Association for Behavior Analysis International

When left untreated, pediatric feeding problems can result in poor weight gain, weight loss, malnutrition, dehydration, cognitive impairment, compromised immune function, and dependency on tube feedings (Cohen, Piazza, & Navanthe, 2006). Therefore, it is imperative that clinicians and researchers continue to develop effective treatment procedures and disseminate their findings to a larger audience. This symposium combines 4 data-based presentations on the assessment and treatment of pediatric feeding problems from 4 different programs: Munroe-Meyer Institute, University of North Carolina Wilmington, Marcus Autism Center, and University of Kansas. Following the 4 presentations, Dr. Cathleen Piazza (Munroe-Meyer Institute) will discuss the presentations and the implications of each presenters findings. The first presentation will focus on the use of applied behavior analysis to treat feeding problems in children with autism spectrum disorder. The second presentation will compare descriptive and functional analyses in the treatment of feeding disorders. The third presenter will discuss the use of alternative bite presentation methods in the treatment of expulsion and packing. The final presenter will discuss the use of response blocking to distinguish between motivational and skill deficits in pediatric feeding disorders.

Children with autism spectrum disorder (ASD) often display feeding problems, and food selectivity, defined as consumption of a limited variety of foods (Schreck, Williams, & Smith, 2004), is the most commonly reported feeding problem. Results of studies have shown that treatments based on applied behavior analysis (ABA) are effective as treatment for feeding disorders in the general pediatric population (e.g., Piazza, Patel, Gulotta, Sevin, & Layer, 2003; Volkert & Piazza, 2012). Although ABA treatments have empirical support for feeding problems, and ABA also has empirical support for the treatment of the core symptoms of ASD, there are no ABA randomized clinical trials with a well-defined cohort of children with ASD and food selectivity. We conducted a randomized clinical trial of ABA treatment of food selectivity in children with ASD relative to a wait-list control group. We randomly assigned 3 children to ABA and 3 children to a wait-list group and compared the effects of treatment in a multiple baseline design across novel, healthy groupings of foods. Results demonstrated that ABA treatment increased acceptance of all food groupings for all six children who participated in the study.

Children typically gain the skills to appropriately feed themselves by the age of two years (Carruth et al., 2004). Those whose skills are delayed have statistically been shown to consume less nutrients (Carruth et al., 2004) and are at risk for both developmental and growth delays (Manikam & Perman, 2000; O?Brien et al., 1991). Though previous research has assessed a multitude of treatments for feeding delays and disorders (Cooper et al., 1995; Manikam & Perman, 2000; Piazza & Carroll-Hernandez, 2004), little research has evaluated whether such delays are maintained by motivational or skill deficits. The current study describes the treatment of age-inappropriate self-feeding skills for four children with developmental disabilities. Response blocking was used to determine whether the absence of appropriate self-feeding was a motivational or skill deficit. Results of response blocking for one child suggest a motivational deficit, whereas results for the other three children suggest a skill deficit. Results will be discussed in terms of response blocking as an assessment procedure as well as backward chaining as a procedure for increasing self-feeding skills.