The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times a day. GIFT focused on (a) encouraging desensitization; (b) widening the food repertoire (in terms of both variety and quantity); (c) reducing inappropriate mealtime behaviors; and (d) encouraging the development of appropriate chewing and swallowing abilities. GIFT was preliminarily implemented among 11 children with a diagnosis of ASD. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the Brief Autism Mealtime Behavior Inventory (BAMBI), and food repertoire were investigated using Wilcoxon signed-rank test in three different times: baseline (T1), after treatment (T2), and one month after treatment (T3). Using Bonferroni correction, statistically significant differences were found between T1 and T2 for behavioral issues, as measured with BAMBI (p = 0.007), as well as for chewing abilities as measured with KCPS (p = 0.005) and for food acceptance (p = 0.005). These improvements were maintained after a month of follow-up, thanks to the collaboration of families and/or primary caregivers. In conclusion, GIFT seems to be an effective approach to improving behavioral issues, food acceptance, and chewing abilities in children with ASD.

Feeding and swallowing disorders (FSD) are common during childhood, with a prevalence of 85% in children with neurodevelopmental disorders. A comprehensive screening is essential to identify FSD and improve health outcomes in a clinical setting. This study aims to develop a new Pediatric Screening tool capable of identifying FSD. This screening tool was developed in three steps: selecting variables based on clinical experience, searching the literature and finding agreement between experts with a two-round Delphi study. This process, which reached 97% of agreement between experts, led to the development of the Pediatric Screening–Priority Evaluation Dysphagia (PS–PED). PS–PED comprises 14 items divided into three main domains: clinical history, health status and feeding condition. We also carried out a pilot test for measuring internal consistency, as measured with Cronbach Coefficient alpha. Concurrent validity, as measured with Pearson correlation coefficient, was tested using a videofluoroscopy swallow study (VFSS) classified with the Penetration Aspiration Scale (PAS). The pilot test was conducted on 59 children with different health conditions. Our findings showed good internal consistency (alpha = 0.731), and a strong linear correlation with PAS (Pearson 0.824). Furthermore, comparing PS–PED and PAS scores, we find preliminary strong discriminant validity to identify children with FSD (p < 0.01). Our results provide evidence on using the 14-item PS–PED as a screening tool for FSD in a clinical sample of children with heterogeneous disease.

Background: Children with Down syndrome (DS) experience more difficulties with oral motor skills, including chewing, drinking, and swallowing. The present study attempts to measure the preliminary effectiveness of Global Intensive Feeding Therapy (GIFT) in DS. GIFT is a new rehabilitation program addressing the specific difficulties and needs of each child, focusing on sensory and motor oral abilities. It follows an intensive schedule comprising 15 sessions over 5 consecutive days, with 3 sessions per day. The principles of GIFT are applied with specific objectives for DS. Methods: GIFT was preliminarily implemented among 20 children diagnosed with DS. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the International Dysphagia Diet Standardization Initiative (IDDSI), and the Pediatric Screening–Priority Evaluation Dysphagia (PS–PED) were used. Data were analyzed using the Wilcoxon signed-rank test before (T0) and after intervention (T1) and at one-month follow-up (T2). The effect size was also measured for specific outcomes, using Kendall’s W. Results: Our findings revealed that children with DS showed no risk of dysphagia according to the PS–PED (mean score 2.80). Furthermore, statistically significant improvements in chewing performance were observed, as measured by the KCPS (p < 0.01), as well as in texture acceptance and modification, as measured by the IDDSI post-intervention (p < 0.01). For both the KCPS and IDDSI, a large effect size was found (Kendall’s W value > 0.8). Parents/caregivers continued using GIFT at home, and this allowed for a positive outcome at the one-month follow-up. Conclusions: GIFT proved to be effective in the rehabilitation of feeding and swallowing disorders in children with DS, as well as for food acceptance.

Background: This pilot investigation aimed to evaluate the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with CHARGE Syndrome (CS). GIFT is a novel rehabilitation program designed to leverage the principles of neuroplasticity, intensity, individualized treatment, and ecological validity. The program comprises 15 sessions conducted over one week, with sessions delivered three times per day. Methods: GIFT was preliminarily implemented in a cohort of seven children diagnosed with CS. To assess the risk of dysphagia, the Pediatric Screening–Priority Evaluation Dysphagia (PS-PED) was administered. The effectiveness of the intervention was evaluated using three instruments: the Karaduman Chewing Performance Scale (KCPS) for chewing performance, the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) for overall feeding abilities, and the Feeding Assessment Scale (FAS) to capture parents’ perceptions. Data were collected at baseline (T0), immediately post-intervention (T1), and at a six-month follow-up (T2). The Wilcoxon signed-rank test was employed for statistical analysis, and effect sizes for specific outcomes were determined using Kendall’s W. Results: The findings indicated that children with CS were at a high risk of dysphagia as measured by the PS-PED at baseline. Statistically significant improvements in chewing performance were observed at the six-month follow-up (p < 0.05). Feeding abilities, as measured by the ASHA NOMS, showed significant enhancement immediately post-intervention (p = 0.02) and at the follow-up (p = 0.03). Similarly, parents reported significant improvements in their children’s feeding abilities at both post-intervention and follow-up assessments (p = 0.02), further corroborating the clinical benefits of the intervention. Conclusions: These preliminary results suggest that GIFT may be an effective rehabilitation program for addressing feeding and swallowing disorders in children with CS. Further studies with larger sample sizes and controlled designs are warranted to substantiate these findings and refine the intervention protocol.

Infants and children with neurological disorders often present with complex and multifactorial clinical conditions. In addition to primary motor impairment, they frequently exhibit secondary disorders that affect overall development, quality of life, and functional autonomy. Feeding and swallowing disorders (dysphagia) are highly prevalent in the pediatric population with neurological disorders and represent one of the primary comorbidities associated with these conditions. In this chapter, we will describe a rehabilitative approach known as Global Intensive Feeding Therapy (GIFT). This intensive, multidisciplinary therapeutic method aims to promote and enhance the functional development of feeding and swallowing abilities. GIFT is an innovative and intensive approach specifically designed for children with feeding and swallowing disorders, such as dysphagia, food selectivity, sensory aversion, and difficulties related to neurological and developmental conditions. This method is based on a global and personalized model, that supports the functional development of feeding and swallowing abilities in a motivating and structured setting. The program is based on session intensity (multiple sessions per day over several weeks) and aims at the acquisition and generalization of feeding and swallowing skills over a short period, thereby helping to improve the quality of life for both the child and the family. The approach is individualized and follows a multidimensional assessment, with caregivers actively collaborating as a central part of the rehabilitation process. In this chapter, we will describe the methodological principles and the compensatory and rehabilitative techniques.