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| Innovations and Extensions in the Treatment of Pediatric Feeding Disorders |
| Sunday, May 24, 2009 |
| 1:30 PM–2:50 PM |
| North 128 |
| Area: DDA/AUT; Domain: Applied Behavior Analysis |
| Chair: Becky Penrod (California State University, Sacramento) |
| Discussant: Michele D. Wallace (California State University, Los Angeles) |
| Abstract: A significant amount of research has demonstrated that behavioral approaches can be particularly effective for treating pediatric feeding disorders. However, the majority of previous research has examined the direct effects of treatments such as escape extinction and most research has been conducted on a small scale, short-term basis. In this symposium we present three papers that attempt to extend the feeding literature in several ways. We begin with a study that extends the use of differential reinforcement and response cost to the treatment of food selectivity in children with autism. The second paper examines the indirect effects of escape extinction on changes in preference for nonpreferred foods. The third presentation is a clinic-wide program evaluation for a short-term intensive outpatient treatment program for pediatric feeding disorders in Austin, Texas. The symposium will conclude with a discussion by Dr. Michele Wallace. |
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| Use of a Multicomponent Treatment for Food Selectivity in Children with Autism |
| LISA BALTRUSCHAT (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.), Adel C. Najdowski (Center for autism and Related Disorders, Inc.) |
| Abstract: According to Kahng, Tarbox, and Wilke (2001) reported the use of differential reinforcement of alternative behavior (DRA) and response cost (RC) to treat eht food refusal of a young child with mild to moderate mental retardation. The present study investigated whether this multicomponent treatment package was effective when applied to three children with autism who displayed food selectivity. For one of the three participants the basic RC+DRA treatment resulted an increase in food acceptance to 100% of bite offers. For the two other participating children the basic treatment was enlarged by three additional treatment components (size fading, preferred food-positive reinforcement, and a free operant procedure). For both of them the modified treatment resulted in an increase in food acceptance to 100% of bite offers. In addition, the participants' caregivers were successfully trained to implement the treatment. |
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| An Evaluation of Emerging Preference for Non-preferred Foods Targeted in the Treatment of Food Selectivity |
| BECKY PENROD (California State University, Sacramento), Kate H Perry (California State University, Sacramento), Traci Oberg (State University of California, Sacramento), Jessica Gamba (California State University, Sacramento) |
| Abstract: The current study conducted a comparison of sequential and simultaneous food presentation in the treatment of food selectivity. Both presentation methods were evaluated in the absence of escape extinction. Neither presentation method was effective in increasing food consumption; consequently, both presentation methods were combined with escape extinction in the form of a nonremoval of the spoon procedure. After the nonremoval of the spoon procedure was introduced, food consumption increased for all participants. These results support prior research showing that the acquisition of food consumption does not occur until after escape extinction is implemented (e.g., Piazza et al., 2003). However, findings from the current research suggest that while the nonremoval of the spoon procedure may have been necessary for the acquisition of food consumption, maintenance of food consumption may have been due to preferences developing for the non-preferred foods targeted during treatment. In the current study, food preference assessments were conducted pre- and post-treatment and it was found that following exposure to a nonremoval of the spoon procedure, participants developed a preference for the foods that were targeted in treatment. |
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| Program Evaluation of an Intensive Outpatient Feeding Treatment Facility |
| MELISSA L. OLIVE (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.), Katharine Gutshall (Center For Autism and Related Disorders, Inc.) |
| Abstract: Research indicates that anywhere from 33-88% of children with disabilities have serious feeding concerns. A variety of interventions for feeding concerns have been reported in the literature. These include but are not limited to differential reinforcement and escape extinction. Prior studies generally focus on one to three children, often in controlled university or hospital settings. This paper will present a program evaluation for a community-based intensive outpatient feeding treatment facility. We summarize results of 15 children with autism treated over the past year. We present data on the intensity, duration, and total intervention time needed to address the feeding concern. Dependent measures to be presented include total treatment time in hours, total bites consumed, number of different foods consumed, number of aggressive/self-injurious behaviors per bite and number of disruptive behaviors per bite. Results indicate that all children showed a substantial increase in total number of bites and number of different foods consumed while concomitantly showing a decrease in number of aggressions, disruptions, and self-injurious behaviors per presentation. |
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