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| Treatment of Pediatric Feeding Disorders: “To spit or not to spit.” |
| Sunday, May 25, 2008 |
| 10:30 AM–11:50 AM |
| Boulevard A |
| Area: CBM/DDA; Domain: Applied Research |
| Chair: Charles S. Gulotta (Kennedy Krieger Institute) |
| Discussant: Linda J. Cooper-Brown (The University of Iowa) |
| Abstract: This symposium will discuss research on the treatment of feeding problems, specifically targeting expelling in children with severe food refusal. Treatment interventions will include manipulations to antecedents and reinforcement. One talk will also examine publication bias on single case research on the behavioral treatment of pediatric feeding disorders. |
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| An Evaluation of the Interaction Between Food Texture and Reinforcement Variables in the Treatment of a Feeding Disorder. |
| MELANIE H. BACHMEYER (The University of Iowa), David P. Wacker (The University of Iowa), Terry S. Falcomata (The University of Iowa), Linda J. Cooper-Brown (The University of Iowa) |
| Abstract: Expulsion (spitting out food) has the potential to lead to significant health problems in the form of malnutrition and inadequate growth, but has received relatively little attention in the literature on pediatric feeding disorders. This study examined the interaction of the type (preferred foods and toys) and delivery (noncontingent and contingent) of positive reinforcement with food textures on the expulsions of a child diagnosed with a pediatric feeding disorder. Both types of reinforcers were implemented within noncontingent and differential reinforcement programs with both lower (table purees) and higher (wet ground) food textures. Two independent observers achieved over 80% agreement on over 30% of sessions. Results suggested that an interaction occurred between the reinforcement and texture variables. Preferred toys were effective in reducing expulsions with both the lower and higher food textures within the noncontingent reinforcement program. Whereas, preferred toys delivered contingently and preferred foods delivered within both reinforcement programs were only effective in reducing the expulsions with the lower food textures. Results will be discussed in relation to avoidance, response effort, and motivating operations. |
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| An Evaluation of Bite Placement during the Treatment of Food Refusal. |
| DANIELLE N. DOLEZAL (Kennedy Krieger Institute/Johns Hopkins University School of Medicine), Charles S. Gulotta (Kennedy Krieger Institute), John P. Rock (Kennedy Krieger Institute) |
| Abstract: Previous research has shown that escape extinction procedures reduce food refusal behavior and increase consumption in children with feeding difficulties. However, in addition to food refusal behaviors maintained by negative reinforcement, children with feeding difficulties may also have skill deficits related to eating that result in low rates of bite acceptance despite the use of escape extinction. In the current study we evaluated how a possible skill deficit in the ability to move the bolus inside the mouth affected compliance with eating. The effects of two specific bite placements (i.e., on tongue and molars) were evaluated using multielement and reversal designs within a treatment package with two children who engaged in food refusal behavior. These alterations were compared to the more typical bite presentation method of using a spoon. All treatment packages consisted of escape extinction and noncontingent access to toys. Results showed that treatment packages manipulating bite placement reduced expels and improved the latency to swallow the food relative to the spoon presentation. These data suggest that varying the antecedent variable of bite placement augmented a treatment package containing extinction and noncontingent access to toys, resulting in better outcomes relative to the treatment package without this antecedent component. |
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| A Preliminary Investigation of Publication Bias in Single-Case Research on the Behavioral Treatment of Pediatric Feeding Disorders. |
| VALERIE M. VOLKERT (The Marcus Institute), Cathleen C. Piazza (Munroe-Meyer Institute), Melanie H. Bachmeyer (The University of Iowa) |
| Abstract: Publication bias, the increased probability of studies with positive findings to be submitted and published, has been studied extensively, but only in research using group-comparison designs. We compared 16 published with 16 unpublished cases admitted to a day-treatment program for behavioral treatment of pediatric feeding disorders (i.e., 32 consecutive admissions) to determine whether the clinical outcomes were better for the published cases than for the unpublished cases. Contrary to the publication bias hypothesis, results showed that the clinical outcomes for the unpublished group were slightly better than for the published group. Reasons for the lack of a publication bias effect are discussed as well as directions for future research. |
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