{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:42:52Z","timestamp":1789764172539,"version":"4.0.1"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,9,1]]},"abstract":"<jats:sec><jats:title>Objectives.<\/jats:title><jats:p>To determine the results of diagnostic evaluation and the effects of nutritional intervention on energy consumption, weight gain, growth, and clinical status of children with neurodevelopmental disabilities and suspected feeding disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We studied 79 children with moderate to severe motor or cognitive dysfunction (male:female, 38:41; age, 5.8 \u00b1 3.7 years) who were referred for diagnosis and treatment of feeding or nutritional problems. Initial assessments included a 3-day calorie intake record, videofluoroscopic swallowing study (VFSS), 24-hour intraesophageal pH monitoring, milk scintigraphy, and esophagogastroduodenoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>These studies demonstrated gastroesophageal reflux (GER) with or without aspiration in 44 of 79 patients (56%), oropharyngeal dysphagia in 21 (27%), and aversive feeding behaviors in 14 (18%). Diagnosis-specific approaches included medical GER therapy in 20 patients (25%), fundoplication plus gastrostomy tube (GT) in 18 (23%), oral supplements in 17 (22%), feeding therapy only in 14 (18%), and GT only in 10 (13%). After 24.6 \u00b1 3.0 months, relative calorie intake, expressed as intake (kcal\/d)\/recommended daily allowance (RDA, kcal\/d), improved significantly (initial:final = 0.78 \u00b1 0.36:1.23 \u00b1 0.27). The z scores increased significantly for both weight (initial:final = \u22122.80 \u00b1 1.33:\u22120.81 \u00b1 0.69) and height (\u22123.14 \u00b1 0.98:\u22122.00 \u00b1 0.67). Improved subcutaneous tissue stores were demonstrated by increased thickness of both subscapular skinfolds (change = 71% \u00b1 26%) and triceps skinfolds (38% \u00b1 17%). After nutritional intervention, the acute care hospitalization rate, compared with the 2-year period before intervention, decreased from 0.4 \u00b1 0.18 to 0.15 \u00b1 0.06 admissions per patient-year and included only 3 admissions (0.02 per patient-year) related to feeding problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>In children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status. These data also indicate that decreased morbidity (reflected by a lower acute care hospitalization rate) may be related, at least in part, to successful management of feeding problems. Our results emphasize the importance of a structured approach to these problems, and we propose a diagnostic and treatment algorithm for children with developmental disabilities and suspected feeding disorders.children, developmental disabilities, fundoplication, gastroesophageal reflux, gastrostomy, hospitalization, nutrition.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.108.3.671","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"671-676","source":"Crossref","is-referenced-by-count":123,"title":["Diagnosis and Treatment of Feeding Disorders in Children With Developmental Disabilities"],"prefix":"10.1542","volume":"108","author":[{"given":"Steven M.","family":"Schwarz","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics and the"},{"name":"Stanley S. Lamm Institute for Developmental Medicine and Child Neurology, Long Island College Hospital, State University of New York Downstate Medical Center, Brooklyn, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julissa","family":"Corredor","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Fisher-Medina","sequence":"additional","affiliation":[{"name":"Stanley S. Lamm Institute for Developmental Medicine and Child Neurology, Long Island College Hospital, State University of New York Downstate Medical Center, Brooklyn, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cohen","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics and the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2001,9,1]]},"reference":[{"key":"2021121010030053400_B1","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/j.1651-2227.1996.tb14129.x","article-title":"Feeding and nutritional characteristics in children with moderate or severe cerebral palsy.","volume":"6","author":"Dahl","year":"1996","journal-title":"Acta 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