According to the University of Michigan (UM), severe feeding disorders affect up to 10% of children without medical or developmental issues, 70-90% of children born prematurely or with chronic medical issues, and up to 90% of children with autism. These children face compounded risk: a lack of adequate nutrition can negatively impact growth, brain development, and heart health, as well as mental health and social development.
While waiting for more comprehensive treatment, children are sometimes placed on feeding tubes—a temporary solution that comes with high costs and does little to address the underlying disorder. Ultimately, the child and family both suffer, as mealtimes and celebrations become stressful, and parents must arrange every day around feeding or transporting their child.
Dr. Amy Drayton is one of only four Michigan psychologists who specializes in treating children with feeding disorders, and in 2016 her intensive feeding program at UM had a waitlist of 319 children. Dr. Drayton knew that to shorten the 20-month wait time and treat more children, she needed to expand her team.
With Health Fund support, Dr. Drayton launched the “Helping Kids Grow” effort, and was able to tackle three major challenges. First, she set up a triage system to better review and evaluate the many referrals she receives. Second, she established an interdisciplinary team to help coordinate evaluation and treatment among various specialists, eliminating long gaps between appointments. Third, she created an intensive behavioral treatment program that uses Applied Behavior Analysis, the only evidence-based treatment for feeding disorders.
Two years after receiving a Behavioral Health grant, the program has been highly successful:
- 51 children have been evaluated for participation through the multidisciplinary assessment clinic for future enrollment in the program.
- 27 children have graduated from the program. Of those, 10 children had discontinued all tube feeding and 16 children’s tube placement surgeries have been prevented. The 96% success rate of preventing or eliminating the need for enteral feeding is far greater than the average of around 70%.
- The program has negotiated contracts with several insurers and is working to meet MDHHS’s new intensive feeding program requirements. Securing insurance coverage has been a barrier to this type of integrated treatment, and represents a major step toward permanently sustaining the program.
- A cost savings analysis was conducted for the 27 children who have graduated from the program. Using conservative estimates, the cost savings for these 27 children over 10 years is $6,260,179 and over 5 years is $3,004,001.
These compelling results have led to recognition in Michigan and also nationally and internationally: the project was presented at the International Pediatric Feeding Disorders conference, one of only seven projects selected to be presented orally. The project is a finalist for the Evan Newport HOPE Award, which “honors staff, faculty, and students who are making a difference in the lives of patients and families by demonstrating a commitment to patient and family centered care, and the ideal patient and family experience.” In addition, the data from “Helping Kids Grow” is being used in a number of scientific publications.
As providers continue to prioritize person-centered, integrated treatment, “Helping Kids Grow” is a model program. It required a significant up-front investment to get off the ground, but it’s the collaboration that enabled the program to thrive and demonstrate what’s possible. For thousands of children in Michigan, and millions more across the globe, the UM project offers hope and concrete steps that health systems can take to address pediatric feeding disorders and help patients—and their families—live fuller lives.