The Multidisciplinary Feeding Program at CHOC Children’s offers comprehensive outpatient feeding evaluations for children who would be appropriate for G-tube weaning or are potentially at-risk for g-tube placement due to small amount of calories the child is able to eat by mouth. The two-hour evaluations are conducted by our team of specialists who are experts in the various aspects of feeding problems, delays and disorders. These experts include a gastroenterologist, gastroenterology nurse practitioner, registered dietician, speech pathologist, occupational therapist, psychologist and clinical social worker. The goal of the evaluations is to gain a better understanding of the child’s feeding problems, as well as the medical or behavioral issues that make feeding a struggle.
What to Expect
Prior to the evaluation, caregivers will be asked to fill out and submit three important documents: a food log, questionnaire and sensory profile. Some families may also be asked to submit medical records and therapy notes. If the food log, questionnaire or sensory profile are not turned in ahead of time, it is very important to bring them already completed to the child’s appointment.
Because watching the child eat is a very important part of the evaluation process, we ask that the child come hungry and ready to eat a meal. We also ask that caregivers bring the following:
- Two preferred foods the child likes to eat.
- Two non-preferred foods the child typically refuses to eat.
- A beverage
Foods can be hot or cold, as a microwave is available for foods that need to be warmed.
The two-hour feeding evaluation takes place in the CHOC Children’s Specialty Care Clinic. Caregivers should allow time to park in our parking structure and will enter the clinic. After checking with at the Specialty Care kiosk, patients are brought to the exam area. In order to get a full understanding of each child’s specific feeding problems, we typically follow the plan below:
- The child is weighed, measured and has blood pressure and temperature taken.
- The family is shown to a treatment room with a one-way mirror and meets all members of the evaluation team.
- The caregiver (parent or legal guardian) and child sit at a table and eat a meal as they would at home, while the team observes behind the one-way mirror. After a mealtime observation, team members come into the room two disciplines at a time to gather information. (For example, the speech pathologist and occupational therapist may come into the room and after they leave the psychologist and nurse practitioner may enter to ask questions or observe more closely.)
- At the conclusion of the evaluation, the whole team meets with the family to provide feedback and preliminary recommendations. The recommendations can range from suggestions for therapy and work the family can do with the child at home to recommendation for admission to our 19-day inpatient feeding program.
The child’s caregiver receives a written report in the mail within a month of the evaluation.