Marcus Autism Center, Atlanta, GA, USA.
Clin Child Fam Psychol Rev. 2010 Dec;13(4):348-65. doi: 10.1007/s10567-010-0079-7.
A systematic review of the literature regarding treatment of pediatric feeding disorders was conducted. Articles in peer-reviewed scientific journals (1970-2010) evaluating treatment of severe food refusal or selectivity were identified. Studies demonstrating strict experimental control were selected and analyzed. Forty-eight single-case research studies reporting outcomes for 96 participants were included in the review. Most children presented with complex medical and developmental concerns and were treated at multidisciplinary feeding disorders programs. All studies involved behavioral intervention; no well-controlled studies evaluating feeding interventions by other theoretical perspectives or clinical disciplines met inclusion criteria. Results indicated that behavioral intervention was associated with significant improvements in feeding behavior. Clinical and research implications are discussed, including movement toward the identification of key behavioral antecedents and consequences that promote appropriate mealtime performance, as well as the need to better document outcomes beyond behavioral improvements, such as changes in anthropometric parameters, generalization of treatment gains to caregivers, and improvements in nutritional status.
对有关儿科进食障碍治疗的文献进行了系统评价。在同行评审的科学期刊（1970-2010 年）中，确定了评估严重拒食或选择性进食治疗的文章。选择并分析了显示严格实验控制的研究。该综述纳入了 48 项单项案例研究报告，共涉及 96 名参与者。大多数儿童表现出复杂的医疗和发育问题，并在多学科的进食障碍项目中接受治疗。所有研究均涉及行为干预；没有符合纳入标准的、针对其他理论观点或临床学科的喂养干预措施的对照良好的研究。结果表明，行为干预与喂养行为的显著改善相关。讨论了临床和研究意义，包括确定促进适当用餐表现的关键行为前因和后果的方向，以及需要更好地记录除行为改善以外的结果，例如人体测量参数的变化、治疗效果向照顾者的推广以及营养状况的改善。
