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| Advancing the Assessment and Treatment of Pediatric Feeding Disorders |
| Monday, May 31, 2010 |
| 1:30 PM–2:50 PM |
| Texas Ballroom Salon C (Grand Hyatt) |
| Area: CBM/DDA; Domain: Applied Behavior Analysis |
| Chair: Megan D. Aclan (The Chicago School, Los Angeles) |
| Discussant: Michele D. Wallace (California State University, Los Angeles) |
| CE Instructor: Joseph Cautilli, Ph.D. |
| Abstract: As more providers begin to treat the problem of pediatric feeding disorders, more emphasis should be placed upon practitioner training on assessment and possible treatment interventions. This symposium addresses these issues through a large scale descriptive analysis and the utilization of basic behavior analytic principles in the treatment of two specific issues. The first talk focuses upon using a known assessment tool for feeding problems within the new population of children with autism. The second talk looks at the not as often used changing criterion design in order to establish and maintain chewing in children with autism who are at a stand-still in terms of texture advancement. The third talk addresses treatment intervention for feeding disorders without the use of the commonly implored escape extinction, thus avoiding potential negative side effects. The symposium concludes with a discussion by Dr. Michele Wallce. |
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| Validation of the Screening Tool of Feeding Problems Within Autism Spectrum Disorders |
| KATHARINE GUTSHALL (Center for Autism and Related Disorders, Inc.), Taira Lanagan (Center for Autism and Related Disorders, Inc.), Courtney Lanagan (FirstSteps for Kids, Inc.) |
| Abstract: Eating is a fundamental behavior required for physical and mental growth. Feeding problems such as refusal, nutritional deficits, selectivity, skill deficits, rumination, and aspiration can all attribute to potential health problems. The Screening Tool of Feeding Problems (STEP) was designed as a method to identify individuals for whom feeding and mealtime behaviors were problematic so that these individuals could receive behavioral or medical intervention (Matson and Kuhn, 2001). However, when developed the STEP was only applied to individuals with mental retardation. Past studies have shown that caregivers often report differences in eating patterns for children diagnosed with Autism Spectrum Disorders (Ledford and Gast, 2006, Martins, Young, and Robson, 2008, Schreck and Williams, 2006, Schreck, Williams, and Smith, 2004). However, few have used any sort of standardized scale to ascertain the true deficits seen within this population. The STEP was administered to the caregivers of over 40 children diagnosed with an Autism Spectrum Disorder. Results from these individuals are able to be compared and contrasted with the results obtained by Matson and Kuhn within the mental retardation population. Further consideration determines if the STEP is an appropriate screening tool for this young population. |
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| Acquisition of Chewing in Children With Autism Utilizing a Changing Criterion Design |
| TAIRA LANAGAN (Center for Autism and Related Disorders, Inc), Katharine Gutshall (Center for Autism and Related Disorders, Inc.), John Galle (Center for Autism and Related Disorders, Inc.) |
| Abstract: The changing criterion design has been widely demonstrated to effectively change behavior across various populations. Prompting and reinforcement have been used as a treatment to effectively increase the number of chews per bite (Shore, LeBlanc & Simmons, 1999). The purpose of this study was to use a changing criterion design to increase chews per bite in two children with Autism Spectrum Disorder. Data were collected on the number of chews per bite during all sessions. Treatment was initiated using a non-edible object presented simultaneously with a bite of food to teach chewing. Results demonstrated that both participants were able to increase the rate of chewing across a variety of foods. |
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| Treating Feeding Disorders Without the Use of Escape Extinction |
| KATHARINE GUTSHALL (Center for Autism and Related Disorders, Inc.), Taira Lanagan (Center for Autism and Related Disorders, Inc.), Nichole Swansfeger (Center for Autism and Related Disorders, Inc.), Megan D. Aclan (The Chicago School, Los Angeles) |
| Abstract: Within the first few years of life, acquiring the skill of eating is one of the most fundamental and important behaviors a child can learn. However, for some children, the act of eating is not learned, or learned inappropriately. In these cases behavioral interventions have been shown to be useful in increasing appropriate eating while decreasing inappropriate mealtime behavior. Interventions tend to include one or more components such as reinforcement, shaping, and escape extinction in order to gain the desired effect (Chung and Kahng, 2006). Within peer reviewed literature, the majority of successful interventions include the use of escape extinction (Kern and Marder, 1996; Cooper, et al. 1995; Coe, et al. 1997). However, knowing that the implementation of escape extinction can result in an increase of adverse side effects such as crying and refusal behavior, it is preferable to use extinction only when necessary. In treating two young boys, with and without developmental disabilities, feeding interventions were employed using reinforcement-based principles only within a reversal and multiple baseline design. Results from these cases indicate that escape extinction may not be necessary in the treatment of all clients. Additionally, thought should be given as to when clinicians and parents believe a client's feeding behavior to be "good enough." |
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