ARFID vs Pediatric Feeding Disorder (PFD) vs Picky Eaters-Differential Diagnosis Decision Tree to Guide Intervention – Dr. Kay A. Toomey

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With the increased use of the ARFID diagnosis, the field of Feeding Disorders has seen children being incorrectly diagnosed and treated as if they have an Eating Disorder. Not only has this created situations in which some children did not get the help they needed early enough, in some cases the inaccurate intervention has actually made the child’s feeding problem worse or even resulted in trauma to the child.

It is imperative that physicians, mental health providers and rehabilitation therapists clearly understand how to identify children in need of intervention, as well as being skilled in differentially diagnosing children with feeding, eating and growth difficulties.

A Differential Diagnosis Decision Tree will be a critical tool for Clinicians to use in delineating which children are picky eaters versus those with a Pediatric Feeding Disorder versus children with ARFID.

With an accurate differential diagnosis, Clinicians can then appropriately guide children and their families into the most helpful intervention programs for the child.

1. 1. Determine the characteristics of a “picky eater” as different from either PFD or ARFID.
2. 2. Evaluate the validity of the criteria for ARFID.
3. 3. Determine critical components of a Differential Diagnosis Decision Tree for Picky Eaters vs PFD vs ARFID.
4. 4. Delineate which Case Study children meet the criteria for which diagnosis.
5. 5. Discriminate appropriate treatment approach based on accurate differential diagnosis

Scope of the Problem
Definitions and Prevalence

• Picky Eating 
• Problem Feeders

Identifying Who Would Benefit from Intervention Early 

• Why is Early Intervention important?

Diagnosis

• Pediatric Feeding Disorder
• ARFID
  • Problems with the ARFID diagnosis
  • Prevalence

Differential Diagnosis Decision Tree
Treatment Approaches 

• Educational
• Clinical

Case Studies – ARFID vs PFD vs Picky Eater?
Recommendations for Intervention