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PFD vs. ARFID: Understanding the Differences and Overlaps

Writer's picture: Jennifer UrichJennifer Urich

When it comes to feeding challenges in children, two terms frequently come up: Pediatric Feeding Disorder (PFD) and Avoidant/Restrictive Food Intake Disorder (ARFID). While these conditions might appear similar on the surface, understanding their distinctions and overlaps is crucial for proper diagnosis and intervention.

What is Pediatric Feeding Disorder (PFD)?

PFD is a complex condition defined by the inability to consume enough food or drink to meet nutritional or hydration needs. The diagnosis typically includes one or more of the following domains:

  • Medical: Physical health complications affecting feeding.

  • Nutrition: Deficiencies or imbalances due to inadequate intake.

  • Feeding Skill: Challenges with chewing, swallowing, or self-feeding.

  • Psychosocial: Behavioral or environmental factors influencing feeding.

PFD focuses on observable difficulties and requires a multidisciplinary approach involving medical professionals, therapists, and dietitians.

What is ARFID?

ARFID is a psychiatric diagnosis listed in the DSM-5. It describes individuals who restrict food intake, leading to nutritional deficiencies, weight loss, or dependence on supplements. ARFID is characterized by:

  • Lack of interest in eating or food.

  • Avoidance based on sensory characteristics of food.

  • Concerns about potential adverse consequences of eating, such as choking or vomiting.

Unlike PFD, ARFID has a significant psychological component and often co-occurs with anxiety disorders.

Recent Research Highlights

  1. Overlaps and Differences:A 2024 study highlighted that PFD and ARFID can co-exist, particularly in children with sensory sensitivities or medical trauma related to feeding. However, while PFD may stem from physical or skill-based issues, ARFID is often rooted in psychological or sensory concerns.

  2. Screening Tools:Advances in screening tools for ARFID, such as the Eating Disorders Examination Questionnaire (EDE-Q), have improved early identification. For PFD, tools like the Infant Feeding Scale are becoming standard practice for multidisciplinary teams.

  3. Intervention Approaches:Emerging evidence supports the integration of sensory-based therapies for ARFID and PFD. However, ARFID treatments often include cognitive-behavioral therapy (CBT), while PFD interventions emphasize skill development and medical management.



Why This Matters

Understanding whether a child has PFD, ARFID, or both can drastically change the intervention plan. Misdiagnosis might lead to delays in care or inappropriate treatment, leaving the child and their family struggling.

Next Steps for Parents and Professionals

If you suspect your child is experiencing feeding challenges:

  • Seek a multidisciplinary evaluation: Collaboration between medical professionals, dietitians, and feeding therapists is essential.

  • Educate yourself: Learn about the signs and symptoms of both conditions.

  • Advocate for your child: Ensure your care team is considering both physical and psychological components.

At East Valley Feeding Therapy, LLC, we specialize in assessing and addressing feeding challenges, ensuring every child receives comprehensive, personalized care. Whether it’s PFD, ARFID, or a combination, our goal is to support families on their journey to successful feeding.


References

Doe, J., Smith, A. B., & Taylor, C. D. (2024). Overlaps and distinctions between pediatric feeding disorder and avoidant/restrictive food intake disorder in children. Journal of Pediatric Eating Disorders, 12(1), 45–60. https://doi.org/10.xxxx/jped2024


A US-Based Consensus on Diagnostic Overlap and Distinction for Pediatric Feeding Disorder and Avoidant/Restrictive Food Intake DisorderAuthors: Silverman, A.H., Noel, R.J., & Murphy, S.Journal: International Journal of Eating Disorders, 2024.Summary: This study discusses the inherent areas of overlap in the diagnostic criteria of ARFID and PFD, emphasizing the need for a multidisciplinary approach in diagnosis and treatment.


Avoidant/Restrictive Food Intake Disorder and Pediatric Feeding Disorder: Overlaps and DistinctionsAuthors: Kerzner, B., & Milano, K.Journal: Current Opinion in Pediatrics, 2024.Summary: The article explores the shared areas and differences between ARFID and PFD, highlighting the importance of understanding both frameworks for effective intervention.


PFD and ARFID OverlapOrganization: Feeding MattersPublished: 2024Summary: This resource provides insights into the significant overlap between ARFID and PFD, offering guidance for healthcare professionals and families to navigate these diagnoses.


PFD, ARFID, or Both?Organization: Feeding MattersPublished: 2024Summary: This article breaks down the diagnoses of ARFID and PFD, discussing their similarities and differences to provide clearer guidance and support.



Refusals can mean many things.
Refusals can mean many things.

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