASD.

Dr. Erinn Finke (814.867.4340/ enh109@psu. edu) or Dr. Benjamin Hickerson (814.867.2900/ bdh14@psu. edu) would be happy to answer any questions you may have about the study, or about the people we are trying to recruit as participants.

Please click (or copy and paste) the link below if you are willing to help us with this important project:

https://pennstate. qualtrics. com/SE/?SID= SV_50eWjcNjF2jdv hi

Thank you in advance for your assistance with this project,

Erinn Finke, Ph.D. and Benjamin Hickerson, Ph.D.
The Pennsylvania State University
 

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