Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


33rd Annual Convention; San Diego, CA; 2007

Event Details

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Symposium #266
Treatment of Pediatric Feeding Disorders
Sunday, May 27, 2007
3:00 PM–4:20 PM
Edward C
Area: CBM; Domain: Applied Research
Chair: Peter Girolami (Kennedy Krieger Institute)
Abstract: This symposium examines several different but important areas related to feeding disorders. Two of the presentations focus on replicating the treatment effects in inpatient settings to outpatient and home settings. One presentation evaluates the impact of taste preference on the often difficult to treat behavior of rumination. Finally, the fourth presentation compares two methods to decrease expelling in children diagnosed with feeding disorders.
Comparison of Two Methods of Re-Presentation to Decrease Expelling.
JAMES H. BOSCOE (Kennedy Krieger Institute), Peter Girolami (Kennedy Krieger Institute)
Abstract: Expelling food is a behavior often exhibited by children diagnosed with severe feeding disorders. Conceptualizing expelling as avoidant behavior, several studies have demonstrated that re-presentation of expelled bites with a spoon is an effective treatment to reduce expelling. This study will compare the effectiveness of re-presentation with a spoon with re-presentation using a bristled teething brush with three children diagnosed with feeding disorders. Although both procedures prevent escape, the teething brush provides for better placement of the re-presented bite directly onto the tongue. For one child diagnosed with oral-motor skill deficits, re-presentation with a teething brush was more effective in decreasing expels than re-presenting bites with a spoon. Results will be discussed in terms of the impact of response effort and/or stimulus properties during brush re-presentation.
Rumination Disorder and the Role of Taste Preference: A Case Study.
ANDREW W. GARDNER (Northern Arizona University), Patricia F. Kurtz (Kennedy Krieger Institute), Lindsay P. Richerson (Northern Arizona University)
Abstract: Rumination occurs in 6-10 % of individuals with mental retardation (Rogers et al. 1992). Treatment typically involves medical evaluation/intervention, and behavioral treatments such as satiation or punishment. In the current study, we analyzed the effects of meal preference, post-meal activity, and taste preference on rumination exhibited by a child with Autism. Assessment was conducted in three phases. During Phase 1, 60-minute post-meal observations of rumination were conducted following high and low preference meals and during structured and unstructured toy play conditions. During Phase 2, components of high preference meals were systematically withdrawn to assess specific foods affecting rates of rumination. Results of these assessments indicated that only highly preferred meals, including meats in particular, were ruminated. During Phase 3, a taste preference assessment of flavored candy and mint sprays was conducted to identify potential stimuli to compete with rumination of preferred meals. Treatment, consisting of provision of the high preference taste on a fixed time schedule (FT 30”) during 40-minute post-meal periods, was evaluated in a multiple baseline design. Rumination was successfully decreased across all meals. Interobserver agreement was assessed for 36% of total sessions and averaged 94%. Results are discussed in terms of reinforcement-based approaches to treatment of rumination.
Evaluation of a Home-Based Intervention for Food Refusal and Food Selectivity.
CHAD D. HARRISON (University of Oregon), Aaron Barnes (University of Oregon), Cynthia M. Anderson (University of Oregon)
Abstract: Food refusal and food selectivity provide a significant challenge to parents and caregivers of children exhibiting such behaviors. Multiple studies have demonstrated the effectiveness of escape extinction as a treatment for food refusal and food selectivity in children. However, most studies have been conducted in highly controlled clinic settings to establish escape extinction as an effective treatment option with little or no examination of the transfer of these procedures to the home setting of the individual. This study will examine the effectiveness of the implementation of a standard protocol procedure for escape extinction as a training procedure for parents and caregivers. This study is a systematic replication of a previous study that suggested positive outcomes using the standard protocol training procedures. The first study was conducted initially in a clinic with transfer to the home setting; in this study we will work entirely in the homes of participants. Additionally, follow-up data will be provided.
Behavioral Treatment of Food Refusal at an Outpatient Hospital Setting.
NICOLE M CARLISLE (William Beaumont Hospital - CARE Program), Ivy M. Chong Crane (William Beaumont Hospital - CARE Program)
Abstract: Previous research on pediatric food refusal has shown that treatment packages based on behavioral interventions (i.e., operant conditioning) are effective in the treatment of feeding disorders. Numerous studies have demonstrated the effectiveness of reinforcement-based procedures and escape-extinction (such as nonremoval of spoon and physical guidance) to increase and maintain food consumption (e.g., Kahng, Tarbox, & Wilke, 2001; Piazza, Patel, Gulotta, Sevin, & Layer, 2003; Piazza et al., 2003). However, patients are typically admitted to an inpatient program in which meals are provided 5 – 8 sessions per day for an extended period of time. Further, follow-up in the home are typically not provided following discharge. The current investigation sought to replicate previous results in an outpatient treatment program. Two preschoolers diagnosed with autism who were attending a center-based intensive behavioral treatment program participated in the study. Both participants exhibited severely limited food repertoires and one child consumed only step 3 ‘blended’ baby foods. At the conclusion of the study both participants consumed over 40 adult table foods. Generalization of treatment gains into the home environment is included for 6-month and 12-month probes.



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