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| Further Developments in the Assessment and Treatment of Children with Feeding Disorders |
| Sunday, May 25, 2008 |
| 1:30 PM–2:50 PM |
| Boulevard A |
| Area: CBM; Domain: Applied Research |
| Chair: Danielle N. Dolezal (Kennedy Krieger Institute) |
| Discussant: Mary Louise E. Kerwin (Rowan University) |
| Abstract: In this symposium, we will present three different assessment and treatment approaches to reduce food refusal behavior and increase consumption across home, inpatient, and outpatient settings. Sean Casey from Pennsylvania State University will present on the use of descriptive analyses to identify and manipulate existing reinforcement schedules in the treatment of food refusal with 2 children in the home setting. Next, Merrill Berkowitz from St. Joseph’s Children’s Hospital will discuss the effects of adult attention provided contingent upon the occurrence of inappropriate behavior during the treatment of food refusal behavior. Finally Bianca Pizzo from Penn State Milton S. Hershey Medical Center will present data on utilizing a taste procedure paired with reinforcement and extinction procedures to increase the variety of foods consumed during one-week of intensive treatment. Following the presentation, Mary Louise Kerwin from Rowan University will discuss the presentations. |
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| Using Descriptive Analysis to Identify and Manipulate Existing Reinforcement Schedules in the Treatment of Food Refusal. |
| SEAN D. CASEY (Pennsylvania State University) |
| Abstract: Treating children who display food refusal behavior can be a major preventative measure for later development of developmental disabilities. The feeding behaviors of 2 children who maintained a failure to thrive diagnosis and displayed food refusal were assessed using descriptive analysis methodology. Assessment was conducted in the home environment to identify the schedules of reinforcement provided by the child's care-providers. Descriptive analyses revealed schedules of reinforcement that were in place for each child’s bite acceptance and food refusal behaviors and successful interventions were implemented by manipulating these existing schedules of reinforcement. Implications for the use of descriptive analysis methodology for assessing feeding problems are discussed. |
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| The Relative Effects of Adult Attention in the Treatment of Pediatric Feeding Disorders. |
| MERRILL J. BERKOWITZ (St. Joseph's Regional Medical Center), Annmarie Marando (St. Joseph's Children's Hospital), Peggy S. Eicher (Children's Seashore House) |
| Abstract: A few studies have been conducted in the field of pediatric feeding disorders examining the functions of inappropriate mealtime behaviors. Piazza et al. (2003) found that most inappropriate mealtime behaviors were maintained by negative reinforcement. For half of the participants, obtaining adult attention was also identified as a function of their inappropriate mealtime behaviors. Many treatment procedures including escape extinction and reinforcement (Ahearn et al., 1996; Hoch et al., 1994) have been found to be effective in increasing children’s consumption of food or liquid. A few studies have been conducted examining methods to train caregivers in the implementation of the above procedures (e.g., Mueller et al., 2003). Although these methods and other have been effective in training most caregivers, we have observed that some caregivers continue to have difficultly refraining from providing attention contingent upon their children’s inappropriate mealtime behaviors, thereby possibly hindering treatment gains. The current investigation utilizes a multielement design to examine the relative effect of adult attention provided contingently on children’s inappropriate mealtime behaviors. Three children exhibiting feeding difficulties participated in the study. Escape extinction and reinforcement components were also components of each child’s treatment package. The results of the evaluation and their implication will be discussed. Limitation of the current study and recommendations for future research will also be provided. |
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| Jump Start Exit Criterion. |
| BIANCA PIZZO (Pennsylvania State University Hershey Medical Center), Keith E. Williams (Pennsylvania State University Hershey Medical Center), Candace M. Paul (Pennsylvania State University Hershey Medical Center), Katherine Riegel (Pennsylvania State University) |
| Abstract: Repeated taste exposure paired with escape prevention has been shown to be an effective treatment for significant feeding problems, particularly food selectivity by type and texture. Previous research has demonstrated the effectiveness of this intervention in an intensive day treatment program over a period of several weeks. The goal of the current study was to determine the effectiveness of this intervention using a new model of service delivery, namely, a one-week period of intensive treatment and outpatient follow up to treat three children with extreme food selectivity. The results showed that each of the three children increased the variety of foods eaten at the end of the one-week intensive treatment and made further gains in variety at the time of three month follow up. In a rapidly changing healthcare environment, new models for delivering services, especially behavioral services, are needed. |
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