Feeding Assessment Consensus Definition
An initial assessment of feeding includes considerations within the medical, nutritional, feeding skill, and psychosocial health domains. Due to the interactions across these domains, impairment in one domain can lead to dysfunction in any of the others (Goday, et al., 2019).
A disturbance in oral intake of nutrients, inappropriate for age, lasting at least two weeks and associated with one or more of medical, nutritional, feeding skill, or psychosocial dysfunctions constitutes pediatric feeding disorder (PFD) (Goday, et al., 2019). The assessment process leads to the diagnosis of the presence or absence of pediatric feeding disorder (American Speech-Language-Hearing Association, 2019); (Goday, et al., 2019).
A thorough assessment also provides the basis for:
- a statement of severity, e.g. mild, moderate, severe (World Health Organization, 2002); (Skeat & Perry, 2005)
- a statement of prognosis (helps to manage intervention resources and promotes accountability)
- the development of a comprehensive management plan
- facilitating inclusion of all relevant healthcare professionals
- achieving the best possible safety, relational. and responsive feeding outcomes for the child
Interdisciplinary collaboration and a team approach is necessary to distinguish physiologic-specific symptoms and signs of pediatric feeding disorder (Goday, et al., 2019). For further information on discipline roles in relation to the assessment and management of PFD:
Refer to: Role Descriptors and Tasks within Full Scope
Effective feeding and eating assessments are very detailed, and require the collection of all relevant information. Feeding and eating assessments can often take more than one hour to complete, or continue over more than one appointment.
Information gathered about the child may include:
- medical, social and feeding history
- medications taken
- current nutrition intake from all sources (oral, enteral, other)
- growth measurements
- oral sensorimotor structure and function
- sensory processing
- overall motor development
- environmental factors
- parent responsiveness to child's cues
- feeding relationship
- an understanding of what is important to the parent and child
Sensitive Assessment of Feeding Issues
Parents of children with pediatric feeding disorder may experience high levels of emotional distress. It is essential that healthcare professionals are mindful of and responsive to parents’ feelings, perspectives, beliefs, and cultural values. An assessment process that is not empathetic may contribute to parents feeling criticized and blamed, resulting in disengagement with the feeding service.