Dumont Eric, Jansen Anita, Duker Pieter C, Seys Daniel M, Broers Nick J, Mulkens Sandra
Deparment of Research and Development, SeysCentra, Malden, Netherlands.
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
Front Pediatr. 2023 Feb 28;11:1108185. doi: 10.3389/fped.2023.1108185. eCollection 2023.
Treating disordered feeding at a young age reduces risks of future feeding problems, but not all children profit equally; can we define predictors of a worse prognosis?
In 252 children, with a mean age of 4; 7 years (SD = 3 years; range 5 months to 17; 10 years), who had undergone behavioral day treatment in the past, several variables were investigated, retrieved from initial consultation (t1) and re-assessed at follow-up (t2).
Logistic regressions were carried out with sex, gastro-intestinal problems, refusal of the first nutrition, syndrome/intellectual disability, Down's syndrome, autism spectrum disorder, comorbidity of medical diseases (other than gastro-intestinal problems), restrictive caloric food intake and selective food intake, as the predictor variables from t1, and age-appropriate food intake at t2 as the dependent variable. The potential role of sensory processing problems was reviewed at t2.
About 73% had improved towards an age-appropriate food intake. Sex (boys), syndrome/intellectual disability, and a lack of varied nutritional intake at t1 were predictors of a worse prognosis. We found a small, but significant correlation between current selective eating patterns and general sensory processing problems.
Feeding disordered children, especially boys, with intellectual disabilities or selective eating patterns are at risk for not achieving an age-adequate food intake at a later age, despite behavioral treatment.
在幼年时期治疗喂养失调可降低未来出现喂养问题的风险，但并非所有儿童都能同样受益；我们能否确定预后较差的预测因素？
对252名儿童进行了研究，这些儿童的平均年龄为4岁7个月（标准差=3岁；范围为5个月至17岁10个月），他们过去曾接受过行为日间治疗，研究从初次咨询（t1）中获取并在随访时（t2）重新评估了几个变量。
以性别、胃肠道问题、拒绝初次营养摄入、综合征/智力残疾、唐氏综合征、自闭症谱系障碍、内科疾病合并症（除胃肠道问题外）、限制性热量食物摄入和选择性食物摄入作为t1时的预测变量，以t2时适合年龄的食物摄入量作为因变量进行逻辑回归分析。在t2时评估了感觉加工问题的潜在作用。
约73%的儿童已改善至适合年龄的食物摄入量。性别（男孩）、综合征/智力残疾以及t1时缺乏多样化的营养摄入是预后较差的预测因素。我们发现当前的选择性进食模式与一般感觉加工问题之间存在小但显著的相关性。
尽管接受了行为治疗，但有喂养障碍的儿童，尤其是男孩、有智力残疾或选择性进食模式者，在较晚年龄仍有无法实现适合年龄的食物摄入量的风险。
