title: Role reversal method for treatment of food refusal associated with infantile feeding disorders.
abstract: OBJECTIVE
  Infantile feeding disorders (IFDs) are common causes of food refusal and failure to thrive, and are frequently encountered by primary care physicians and specialists. We have published the Wolfson criteria for IFD, which have eased the approach to the diagnosis of IFDs. Along with and complementary to the Wolfson criteria, we have also developed the role reversal treatment method for IFD, which has been briefly described earlier. The aim of this study was to validate the role reversal treatment method on a cohort of infants diagnosed as having IFD and to present a detailed description of this method for the first time.
  
  
  METHODS
  Parents of infants and children diagnosed as having IFD were invited to participate in the study; they were handed over a questionnaire comprising 6 categories of questions related to patient and parents behaviors, attitudes, and perceptions, which was completed at initiation and at the end of treatment. Full response was defined as improved normative feeding, cessation of abnormal parental feeding, and improved or normal growth patterns. A partial response was defined as success with two-third categories.
  
  
  RESULTS
  We enrolled 38 patients, and 32 patients completed the study. Improved feeding occurred in 78%, full recovery was documented in 53% of infants by 6 months, and partial response was observed in another 25%. All forms of pathological feeding improved significantly (mechanistic, nocturnal, persecutory, forced feeding, and distraction).
  
  
  CONCLUSIONS
  The role reversal treatment method is a simple and effective approach to the treatment of food refusal associated with IFD.
authors.affiliation: *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Holon †School of Nutritional Sciences, Hebrew University, Rehovot ‡Epidemiology Unit, Wolfson Medical, Center, Tel Aviv University, Israel.
authors.forename: Idit
authors.initials: I
authors.lastname: Segal
authors.forename: Anat
authors.initials: A
authors.lastname: Tirosh
authors.forename: Tali
authors.initials: T
authors.lastname: Sinai
authors.forename: Sari
authors.initials: S
authors.lastname: Alony
authors.forename: Anat
authors.initials: A
authors.lastname: Levi
authors.forename: Lia
authors.initials: L
authors.lastname: Korenfeld
authors.forename: Tsili
authors.initials: T
authors.lastname: Zangen
authors.forename: Avi
authors.initials: A
authors.lastname: Mizrachi
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Arie
authors.initials: A
authors.lastname: Levine
mesh_terms: D002648:Child; D002675:Child, Preschool; D005183:Failure to Thrive / Q000209:etiology; D005247:Feeding Behavior; D019959:Feeding and Eating Disorders of Childhood / Q000150:complications / Q000628:therapy*; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D008297:Male; D016487:Parenting; D010290:Parents; D011795:Surveys and Questionnaires