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| Current Strategies to Assess and Treat Multiple Topographies of Food Refusal |
| Saturday, May 25, 2019 |
| 3:00 PM–3:50 PM |
| Hyatt Regency West, Lobby Level, Crystal Ballroom A |
| Area: DDA; Domain: Applied Research |
| Chair: Elizabeth A. Masler (Kennedy Krieger Institute) |
| Discussant: Valerie M. Volkert (Marcus Autism Center and Emory School of Medicine) |
| CE Instructor: Elizabeth A. Masler, M.A. |
| Abstract: A variety of effective behavioral treatments to address pediatric food refusal have been thoroughly discussed in the behavior-analytic literature. Due to the complexity of food refusal, children often present with multiple topographies (e.g., inappropriate mealtime behavior, expulsion, packing) and interventions often include multi-component treatment packages. This symposium includes a study that evaluated the sequential introduction of treatment components designed to address multiple topographies of food refusal. Results suggested that at least three topographies were likely members of a single response class which required simultaneous treatment, although packing was the most resistant to intervention. Thus, the second study focused on a single topography of food refusal, packing. An assessment model was introduced and evaluated to guide the treatment of packing. Results indicated that such a model may be useful in identifying an effective treatment for packing. Together, these studies provide assessment models that may be useful in determining when specific treatment components may be effective. |
| Instruction Level: Intermediate |
| Target Audience: 1) Practitioners
2) Researchers |
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| Analysis of Response Classes in Pediatric Food Refusal |
| MEARA X. H. MCMAHON (University of Georgia), Carrie S. W. Borrero (Kennedy Krieger Institute), John C. Borrero (University of Maryland, Baltimore County) |
| Abstract: Multicomponent intervention packages used to treat pediatric food refusal often consist of several procedures that may be cumbersome for caregivers to implement (e.g., Pangborn, Borrero, & Borrero, 2012; Werle, Murphy, & Budd, 1993). Practitioners may avoid the use of additional procedures by sequentially introducing treatment components only when necessary. In the present study, the sequential introduction of treatment components designed to address multiple topographies of food refusal was evaluated using reversal designs for three children. Extinction analyses were conducted to determine if topographies were members of a response class. An evaluation of temporal relations between responses suggested that inappropriate mealtime behavior (IMB) was most likely to occur first if untreated. When escape extinction procedures were implemented for IMB, other topographies of food refusal increased. Results suggest IMB, expulsion and packing may be members of the same response class and all topographies may need to be addressed when designing treatment procedures. |
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Evaluation of a Packing Assessment to Decrease Packing Among Children With Food Refusal |
| ALEXANDRA MARIE RIVERO (Kennedy Krieger Institute / UMBC), Carrie S. W. Borrero (Kennedy Krieger Institute) |
| Abstract: A significant problem among children who engage in pediatric food refusal is packing (i.e., pocketing or holding accepted food in the mouth), which could hinder successful treatment. Previous research has identified effective treatments to reduce packing; however, an assessment model to guide treatment decisions is lacking. In the present study, a multielement design was used to identify conditions under which low levels of packing occurred for four children with pediatric food refusal. Results were used to empirically inform treatment selection to decrease packing for three children. Assessments indicated that packing was related to texture, food preference, or response effort and subsequently informed individualized treatments, which led to decreased levels of packing. Results suggest that this model may be useful in the design of treatment packages for children who engage in packing at clinically problematic levels. |
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