Inside Pediatrics Winter 2017

a G-tube. He would drink a little bit of water, but it wasn’t significant. When he graduated the program after seven-and-a- half weeks, he consumed 100 percent of his nutrition orally. Two years later, while his parents still monitor his eating and continue to work with him, he eats his bologna sandwich in the school cafeteria at lunchtime with other students. The transition to eating in a school cafeteria was a difficult one, and her son initially lost four pounds after starting kindergarten, but Watkins worked with school counselors, administration and teachers to put a plan in place. She called the clinic for advice during this time and was guided toward success. “I can’t say enough about the staff there,” Watkins said. “Even today, two years after we graduated from the program, I could call and get help.” Graduates of the Intensive Feeding Program are discharged upon reaching their identified goals. Once children complete the day treatment program, the team guides additional feeding goals at specified intervals for the next year post-discharge. Mastin said the success of the program is rooted in the partnership with caregivers, an integrated team approach and making treatment plans and changes based on measurable data and observation. The program uses a behavioral modification approach while integrating oral-motor skill development and the provision of optimum nutritional interventions. “We meet children where they are in terms of their eating and drinking and systematically build on their current skills while teaching them new skills,” Mastin said. The program currently cares for three children at a time in day treatment. The process for a child to participate in the day treatment program begins with a referral and subsequent comprehensive evaluation. During that evaluation, the team makes recommendations from a medical, nutritional, therapeutic, behavioral and psychosocial perspective. The team identifies whether a child is a candidate for the day treatment program, and if the family and team agree, the program will continue to follow up with the child until he or she is admitted into the day treatment program. During this time, the medical

Michelle Mastin, PhD, clinical psychologist and director of the Intensive Feeding Program at Children’s of Alabama, observes Hilyer Watkins with mother, Bridgit, during a treatment session.

said Michelle Mastin, PhD, clinical psychologist and director of the program. “While we understand the commitment and sacrifice that families make to participate in the feeding program, without active and engaged parent involvement, we would not be successful helping the child sustain progress and make additional gains following the day treatment admission.”

“Intense doesn’t even describe it,” said Bridgit Watkins, whose son, Hilyer, graduated from the program. “It’s in the name, and they try to warn you, but until it’s your child, you just don’t understand how different things are going to be and how it carries over into your homelife.” Like most children entering the program, Hilyer, who was 4 at the time, was 100 percent dependent on

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