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Dr. Kay A. Toomey, PhD
6 Hours 30 Minutes
- PESI Inc.
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Toomey & Associates, Inc.
Kay A. Toomey, PhD, is a Pediatric Psychologist who has worked with children who don't eat for almost 30 years. She has developed the SOS Approach to Feeding as a family-centered program for assessing and treating children with feeding problems. Dr. Toomey speaks nationally and internationally about her approach. Dr. Toomey helped to form The Children's Hospital - Denver's Pediatric Oral Feeding Clinic, as well as the Rose Medical Center's Pediatric Feeding Center. Dr. Toomey co-chaired the Pediatric Therapy Services Department at Rose Medical Center prior to entering private practice. Dr. Toomey acted as the Clinical Director for Toomey & Associates, Inc.'s Feeding Clinic for six years and SOS Feeding solutions @ STAR for eight years. Dr. Toomey is currently the President of Toomey & Associates, Inc., and acts as a Clinical Consultant to the Feeding Clinic at STAR institute.
Financial: Kay Toomey is in private practice. She is a clinical consultant for The Feeding Clinic @ STAR. She is a professional consultant for Nestle/Gerber Food Products, Inc. Dr. Toomey is an author and receives royalties. She receives a speaking honorarium from PESI, Inc.
Non-financial: Kay Toomey is a non-paid advisory board member of Feeding Matters. She is a member of the American Psychological Association; the Colorado Psychological Association; Society of Pediatric Psychology; and Society for Developmental and Behavioral Pediatrics.
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- Determine physical, motor, sensory, oral-motor, environmental, nutritional and behaviour factors necessary to consider, to properly assess feeding problems.
- Distinguish differential criteria for determining a child’s diagnosis as a typical eater, picky eater, problem feeder or a child with ARFID.
- Evaluate the diagnosis of ARFID to discover sensory sensitivity, fear of aversive consequences and/or apparent lack of interest in eating or food.
- Utilize practical treatment strategies to advance children’s feeding skills, improve family meal routines and increase children’s intake of more nutritious foods.
- Conduct more thorough and accurate diagnoses, to implement the right treatment approaches for the distinct types of feeding/eating problems.
- Discriminate when a child needs additional evaluation and intervention by specialists for more intense treatment.
Prevalence of the Problem
The Complexity of Feeding/Eating
- Picky eating
- Problem feeding
How to Complete a Comprehensive Feeding Assessment
- 7 areas of human function
- How children learn to eat (or not)
Differential Diagnoses Criteria, Research and Limitations
- Oral-motor skills
- Sensory-motor skills
- Postural and motor skills
Treatment Approaches – Align Treatment w/ Diagnosis
- Picky eating
- Able to tolerate new foods on plate
- Decreased range or variety of foods that will eat
- Frequently eats a different set of foods than the rest of the family
- Problem feeding
- Restricted range or variety of foods
- Refuses entire categories of food textures
- Cries and “falls apart” when presented with new foods
- Accept a limited diet in relation to sensory features
- Food refusal is related to aversive or fear-based experiences
- Extreme pickiness; distractible and forgetful
Case Studies: When Assessments Go Well, and When They Don’t
- Systematic desensitization
- Flooding/escape extinction
- Eating disorders
Practical Feeding Strategies for Pediatric Feeding Disorder
- Picky eating –
- Case 1 = 2 ½ year old male with limited number of accepted foods he will eat, variable eating from one day to the next, issues staying at the table
- Case 2 = 2 ½ year old female with restricted food range, over reliance on liquids for calories and swallowing assistance
- Case 3 = 9 year, 8 month old male with lack of healthy proteins per parents, and no vegetables in his food range
- Problem feeding –
- Case 1 = 3 year, 10 month old female with a G-tube, born at 26 weeks gestation, complicated medical history
- Case 2 = 4.25 year old female born with congenital Rubella, poor weight gain, restricted food range, episodes of gagging and coughing, episodes of refusing to eat
- ARFID –
- Case 1 = 15 year old male with chronic “chok-y” sensation, significant weight loss, hospitalized in an Eating Disorders program
- Case 2 = 13 year old male with difficulties eating food at school, restricted food range per parental report, refusal to eat vegetables
When to Refer
- Routines and environmental supports
- Matching foods to a child’s skillset
- Management of maladaptive behaviours
- Red Flags
- Picky Eater vs Problem Feeder criteria
- Psychologists working with Feeding Disorders, Eating Disorders and/or ARFID
- Other mental health providers working with Feeding Disorders, Eating Disorders and/or ARFID (e.g. social workers, counselors)
- Pediatric Occupational Therapists
- Pediatric Speech Pathologists
- Pediatric Feeding Specialists
- Physicians and/or Psychiatrists working with Feeding Disorders, Eating Disorders and/or ARFID
- Registered Dietitians working with Feeding Disorders, Eating Disorders and/or ARFID
- Day care providers
Total Reviews: 15