Treatments and Services
Pediatric Feeding Program
What is the Pediatric Feeding Program at Seattle Children’s Autism Center?
We assess and treat children age 1 to 13, with or without autism spectrum disorder, who struggle with eating and drinking in ways that either:
- Put their physical or emotional health at risk
- Lead to dependence on tube feedings or oral formulas
- Cause stress for you and your child at meals
We are one of the only programs in the Pacific Northwest where experts from many areas of healthcare work as a team to give your child and family complete care. Many complex factors affect if and how a child will eat. Our team works closely with each other and with you to:
- Understand your child’s unique feeding problems
- Understand how feeding problems affect your family
- Provide targeted treatment that leads to meaningful change
Who can the Pediatric Feeding Program help?
We treat children with all types of complex feeding problems, such as those who:
- Eat or drink very little and do not gain weight or grow.
- Eat only certain food types or textures.
- Get some or all of their nutrition through a tube in their stomach, bowel or vein (G tube, J tube or NG tube).
- Struggle with the oral motor skills they need to chew, swallow, and eat or drink safely.
- Have sensitivities that make it hard for them to eat a wide range of food types and textures. For example, they might struggle with the way eating or drinking feels or with the taste, smell, texture, bite size or sight of food. They might seem afraid of food coming near their face or mouth.
- Learned that eating is unpleasant or difficult.
- Felt pain with eating due to a health problem, like gastroesophageal reflux or irritable bowel disease.
- Have severe anxiety about mealtimes linked with challenging behaviors. These may include refusing to come to the table for meals, not following directions during meals, having tantrums and being aggressive.
- Have a condition called “avoidant restrictive food intake disorder" (ARFID).
Seattle Children’s has other programs that help children with feeding issues. To learn how these programs differ, see Intensive Feeding Program and Growth and Feeding Dynamics Clinic. Feeding problems are different from eating disorders, which are serious medical and behavioral problems like anorexia nervosa.
How will the Pediatric Feeding Program meet my needs?
Our goal is to build healthy feeding patterns that your child and family can keep using at home and in the community.
- Members of our team have special training in their field and in the unique needs of children who struggle with eating.
- Our team includes child psychologists, registered dietitians, speech and language pathologists (SLPs), licensed behavior analysts, social workers and nurse practitioners.
- We work together to understand:
- Your child’s skills
- Any sensory or medical challenges your child has related to eating
- How your child has learned and felt about eating
- Your child’s response to feeling hungry or full
- Parents and caregivers are keys to your child’s success. You will have an active role in setting treatment goals and figuring out what works.
- We count on you to practice treatment during visits and at home.
- Each child with a feeding problem is different. Drawing from a broad range of treatment methods, we make a treatment plan and schedule to fit your child’s needs.
- During treatment, you and your child’s team will carefully collect data to learn what is working for your child.
- We ask your child to answer questions about themselves, if they can. We also ask you about your child’s behavior and symptoms. You complete data sheets tailored to your family.
- These and other tools help us track your child’s progress and refine their treatment to make it a success.
- Our program does research to learn more about the best ways to help children and families with feeding disorders. We consult with and teach other healthcare providers about feeding disorders and treatment.
Services We Offer
Deciding the best treatment for your child starts with the Pediatric Feeding Program Intake Clinic. During 2 visits, we will:
- Meet you and your child
- Assess your child’s feeding problems
- Learn about your family’s goals for treatment
Then we will recommend a treatment plan, which may combine many methods of care. We may recommend Seattle Children’s services or other care options to discuss with the provider who referred you.
If we recommend this service for your child, we will see them in clinic from 8 a.m. to 5 p.m., Monday through Friday, for 2 to 3 weeks.
During this time, the care team will:
- Work with you and your child on a focused treatment that is custom-made for your child and family
- Teach you treatment methods to practice at home
- Give you tools to track your child’s progress
Because this therapy is so intensive, we can only work with 1 child and family per month.
If your child is in our outpatient feeding therapy service, we will see your child on a regular schedule for many weeks. Visits may be:
- In person at Seattle Children’s Autism Center.
- Via videoconference at a Seattle Children’s regional clinic or in your home or a community setting like your child’s school. The video visit option depends on factors like your child’s needs, the providers your child sees and your insurance.
How often and how long we see your child will depend on their treatment plan. The team will set a schedule when treatment starts. A common schedule is once a week for a few months.
Your child will see the experts from our team who match your child’s needs.
We will teach you treatment methods to practice at home and give you tools to track progress. At each clinic visit, we will practice treatments and check progress together.
We offer classes to help parents understand feeding disorders in children and the first steps towards care. Classes are meant for families who are on the waiting list for the intake visit or our feeding therapy services. You can take classes:
- In person at the clinic.
- Using your tablet, laptop or desktop computer that has a camera. You can take part from home, work or wherever you are.
Learn about Feeding First Steps: Parent Education Class (PDF).
What to Expect at a Pediatric Feeding Program Intake Clinic Visit
- Complete the family questionnaire sent to you by the scheduling team.
- Keep a food diary. Our scheduling team will send you instructions.
- Ask your child’s doctor for any test results that relate to their feeding issues. Have your provider fax them to us at 206-987-8081.
- Your completed family questionnaire
- Your completed food diary
- List of your child’s current healthcare providers (with contact information) and treatment goals
- List of medicines and supplements your child takes (with doses) and any special diet they follow
- Foods and drinks that your child is willing to accept and those they struggle with
During the 60-minute visit we will:
- Get a complete history of your child’s feeding struggles
- Review your child’s current treatment plan
- Review your child’s current food and drink intake patterns and preferences
- Teach about therapies and approaches your child may need
- Check how well your child can swallow
After your Intake Clinic visits:
- We will recommend a treatment plan.
- We may recommend 1 of our services or care options for you to discuss with the provider who referred you. If your provider has questions, we are happy to talk with them.
Scheduling an Appointment With the Feeding Program
If you would like an appointment, ask your primary care provider to refer you to the Pediatric Feeding Program at Seattle Children’s Autism Center.
- When we get the referral, we will place your child on our waiting list. It may take many months to get service.
- When a space opens for your child, we will contact you to schedule your intake visits.
Learn about autism resources such as useful links, videos and recommended reading for you and your family.
When we call to schedule your appointment, we may ask for more details, like these:
- Your child’s growth charts from birth to now
- Details about any current medical concerns
- Results of lab tests or diagnostic procedures
- Other evaluations your child has had
- Current treatment plans or progress summaries from therapists (like occupational therapists, speech therapists and psychologists) that your child sees in the community
- Videos of your child eating at home or in therapy
- A food diary to track your child’s eating and drinking over several days
Who’s on the team?
Providers in the program include:
- Danielle Dolezal, PhD, BCBA-D, clinical supervisor, Pediatric Feeding Program
- Yaniz Padilla Dalmau, PhD, BCBA-D
Behavioral mental health therapists
- Valori Berends Neiger, MS, BCBA, LBA
- Anna Levin, MEd, BCBA, LBA
- Amber Persons-Geer, MSW, LAICSW, BCaBA, program coordinator
- Blayne Stemple, MEd, LBA, BCBA
- Barb Buchanan, MS, RD, CD
- Lauren Kipp, CCC-SLP
Based on your child’s needs, we will involve healthcare providers from other areas of Seattle Children’s. These may include Occupational Therapy, Gastroenterology, Neurodevelopmental Medicine and the Aerodigestive Program.
If you would like an appointment, ask your child’s primary care provider to refer you. If you have an appointment, contact the Feeding Program at 206-987-8080. Learn more about how to get services at the Autism Center.
Providers, see how to refer a patient.