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Seminar Detail

Picky Eaters vs Problem Feeders vs Avoidant/Restrictive Food Intake Disorder (ARFID)

Friday, January 17, 2020 at 8:00 AM - 4:00 PM

This event is not currently available for purchase.

For more information: Call (800) 844-8260
Course Description:

Pediatric feeding disorders make it difficult or impossible for a child to eat, drink, or digest food normally, often compromising their health and development.

The limited intake seen in these children reflects concern such as:
  • Food aversions
  • Lack of interest in eating or food
  • Avoidance based on sensory characteristics of food
  • Fear of choking or other adverse consequences
  • Serious medical and psychological complications consist of
    • Severe malnutrition
    • Growth failure
    • Marked interference with psychosocial functioning
Join feeding expert, Dr. Kay Toomey, who has over 30 years of clinical experience assessing and treating children with a wide range of feeding challenges. She will show you clear guidelines to utilize the appropriate therapy approach.

Learn practical therapeutic interventions to use with children from each diagnostic group and ways to improve family meal routines and increase children’s intake of more nutritious foods
  • Identify physical, motor, sensory, oral-motor, environmental, nutritional and behavior factors necessary to consider, to properly assess feeding problems.
  • Delineate differential criteria for determining a child’s diagnosis as a typical eater, picky eater, problem feeder or a child with ARFID.
  • Learn when to refer to a specialist for additional treatment.
Change the lives of the children you work with … Register today!

  1. Identify physical, motor, sensory, oral-motor, environmental, nutritional and behavior factors necessary to consider, to properly assess feeding problems.
  2. Delineate differential criteria for determining a child’s diagnosis as a typical eater, picky eater, problem feeder or a child with ARFID.
  3. Evaluate the diagnosis of ARFID to discover sensory sensitivity, fear of aversive consequences and/or apparent lack of interest in eating or food.
  4. Utilize practical treatment strategies to advance children’s feeding skills, improve family meal routines and increase children’s intake of more nutritious foods.
  5. Conduct more thorough and accurate diagnoses, to implement the right treatment approaches for the distinct types of feeding/eating problems.
  6. Discriminate when a child needs additional evaluation and intervention by specialists for more intense treatment.

Prevalence of the Problem
  • Picky eating
  • Problem feeding
The Complexity of Feeding/Eating
  • 7 areas of human function
  • How children learn to eat (or not)
How to Complete a Comprehensive Feeding Assessment
  • Medical/organs
  • Oral-motor skills
  • Sensory-motor skills
  • Postural and motor skills
  • Nutrition
  • Learning/cognition
  • Environment
Differential Diagnoses Criteria, Research and Limitations
  • 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
Treatment Approaches – Align Treatment w/Diagnosis
  • Systematic desensitization
  • Flooding/escape extinction
  • Eating disorders
Case Studies: When Assessments Go Well, and When They Don’t
  • 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
Practical Feeding Strategies for Pediatric Feeding Disorder
  • Routines and environmental supports
  • Matching foods to a child’s skillset
  • Reinforcement
  • Management of maladaptive behaviors
When to Refer
  • Red Flags
  • Picky Eater vs Problem Feeder criteria
Target Audience

  • Psychologists working with Feeding Disorders, Eating Disorders and/or AFRID
  • 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
  • Teachers/Educators
  • Nurses


Dr. Kay A. Toomey, is a Pediatric Psychologist with over 30 years of clinical experience assessing and treating children with a wide range of feeding challenges. She developed the SOS Approach to Feeding as a family-centered program for assessing and treating children with feeding problems. 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. She also acts as a consultant to Gerber Products. Dr. Toomey co-chaired the Pediatric Therapy Services Department at Rose Medical Center prior to entering private practice. She acted as the Clinical Director for Toomey & Associates, Inc.’s Feeding Clinic for six years and SOS Feeding Solutions at STAR Institute for eight years, and speaks nationally and internationally about her approach. Dr. Toomey is currently the president of Toomey & Associates, Inc., and acts as a clinical consultant to the Feeding Clinic at STAR Institute.

Speaker Disclosures:

Financial: Kay Toomey is in private practice. She receives a consulting fee from Nestle Infant Nutrition/Gerber division. She receives a speaking fee from Education Resources, Inc.; and SPD Foundation/STAR Institute. Dr. Toomey receives a speaking honorarium from PESI, Inc.

Non-financial: Kay Toomey is a member of Feeding Matters.
Credits listed below are for full attendance at the live event only. After attendance has been verified, pre-registered attendees will receive an email from PESI Customer Service with the subject line, “Evaluation and Certificate” within one week. This email will contain a link to complete the seminar evaluation and allow attendees to print, email or download a certificate of completion if in full attendance. For those in partial attendance (arrived late or left early), a letter of attendance is available through that link and an adjusted certificate of completion reflecting partial credit will be issued within 30 days (if your board allows). Please see “live seminar schedule” for full attendance start and end times. NOTE: Boards do not allow credit for breaks or lunch.

If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

The planning committee and staff who controlled the content of this activity have no relevant financial relationships to disclose. For speaker disclosures, please see speaker bios.

PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.

Registered Dietitians & Dietetic Technicians
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PESI, Inc. PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from July 1, 2019 through June 30, 2022. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 6.0 continuing professional education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. This program/material is designated as LEVEL 2.

This course is designed to qualify toward your professional development requirement. The program is 6.25 clock hours in length.

Wisconsin Educators: This course may be used toward your Professional Development Plan if it meets your individual goals. Please contact DPI with questions regarding individual PDP’s. This course is 6.25 clock hours.

Illinois Early Intervention Professionals
Approved by the Illinois Early Intervention Training Program for 5.25 total contact hours in the area(s) of 1.0 - Assessment; 1.75 - Atypical Development; 2.0 - Intervention; 0.5 - Typical Development.

Nurses, Nurse Practitioners, and Clinical Nurse Specialists
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PESI, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Nurses in full attendance will earn 6.3 contact hours. Partial contact hours will be awarded for partial attendance.

Occupational Therapists & Occupational Therapy Assistants
PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate.

Psychologists & Physicians

PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PESI, Inc. designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The following state psychologist boards recognize activities sponsored by PESI, Inc. as an approved ACCME provider: Alaska, Arkansas, California, Colorado, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oklahoma, Pennsylvania, South Carolina and Wisconsin. This activity consists of 6.0 clock hours of continuing education instruction. Certificates of attendance will be issued for you to submit to your state licensing board to recognize for continuing education credit.

Minnesota Psychologists: This activity has been approved by the Minnesota Board of Psychology for 6.5 continuing education hours.

Psychologists/School Psychologists: PESI, Inc. is approved by the National Association of School Psychologists to offer professional development for school psychologists. PESI maintains responsibility for the program. Provider #1140. PESI is offering this activity for 6.25 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance.

Speech-Language Pathologists

This course is offered for .6 ASHA CEUs (Intermediate level, Professional area).

** Please note that Speech-Language Pathologists must complete the post-test and evaluation within two weeks of attending the live event if they would like their participation submitted to the ASHA CE Registry. Detailed instructions will be provided the day of the program under the Handouts section of the online program.

Social Workers
PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this course. ACE provider approval period: January 27, 2020 - January 27, 2023. Social Workers completing this course receive 6.25 Clinical Practice continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation.

Minnesota Social Workers: PESI, Inc. is an approved provider with the State of Minnesota, Board of Social Work. Provider #: CEP-140. This course has been approved for 6.0 continuing education hours.

Other Professions
This activity qualifies for 380 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific requirements.

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