When I have a family contact me for a feeding evaluation or come in for the first time, I am looking for what I call the “ah-ha” moment. This is the pattern of deficits that go together based on what the family is reporting to me. I will typically use this as my guide throughout the evaluation. It initially is not a definitive diagnosis for this child, but I have to look at the individuality of the child. It at least gets me thinking about what I might want to look at for a specific child.
My first question to families is often, “What brings you here today, or what are your concerns?” I ask that general question first because I want to know the parents' perspective; parents are usually right about what is concerning about their child. They are pretty right on with what their concerns are. It is really nice to see parents have that initial insight into what foods or parts of a meal are difficult for their child, and this is what guides the evaluation. It also guides our whole process as clinicians, putting that evaluation together and then developing a treatment plan from that point. It also gets me thinking about what other questions I want to ask families as the evaluation goes on.
Then I ask the family to, “Take me through a day of eating with your daughter.” This allows me to step into the parents' world. It lays out what a typical day looks like, and it will often bring out the parents' emotions that they face day in and day out with meals and food. A lot of times emotions will come up at this point, and most often it is frustration, because they cannot figure out what is going on with their child.
