Lydia Blank*, Georg Friedrich Hoffmann, Rainer Blank
Aim: To examine the long-term outcome of severe paediatric feeding and eating disorders as perceived by their caregivers in relation to predominant areas of comorbidities in the neurodevelopmental and behavioural field.
Methods: A sample of 103 patients (ICD-10 F98.2, age below 7 years, all previously referred for a four-week inpatient eating intervention between 2009 and 2016) was followed up by a parent questionnaire with the target parameters being age-appropriate eating and long-term improvement (Likert scale 1-10).
Four comorbidity subgroups were compared: 1) neurological comorbidities (“Neuro-group”, n=28), 2) behavioural comorbidities (“Psy-group”, n=24), 3) developmental delay without severe neurological or behavioural disorders (“DD-group”, n=22) and 4) without any neurodevelopmental or behavioural disorders (non- DNP-group, n=29).
Results: After a mean follow-up period of 3.5 years (n=103), the non-DNP-group (normal development and low rate of comorbidities) achieved the best outcome. The Neuro-group had the least age-appropriate eating behaviour on follow-up, while their caregivers experienced good life satisfaction and surprisingly low burden of disease; they were similarly satisfied with previous treatment as caregivers of non-DNP-group. Caregivers of Psy-group described a better outcome than those from the Neuro- and DDgroup, however lowest satisfaction and felt highest burden of the child eating problems.
Conclusion: Feeding and eating disorders are persisting for a long time in children with disabilities. It seems that caregivers of children with neurological disabilities adequately lowered their outcome expectations and developed better coping strategies. This stays in contrast to caregivers of children with behavioural disorders.
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