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Feeding Disorders of Early Childhood: An Empirical Study of Diagnostic Subtypes
No full textFeeding disorders in DSM-5: Diagnostic and therapeutic considerations
Ammaniti M. ("Sapienza" University of Rome, Italy), Bryant-Waugh R. (Great Ormond Street Hospital, United
Kingdom), Ammaniti M. ("Sapienza" University of Rome, Italy), Chatoor I. (Children National Medical Center,
United States), Keren M. (Université d'Israël et AEPEA, Israel), Lucarelli L. (Psychology Department. University of
Cagliari, Italy), Cimino S. ("Sapienza" University of Rome, Italy), D'Olimpio F. (University of Naples, Italy)
In DSM-IV-TR Feeding Disorder of Infancy or Early Childhood is a broadly defined category which in practice
includes a range of presentations and is therefore of limited clinical utility. In DC: 0-3 R Feeding Behavior Disorder
includes six subcategories describing specific types of feeding disorder starting from the early months of life.
However, it is important to emphasize that only some of these categories have been confirmed by clinical research,
with a range of other classificatory terms used in the literature also having limited empirical support. Inconsistent
use of terminology and inadequacies with current diagnostic and classificatory systems remain a significant problem
for the field of feeding disorders. In the draft revisions for DSM-5, consistent with a wider recognition of the need to
reflect growing evidence of continuity between psychopathology more generally across the age range, it has been
proposed to move all feeding and eating disorders into a single category of Feeding and Eating Disorders. Across
both DSM-5 and ICD-11 it is proposed that disorders should no longer be placed under a heading of "onset usually
occurring in childhood and adolescence" but a life-span approach should be adopted with guidance given regarding
age-related manifestations of the same core disturbance. Accordingly the intention is that disturbances in feeding
and eating should be organized by core features of psychopathology and presentation, with DSM 5 Feeding and
Eating Disorders including a proposed category of Avoidant/Restrictive Food Intake Disorder. This would in effect
subsume Feeding Disorder of Infancy or Early Childhood. This Symposium will approach some of the key issues
relating to the diagnosis of feeding disorders from four different perspectives. Our aim is to illustrate and emphasize
the importance of sensitive and valid diagnostic placeholders in developing and evaluating therapeutic interventions,
and in furthering the feeding disorders field in both research and clinical practice. We need to improve our ability to
consistently select and implement optimal strategies for specific feeding disorders, and to evaluate the outcomes of
our therapeutic interventions to confirm and enhance our intervention strategies. Rachel Bryant-Waugh will provide
an overview of diagnostic issues across DSM-IV-TR, DC: 0-3 R and proposed revisions for DSM-5. Massimo Ammaniti (Chair) will use research data to discuss the differentiation among the DC:0-3R categories of Infantile
Anorexia, Sensory Food Aversion and Feeding Disorder Associated with Insults to the Gastrointestinal Tract. Miri
Keren will present parent-infant group therapy as a model for treating Infantile Anorexia and Irene Chatoor will
present 5 – 10 year follow-up data on a cohort of toddlers with Infantile Anorexia. Speakers will together present for
a maximum of 60 minutes with at the end of the session time being given over for active discussion with delegates
of the issues raised
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