Get Pediatric Feeding Evaluation Template

The Pediatric Feeding Evaluation Template is an essential tool for assessing children's feeding skills and needs. Completing this form online simplifies the process and ensures that all necessary information is captured accurately.

Follow the steps to complete the Pediatric Feeding Evaluation Template effectively.

1. Click ‘Get Form’ button to access the template and open it in your preferred editor.
2. Begin by filling in the preliminary information section. Provide details such as the reason for referral, chronological age, primary caregiver, informant for evaluation, and primary language. Ensure that all information is complete and accurate for a comprehensive assessment.
3. Proceed to the background information section to document medical and ancillary care teams, previous hospitalizations, surgeries, medications, and allergies/intolerances. Detail any cultural preferences relevant to feeding.
4. In the birth history section, list any complications during pregnancy, delivery method, and details regarding birth weight and APGAR scores. This provides context for the child's developmental background.
5. Document any congenital malformations, conditions, or disorders that may affect feeding. This includes conditions of the nervous, circulatory, respiratory, and digestive systems.
6. Fill in the swallowing/feeding and nutrition history. Describe feeding methods used, such as breastfeeding or bottle-feeding, and indicate any concerns observed during these methods.
7. In the evaluation information section, provide details on meals and snacks, typical feeding position, sensory preferences, and any modifications to food or fluid. Also, assess the oral motor/peripheral structures and document any signs of stress during assessments.
8. Compose the clinical summary that includes the patient's name, age, and gender, along with a prognosis for safe and adequate oral intake.
9. List diagnoses, recommendations, and plans for therapy based on the evaluation. Highlight any educational needs or barriers to learning for families.
10. Finally, review all information for accuracy, save your changes, and download or print the form as needed, ensuring easy access for future use.

Complete your Pediatric Feeding Evaluation Template online today to support the assessment process.