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Feeding is an essential and complex behavior involving biological and social processes (American Academy of Pediatrics 1988). When this process is disrupted, serious consequences can result and intervention may be necessary (Manikam and Per-man 2000). Pediatric feeding disorders are common, occurring in 25%-45% of healthy children and up to 80% of children with developmental disabilities (Linscheid et al. 2003). The category of feeding disorders encompasses a heterogeneous group of presenting problems ranging from problematic picky eating (Dovey et al. 2008) to complete refusal or inability to take in food by mouth. Severe feeding disorders, which typically require intensive medical and behavioral treatment, are estimated to occur in 3%-10% of children (Kerwin 1999).

A number of specific medical populations are at increased risk of developing feeding disorders. For example, between 40% and 70% of infants born prematurely develop significant feeding problems (Hawdon et al. 2000). Children who require extended tube feeding, interrupting normal oral feeding patterns, are also at risk of feeding difficulties (Linscheid et al. 2003), as are children with gastrointestinal problems, including abdominal pain, reflux, and vomiting. Treatment for childhood cancer, which often results in nausea and vomiting, can precipitate the development of a feeding disorder in children who had previously normal eating patterns

(Bernstein 1978). Other conditions, including autism (Schreck et al. 2004), Down syndrome (Cooper-Brown et al. 2008), cystic fibrosis (Linscheid et al. 2003), and craniofacial anomalies (Cooper-Brown et al. 2008), have been associated with high levels of feeding disturbances. This list is not meant to be exhaustive but rather provides just a sampling of the myriad medical and developmental issues that can contribute to feeding problems. For a more comprehensive list of causes of feeding disorders in children, see Rudolph and Link (2002).

Given the high prevalence of pediatric feeding disorders, particularly among those with medical and developmental issues, a thorough understanding of their etiology, classification, assessment, and treatment is essential for mental health clinicians who provide consultation in pediatric settings. Feeding problems are a common referral issue in both inpatient and outpatient settings. Within the hospital setting, estimates suggest that up to 85% of feeding problems present with at least some behavioral component (Burklow et al. 1998), highlighting the opportunity and need for collaboration between medical and mental health specialists in caring for this population. Furthermore, psychologists and psychiatrists have long been acknowledged as important members of multidisciplinary feeding teams, and behavioral intervention techniques have considerable empirical evidence to support their efficacy (Kerwin 1999).

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