Paeds Cases · mental-behavioural-and-psychosomatic
Avoidant restrictive food intake disorder OSCE — boundary, safety and evidence-based care
Observed structured encounter testing an ARFID consultation: holding the boundary with anorexia nervosa, assessing medical and refeeding safety, classifying the driver pattern, and co-building an evidence-based CBT-AR or FBT plan that stops coercion.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 13-year-old with sudden food refusal after a choking scare and falling weight; Station B is an 8-year-old with autism, six accepted brand-specific foods, faltering growth and ninety-minute force-feeding battles.
Station objectives
- Hold the boundary between ARFID and anorexia nervosa by screening explicitly for weight and shape overvaluation. [2] [3]
- Assess medical and refeeding safety in the low-weight or falling-weight child. [6]
- Classify the dominant ARFID driver pattern and choose pattern-matched evidence-based therapy. [3] [4]
- Stop coercion and co-build a non-coercive, family-supported plan. [3] [5]
References8ShowHide
- [1]Katzman DK, Spettigue W, Agostino H, et al. Incidence and Age- and Sex-Specific Differences in the Clinical Presentation of Children and Adolescents With Avoidant Restrictive Food Intake Disorder. JAMA pediatrics, 2021.PMID 34633419
- [2]Katzman DK, Guimond T, Spettigue W, et al. Classification of Children and Adolescents With Avoidant/Restrictive Food Intake Disorder. Pediatrics, 2022.PMID 35945342
- [3]Kambanis PE, Thomas JJ Assessment and Treatment of Avoidant/Restrictive Food Intake Disorder. Current psychiatry reports, 2023.PMID 36640211
- [4]Thomas JJ, Becker KR, Kuhnle MC, et al. Cognitive-behavioral therapy for avoidant/restrictive food intake disorder: Feasibility, acceptability, and proof-of-concept for children and adolescents. The International journal of eating disorders, 2020.PMID 32776570
- [5]Spettigue W, Norris ML, Santos A, et al. Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments. Journal of eating disorders, 2018.PMID 30123505
- [6]Bryson AE, Scipioni AM, Essayli JH, et al. Outcomes of low-weight patients with avoidant/restrictive food intake disorder and anorexia nervosa at long-term follow-up after treatment in a partial hospitalization program for eating disorders. The International journal of eating disorders, 2018.PMID 29493804
- [7]Sharp WG, Berry RC, Burrell L, et al. Scurvy as a Sequela of Avoidant-Restrictive Food Intake Disorder in Autism: A Systematic Review. Journal of developmental and behavioral pediatrics : JDBP, 2020.PMID 32044868
- [8]Couturier J, Isserlin L, Norris M, et al. Canadian practice guidelines for the treatment of children and adolescents with eating disorders. Journal of eating disorders, 2020.PMID 32021688