| Trouble d’alimentation sélective et/ou d’évitement: options de traitement | T | Trouble d’alimentation sélective et/ou d’évitement: options de traitement | Avoidant/restrictive food intake disorder: Treatment options | | French | Psychiatry | Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | NA | NA | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2016-02-02T05:00:00Z | | | | | | 0 | 0 | 0 | | Health (A-Z) - Procedure | Health A-Z | <p>Découvrez les traitements proposés pour traiter l’ARFID en milieu hospitalier et à domicile.</p> | <p>On sait peu de choses jusqu’à présent sur les traitements du
<a href="/Article?contentid=274&language=French">trouble d’alimentation sélective et/ou d’évitement</a> les plus efficaces, en particulier dans le cas de jeunes patients. Règle générale, le traitement proposé sera le même que celui offert pour traiter les enfants et les adolescents aux prises avec une
<a href="/Article?contentid=268&language=French">anorexie mentale</a>.</p> | <h2>À retenir</h2>
<ul><li>À l’heure actuelle, le traitement de l’ARFID est semblable à celui de l’anorexie nerveuse.</li>
<li>L’enfant dont le poids est extrêmement faible et dont la fréquence cardiaque est irrégulière et la tension artérielle basse devra être admis et traité en milieu hospitalier. Le traitement visera à lui procurer suffisamment de nutriments afin qu’il retrouve un poids santé, tout en limitant tout exercice physique.</li>
<li>Lorsque l’état de santé de l’enfant est stable, il sera pris en charge par le programme de traitement des troubles alimentaires en consultation externe et suivi par une équipe pluridisciplinaire. Il participera à une psychothérapie et un suivi régulier de son poids, de sa fréquence cardiaque et de sa tension artérielle sera effectué.</li>
<li>À domicile, l’objectif de la thérapie sera de réintroduire les aliments que l’enfant avait retranchés de son alimentation, notamment par la technique de l’enchaînement alimentaire.</li>
<li>Lorsque la cause sous-jacente de l’ARFID est une dépression ou un trouble anxieux, on pourrait prescrire à l’enfant des médicaments ou une thérapie cognitivo-comportementale.</li></ul> | | | | | | | | | | | | | | | | <h2>Traitement médical en milieu hospitalier</h2>
<p>Si votre enfant a perdu beaucoup de poids et qu’il est dans un état de santé précaire (une fréquence cardiaque lente ou irrégulière ou une tension basse), il faudra le garder en observation à l’hôpital afin de suivre étroitement l’évolution de sa fréquence cardiaque, de sa tension artérielle et de son poids.</p>
<p>L’ARFID occasionne une perte de poids importante chez l’enfant et l’amène à restreindre de beaucoup son apport alimentaire. En milieu hospitalier, l’enfant recevra les nutriments dont il a besoin pour l’aider à se refaire une santé. Il sera sans doute également moins actif pendant son séjour à l’hôpital.</p>
<p>L’équipe de soins de votre enfant ajustera sa nutrition pendant son séjour à l’hôpital afin qu’il puisse reprendre un poids santé de manière graduelle et constante. L’objectif est d’alimenter votre enfant en nutriments de manière à ce qu’il prenne du poids tout en introduisant à nouveau divers aliments qu’il a pu décider de supprimer durant sa maladie.</p>
<p>À titre de parent ou de soignant, vous serez normalement appelé à participer à l’alimentation de votre enfant en aidant à surveiller ses repas. Le but est de faire en sorte qu’il obtienne son congé de l’hôpital lorsque son état de santé sera considéré comme étant sécuritaire au point de pouvoir quitter l’hôpital (votre enfant ayant retrouvé un poids santé ainsi qu’une fréquence cardiaque et une tension artérielle stables).</p>
<h2>Le traitement en consultation externe avec le soutien d’une équipe de soins</h2>
<p>Si l’état de santé de votre enfant aux prises avec l’ARFID est stable et ne nécessite pas un séjour à l’hôpital, il sera pris en charge par le programme de traitement des troubles alimentaires en consultation externe. Il sera alors confié à une équipe de spécialistes, composée d’un psychiatre, d’un psychologue, d’une diététicienne, d’un pédiatre spécialisé dans le traitement des enfants ou des adolescents, selon les cas, et d’un infirmier ou d’une infirmière ou d’un travailleur social. Ces professionnels conjugueront leurs efforts afin de mettre en place le plan de soins le mieux adapté aux besoins particuliers de votre enfant.</p>
<p>Votre enfant devra se rendre à l’hôpital pour ses rendez-vous, mais il n’aura pas à y séjourner. Les rendez-vous visent à offrir une psychothérapie à votre enfant afin de régler ses problèmes alimentaires et à assurer un suivi régulier de son poids, de sa fréquence cardiaque et de sa tension artérielle. En outre, le suivi de son poids permet à l’équipe de soins de vérifier le rythme de reprise du poids de votre enfant. La prise de poids est effectivement un élément essentiel du retour de votre enfant à un état de santé optimal.</p> | | | | <h2>En savoir plus</h2><p>Pour plus d’informations sur trouble d’alimentation sélective et/ou d’évitement (ARFID), consultez les pages suivantes:</p><p>
<a href="/Article?contentid=274&language=French">L’ARFID: présentation générale</a></p><p>
<a href="/Article?contentid=275&language=French">L’ARFID: signes </a>
<a href="/Article?contentid=275&language=French">avant-coureurs</a><a href="/Article?contentid=275&language=French"></a></p><p>
<a href="/Article?contentid=273&language=French">L’ARFID: complications médicales</a></p><p>
<a href="/Article?contentid=272&language=French">L’ARFID: comment aider votre enfant à la maison</a><br></p><h2>Ressources</h2><p style="font-weight:normal;">
<a href="http://www.nedic.ca/" target="_blank">NEDIC – Centre d’information sur les troubles alimentaires</a> (Canada)</p><p style="font-weight:normal;">
<a href="https://www.nationaleatingdisorders.org/">NEDA – Association nationale des troubles alimentaires</a> (États-Unis)</p><p style="font-weight:normal;">L'académie américaine de pédiatrie –
<em>
<a href="https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Is-Your-Teen-at-Risk-for-Developing-an-Eating-Disorder.aspx" target="_blank">Eating Disorders in Children</a></em></p><p style="font-weight:normal;">
<a href="https://www.beateatingdisorders.org.uk/" target="_blank">BEAT – Lutter contre les troubles alimentaires</a> (Royaume Uni)</p><p style="font-weight:normal;">
<a href="https://keltyeatingdisorders.ca/" target="_blank">Troubles alimentaires Kelty</a> (Centre de ressources sur la santé mentale Kelty, Hôpital pour enfants de la Colombie-Britannique)</p><p style="font-weight:normal;"></p><p style="font-weight:normal;">Le Centre hospitalier pour enfants de l’est de l’Ontario –<a href="https://www.cheo.on.ca/fr/troubles_alimentaires_info" target="_blank"><em>Troubles de l'alimentation</em></a></p>
<br> | | | | | |
| Avoidant/restrictive food intake disorder (ARFID): Treatment options | A | Avoidant/restrictive food intake disorder (ARFID): Treatment options | Avoidant/restrictive food intake disorder (ARFID): Treatment options | | English | Psychiatry | Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | NA | NA | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2023-09-12T04:00:00Z | | | | | | 11.7000000000000 | 47.3000000000000 | 1202.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn how ARFID can be treated in hospital and at home.</p> | <p>Little is known about the most effective treatments especially for young people with <a href="/Article?contentid=274&language=English">avoidant/restrictive food intake disorder (ARFID)</a>. In general, treatment is similar to that offered to children and teens with
<a href="/Article?contentid=268&language=English">anorexia nervosa</a>.</p><p>The main goals of treatment include:</p><ul><li>achieving and maintaining a healthy weight and height</li><li>achieving healthy eating patterns</li><li>increasing the variety of foods eaten</li><li>learning ways to eat without fear of pain or choking</li></ul> | <h2>Key points</h2>
<ul>
<li>At the moment, the treatment for ARFID is similar to the treatment for anorexia nervosa.</li>
<li>If a child is at an extremely low weight with an irregular heart rate or low blood pressure, they will receive treatment in a hospital. This treatment focuses on giving enough nutrition to return the child or teen to a healthy weight and limiting exercise.</li>
<li>If a child is medically stable, they will be treated at an outpatient eating disorders program by a team of professionals. They will receive psychological treatment and have their weight, heart rate and blood pressure checked regularly.</li>
<li>At home, the goal is to reintroduce all the foods that a child has cut out from their diet, for example through food chaining.</li>
<li>If depression or anxiety is an underlying cause of ARFID, a child might be prescribed medications or receive cognitive behavioural therapy.</li>
</ul> | | | | | | | | | | | | | | | | <h2>In-hospital medical treatment</h2><p>If your child is at an extremely low weight and is medically unstable (slow or irregular heart rate or low blood pressure), they will need to be admitted to hospital so their heart rate, blood pressure and weight can be monitored closely.</p><p>ARFID causes some children to lose a lot of weight and cut out many foods from their diet. While in hospital, your child will receive the nutrition they need to help them return to health. Their activity may also be limited. </p><p>Your child's healthcare team will adjust the amount of nutrition throughout your child's hospital stay so your child can regain weight in a steady, regular pattern. The goal is for your child to receive the amount of nutrition that their body requires to gain weight and reintroduce a variety of foods that they may have cut out during their illness.</p><p>As a parent or caregiver, you will typically be involved in feeding by helping to supervise meals with your child. The goal for discharge is for your child to be at a medical status that is considered safe to be out of hospital (at a safe weight and with a regular heart rate and blood pressure).</p><h2>Outpatient treatment with a care team</h2><p>If your child with ARFID is medically stable and does not need an in-hospital stay, you will be seen by an outpatient eating disorders program. There, your child will be cared for by a team of specialists, including a psychiatrist, psychologist, dietitian, adolescent medicine doctor or paediatrician, nurse or social worker. These experts will work together to come up with the best possible care plan to meet your child's unique needs.</p><p>Your child will visit the hospital to come to appointments, but they will not stay overnight. These hospital appointments will include psychological treatment to address the eating disorder and regular checks of your child's weight, heart rate and blood pressure. The weight checks help your child's team see how much weight your child is gaining. Weight gain is a vital part of returning the body back to health.</p><p>Because ARFID is a relatively new eating disorder, health-care providers are just learning more about the best treatments. Currently, one of the first treatments recommended for young people with ARFID is an outpatient treatment program called family-based treatment (FBT), which focuses on recovery of the eating disorder. Parents/caregivers play an essential role in the treatment and recovery of their child. FBT includes 3 treatment phases.</p><ul><li>Phase 1 focuses on weight restoration. Parents, supported by the therapist, take responsibility for making sure that the adolescent is eating sufficiently and also takes on all meal planning and preparation.</li>
<li>Phase 2 is when substantial weight recovery has occurred, and the adolescent gradually assumes responsibility for their own eating.</li>
<li>Phase 3 is when weight is restored, and the focus is on general issues of adolescent development.</li></ul><p>Another treatment that is currently being studied is cognitive behavioural therapy (CBT) for patients with ARFID ages 10 through older adults. CBT involves working with a therapist and addressing relationships between thoughts, feelings, and behaviours. CBT for patients with ARFID is most often family-supported for children and adolescents and involves psychoeducation, treatment planning, addressing the eating issues, and preventing relapse.</p><p>The treatment can also involve using methods such as exposure therapy, in which a therapist will work with the adolescent and family to reintroduce foods they fear or have been avoiding.</p> | | | <h2>At SickKids</h2><p>SickKids has an eating disorder program that treats children and teens who are struggling with symptoms of anorexia nervosa, bulimia nervosa and avoidant restrictive food intake disorder. For more information on our program visit: <a href="http://www.sickkids.ca/adolescentmedicine/eating-disorders-program">www.sickkids.ca/adolescentmedicine/eating-disorders-program</a></p> | <h2>Further information</h2><p>For more information on avoidant/restrictive food intake disorder (ARFID), please see the following pages:</p><p>
<a href="/Article?contentid=274&language=English">ARFID: Overview</a></p><p>
<a href="/Article?contentid=275&language=English">ARFID: Signs and symptoms</a></p><p>
<a href="/Article?contentid=273&language=English">ARFID: Medical complications</a></p><p>
<a href="/Article?contentid=272&language=English">ARFID: How to help your child at home</a><br></p><p>Please visit our teen mental health hub for teen-specific resources on
<a href="https://teens.aboutkidshealth.ca/Article?contentid=3790&language=English&hub=mentalhealthAZ#mentalhealth">treatment and outcomes for avoidant/restrictive food intake disorder (ARFID)</a>.<br></p><h2>Resources</h2><p>
<a href="http://www.nedic.ca/" target="_blank">NEDIC – National Eating Disorder Information Centre</a> (Canada)<br></p><p>
<a href="https://www.nationaleatingdisorders.org/" target="_blank">NEDA – National Eating Disorder Association</a> (United States)</p><p>American Academy of Pediatrics –
<em>
<a href="https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Is-Your-Teen-at-Risk-for-Developing-an-Eating-Disorder.aspx" target="_blank">Eating Disorders in Children</a> </em></p><p>
<a href="https://www.beateatingdisorders.org.uk/" target="_blank">BEAT – Beating Eating Disorders</a> (United Kingdom)</p><p>
<a href="https://keltyeatingdisorders.ca/" target="_blank">Kelty Eating Disorders</a> (Kelty Mental Health Resource Centre, BC Children's Hospital)</p><p>Children's Hospital of Eastern Ontario –
<a href="https://www.cheo.on.ca/en/eating_disorder_info" target="_blank">
<em>Eating Disorders</em></a></p><p>
<a href="https://anad.org/">ANAD – National Association of Anorexia Nervosa and Associated Disorders</a> (United States)</p> | | | | | |
