Feeding problems OSCE — selective eating counselling and ARFID/PFD plan

Station A — Toddler food refusal counselling (8–10 minutes)

Candidate task. Take a focused feeding history from a parent actor, interpret a growth chart showing stable centiles, and counsel on management. ^[1]

Parent script highlights. Child is 26 months. Used to eat family foods. Now refuses vegetables and meats. Accepts yoghurt, banana, toast and cheese. Meals last 45 minutes with spoon-forcing and threats. No cough with drinks. Wet nappies normal. Development otherwise typical. ^[1]

Marks for. ^[1]

1. Structured history: accepted foods, textures, meal duration, force tactics, choking/cough, stools, energy, prior advice. ^[1]
2. Growth interpretation: stable trajectory lowers urgency but does not ignore family distress. ^[7]
3. Clear advice: stop force-feeding; structured meals/snacks; calm exposure; avoid turning every meal into a battle. ^[1]
4. Safety-net: what would change the plan (weight fall, dehydration, cough/cyanosis with feeds, total collapse of intake). ^[1]
5. Communication: non-blaming language; shared plan for this week. ^[1]

Failing behaviours. Moralising the child; ordering a large unnecessary work-up immediately; endorsing force-feeding; no follow-up plan. ^[1]