As children often have more than one type of feeding difficulty it is recommended that clinicians focus on managing the problematic behaviour rather than targeting their input to any specific diagnosis [17]

The choice of strategies for management and goal setting are determined by the outcomes of the clinical assessment and should be individualised to the child and family’s needs and strengths taking account of the duration and severity of the problem and the impact on growth.

• Children with food refusal may benefit from a supportive mealtime environment that establishes a reciprocal feeding relationship where:
  • Parents decide the what, when and where of feeding and
  • Children decide how much they will eat or if they will eat at all.
• Children who are willing to eat but who experience difficulties with chewing and swallowing will benefit from speech or occupational therapy based interventions
• Identification of disrupted child-parent interactions or high levels of child distress may indicate the need for referral for psychological support and intervention.

Children with delayed development learn in a similar way to typically developing children.  However acquisition of new skills usually takes longer.  Strategies may need to be implemented in small steps.  Parents may need support to be consistent with strategies and recognise achievements. 

Examples of strategies to achieve identified goals are included in the case scenarios.

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