Intensive Day-Treatment Feeding Program: Treatment

The Intensive Day-Treatment Feeding Program uses a goal-oriented and scientifically supported approach based on the principles and procedures of applied behavior analysis (ABA). Our intensive program is for infants, children, and adolescents who have not made progress in outpatient feeding therapy or whose feeding disorder is causing medical emergencies. The child’s team observes and measures child and caregiver behavior and makes data-based decisions. The approach is highly successful and children in programs that use this approach meet 90% of their treatment goals.

The child and family participate in two levels of services. The child and family start in the intensive feeding program that helps caregivers make a big change in the child’s feeding behavior. Once the intensive feeding program ends, the child and family will remain with their same feeding team for an outpatient follow-up program. The goal of the service continuum is for the child to eat like other children. Caregivers play a critical role as members of the treatment team and the program’s success depends on caregiver participation.

Children are appropriate for the Intensive Day-Treatment Feeding Program if they have had at least 3 months of outpatient feeding therapy and:

• Do not eat many foods
• Get most calories from tube feedings
• Have mealtime behavior that causes stress for caregivers
• Have oral-motor skill deficits
• Are not eating like other children
• Are not growing well

If your child has not had at least 3 months of outpatient therapy, they may still be appropriate for the Intensive Day-Treatment Feeding Program if they:

• Have a naso-gastric tube and the amount they eat or drink has not increased for at least 3 months
• Have been hospitalized for dehydration two or more times in the past 2 months
• Are losing weight

Intensive Day-Treatment Feeding Program (Level 1)

The purpose is to help caregivers make a big change in the child’s feeding behavior.

What to expect:

Caregiver participation is required. The child will come to the clinic all day, Monday through Friday, for approximately 8-12 weeks. A team will work with the child and caregiver and assess why the child has a feeding disorder. The team will use that information to develop a treatment plan and teach caregivers how to do the treatment in the clinic. The team will then go to the home or arrange for telehealth observations (caregivers and child at home, team in clinic) during the final week of the intensive admission and make sure the treatment works for the caregivers in the home. Caregivers are NOT required to be present for all appointments, but must attend at least weekly training appointments throughout the admission.

The child graduates from the Intensive Day-Treatment Feeding Program when:

• The child meets their treatment goals
• The caregivers are trained to use the treatment
• And, the team has observed the child eat outside of the clinic (e.g., in the home)

Intensive Follow-up Feeding Program (Level 2)

The purpose is to make sure the child’s improved feeding behavior maintains after the child and family finish the Intensive Day-Treatment Feeding Program and to continue progressing the child to age- or developmentally typical eating.

What to expect:

The intensive follow-up feeding program starts right after the child finishes the intensive day-treatment feeding program. The appointments are once or twice per week for 30 minutes to 1 hour each. The therapist will watch the caregiver feed the child. The therapist will give the caregiver homework which will include feeding the child in a certain way and keeping records of the child’s feeding behavior. We typically do intensive follow-up appointments via telehealth. The child and family participate in the intensive follow-up feeding program until the child is an age or developmentally typical feeder or until the caregiver’s goals for the child are met. The intensive follow-up program is about 2 to 3 years, but overall length varies depending on the child’s unique needs and the caregiver’s ability to participate.

Important Information for the Intensive Day-Treatment and Follow-up Feeding Program for Treatment:

How do I schedule feeding treatment?

• The first step is an evaluation. Click here to go return to the CSH feeding services home page.

Where do I go for the intensive day-treatment feeding program treatment?

• The intensive day-treatment feeding program offers treatment at the Children’s Specialized Hospital Somerset site, located at 888 Easton Ave. in Somerset, NJ 08873

What is the appointment schedule for the intensive day-treatment feeding program?

• The child will come to the clinic all day, Monday through Friday, for approximately 8-12 weeks.
• A team will work with the child and caregiver and assess why the child has a feeding disorder. The team will use that information to develop a treatment plan and train caregivers to do the treatment in the clinic.
• The team will go to the home or arrange for telehealth observations (caregivers and child at home, team in clinic) during the final week of the intensive admission and make sure the treatment works for the caregivers in the home.
• Children most commonly come to our program 12-week admissions.

Are caregivers required to attend?

• Yes, but not for all appointments. See below for caregiver participation requirements:
  • All day for the first 3 days of the admission
  • At least 2 hours per week, starting on week 2 until the final 2 weeks of the admission (i.e., Weeks 2-10 during the 12-week admission)
  • 3-5 days during the second-to-last week of the admission
  • 3-5 days of the final week of the admission (home visits)
  • Caregivers may be required to attend full days if the child has unique medical conditions (e.g., seizure disorder) or scheduled tube feedings. We will review these requirements with you during your child’s evaluation.

What approach does the intensive day-treatment feeding program use?

• Our approach uses applied behavior analysis (ABA) as one of the primary tools for assessment and treatment.
• ABA treatments are evidence-based and highly effective for children with feeding disorders.
• This approach is data-based, protocol driven, and outcome oriented, and throughout each child's admission, the team analyzes the data at least daily and makes treatment decisions based on those data.

Is my child allowed to miss school to attend this program?

• It is common that a child admitted to this program will miss school. However, please discuss this program with your child’s school administration. We are happy to provide information and/or letters to schools if appropriate. There also may be time between meals to target school-related activities.

How do caregivers miss work for 12 weeks to attend the intensive day-treatment feeding program with their child?

• Each family situation is unique. Please speak with your employer about options available including FMLA, sick leave, and vacation leave. Also, discuss options as a family including splitting the time between caregivers or asking other extended family members to assist. Review the caregiver attendance requirements in Question 3b of this list, as caregivers are not required to attend all appointments.

What if I need housing during the admission?

• We are still developing partnerships for housing options at this time. The Ronald McDonald House is one potential option, but the spots there fill up quickly. If you would like assistance with housing, please let us know as soon as possible and check in with our treatment team for updates.

What does my child do during the day?

• The typical admission day may look different for each child, depending on their unique needs and goals. Most often, your child will have five meals with breaks between each meal. Your child might play, nap, or work on other skills or behavior between meals, depending on your child’s needs. Please see below for a sample schedule.

Return to Feeding Services Homepage

Need Help? Contact our Feeding Intake Coordinator, call 908-301-5915