Association for Behavior Analysis International

Food selectivity is defined as consumption of a limited variety of foods (Schreck & Williams, 2006). Children with selective diets often consume foods that are high in fat and/or sodium (e.g., French fries) and/or low in nutritional content, which is of concern because poor dietary intake is associated with health, learning, and behavior problems. Children who are selective eaters and who consume these types of diets are at greater risk for developing severe health problems such as obesity, Type-2 diabetes, chronic constipation, and hypertension (Freedman, Dietz, Srinivasan, & Berenson, 1999; Ludwig et al., 1999). Given the negative consequences associated with food selectivity, validation and dissemination of effective treatments is critically important. This symposium includes two data-based presentations from different programs.

Many children with autism spectrum disorder (ASD) display food selectivity (consumption of a limited variety of foods; Schreck, Williams, & Smith, 2004). Treatments for pediatric feeding disorders based on applied behavior-analytic (ABA) research have the most empirical support (Volkert & Piazza, 2012). To our knowledge, no empirical evidence supports the use of an alternative treatment approach, Sequential Oral Sensory (SOS), despite its wide use. In the current study, we modified the SOS procedure to evaluate it scientifically as a treatment for food selectivity in two children with ASD using a multiple baseline across foods design. When acceptance of target foods did not increase during SOS, we implemented the ABA treatment and observed high levels of acceptance. Additionally, once we implemented ABA treatment with the first food, both children began accepting bites of the other two foods that were not in treatment (i.e., generalization). For one participant, generalization did not occur during an additional assessment with three foods that were never exposed to SOS. The findings of the current study suggest that although SOS in isolation was not effective, implementation of SOS prior to an ABA treatment produced more robust effects.

In clinical settings, absent an intensive feeding program, high rates of problem behavior can deter parents and clinicians from successfully implementing food acceptance protocols. After initial ineffective attempts to increase acceptance using escape extinction and shaping with one participant, the experimenter implemented a hierarchical presentation of steps along with shaping, chaining, and modeling. Results showed an increase in food acceptance and decrease in problem behavior. Due to rapid food acceptance in the 9 step hierarchy, the total number of required steps was reduced to 3. A multiple probe design across foods with terminal baseline probes throughout was used to determine if additional shaping steps were needed. In one day, both participants met the response requirements for each novel food within the reduced 3 step hierarchy with negligible rates of problem behaviors. This procedure is a viable alternative to parents and clinicians that want to obviate side effects of using escape extinction.