Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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46th Annual Convention; Online; 2020

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Poster Session #224
CBM Sunday Poster Session
Sunday, May 24, 2020
1:00 PM–3:00 PM
Virtual
71. Emotional Responding During Escape Extinction of Inappropriate Mealtime Behavior
Area: CBM; Domain: Applied Research
CHRISTOPHER ENGLER (University of Nebraska Medical Center's Munroe-Meyer Institute), Kathryn M. Peterson (University of Nebraska Medical Center's Munroe-Meyer Institute), Cathleen C. Piazza (Rutgers University)
Discussant: Michele R. Traub (St. Cloud State University)
Abstract:

Escape extinction is a well-established treatment for increasing acceptance and decreasing inappropriate mealtime behavior of children with feeding disorders (Volkert & Piazza, 2012), but some researchers have characterized escape extinction as intrusive because of potential negative side effects. One potential negative side effect is an increase in emotional responding (Lerman & Iwata, 1996). Woods and Borrero (2019) found that extinction-induced negative vocalizations occurred in three of 10 data sets (30%). In the current study, we assessed whether negative vocalizations occurred during extinction of inappropriate mealtime behavior for children diagnosed with a pediatric feeding disorder. We analyzed data of 79 children with food refusal, liquid refusal, or both, resulting in 121 data sets (67 and 54 data sets for solid and liquid intake, respectively). We observed an initial increase in negative vocalizations following extinction implementation in 70% of the data sets. However, we also observed that negative vocalizations decreased to zero within an average of six treatment sessions or after approximately 70 min of exposure to extinction. We discuss these findings as they relate to caregiver preference for escape extinction over other interventions as well as treatments that could be added to escape extinction to reduce negative vocalizations (e.g., noncontingent attention).

 
73. The Use of a Levels System to Treat an Adolescent Exhibiting Food Refusal
Area: CBM; Domain: Applied Research
HAILEY RIPPLE (Kennedy Krieger Institute), Rita Druffner (Kennedy Krieger Institute), Hallie Smith (Kennedy Krieger Institute)
Discussant: Michele R. Traub (St. Cloud State University)
Abstract:

A levels system is typically comprised of differential reinforcement, a response cost, and punishment (Hagopian, 2002). Specifically, levels systems involve the manipulation of a participant’s access to/ restriction of reinforcement based upon a specific behavioral criterion. While levels systems have been used to intervene on various problem behaviors (Grace, Thompson, & Fisher, 1996; Hagopian et al., 1996) and to increase independence and self-feeding during meals (Gonzalez, Taylor, Borrero, & Sangkavasi, 2013), current literature has not yet documented their use in treating food refusal - specifically with the goal of increasing volume and overall meal completion. The current study examined the effectiveness of a levels system to treat food refusal in a 12-year-old female with a mild intellectual disability, fetal alcohol syndrome, attention-deficit/hyperactivity disorder, and a history of being significantly underweight (body mass index below the 1st percentile). Results indicated that a levels system was successful in increasing the volume of food consumed at each meal and decreasing refusal during the meal. Specifically, by the end of treatment the participant was consuming an age appropriate volume and variety of food at each meal within an appropriate mealtime duration.

 
75. Increasing Parent Compliance With In-Session Practice by Altering Child's Criteria for Reinforcement to Include Accuracy of Parental Implementation
Area: CBM; Domain: Service Delivery
NICOLE HIGGINS (Kennedy Krieger Institute, Johns Hopkins Medical School)
Discussant: Michele R. Traub (St. Cloud State University)
Abstract: Behavior problems are prominent in children with developmental delays. Common concerns often include, but are not limited to, noncompliance, hyperactivity, inattention, and disruptive or unsafe behaviors. Parent training is a common behavioral intervention for parents of children with problem behaviors in which clinicians teach parents to accurately define, assess, and implement behavior management techniques based on concepts of behavior modification. While previous research has shown parent training to be effective, challenges related to accurate implementation of treatment recommendations may still arise in clinical practice. The present case study aims to explore increasing parent compliance within session practice by altering child’s reinforcement (e.g., treasure box) to include accurate parent implementation of treatment recommendations. The target skill identified is parent ability to deliver effective demands. To date, the study includes one parent-child dyad receiving treatment to address tantrums, noncompliance, and elopement. At baseline, parent delivery of effective instructions was not observed. Accurate implementation of intervention by the parent was not observed following education, modeling, and parent practice despite corrective feedback provided. Immediately following altering the child’s reinforcement for session dependent on parent’s accurate implementation of recommendation, percentage of correct implementation of effective demands increased and generalization effects were observed.
 
76. A Comparison of a Food Chaining Approach to an Applied Behavior Analytic Approach in the Treatment of Food Selectivity in Children With Autism Spectrum Disorder
Area: CBM; Domain: Applied Research
CONNOR SHEEHAN (Center for Pediatric Behavioral Health), Melanie H. Bachmeyer-Lee (University of North Carolina Wilmington), Caitlin A. Kirkwood (Center for Pediatric Behavioral Health, University of North Carolina Wilmington), Emily G. Doane (University of North Carolina Wilmington)
Discussant: Michele R. Traub (St. Cloud State University)
Abstract:

Applied behavior-analytic (ABA) interventions are the most empirically supported approach to the assessment and treatment of pediatric feeding disorders (Volkert & Piazza, 2012). Despite the effectiveness of behavior-analytic interventions, interventions with limited empirical support are often the first-line treatments for feeding difficulties (Peterson, Piazza, & Volkert, 2017). Food chaining is a sensory-integration approach often recommended by occupational and speech and language therapists that introduces new foods into a child’s diet by building off the child’s past successful eating history. The current study used a nonconcurrent multiple-baseline design to compare a food chaining approach to an ABA approach, that consistent of noncontingent attention and escape extinction, for the treatment of food selectivity for 3 children with feeding disorders. We observed an increase in acceptance of target foods and a decrease in inappropriate mealtime behavior only after exposure to the ABA treatment. Results are consistent with previous research supporting the use of behavior-analytic interventions over sensory-based interventions in the treatment of pediatric feeding disorders (Addison et al., 2012; Peterson, Piazza, & Volkert, 2017). We discuss implications for creating and implementing empirically supported treatments for children with feeding difficulties.

 
80. The Use of Behavioral Principles to Address Infant Feeding Problems
Area: CBM; Domain: Service Delivery
Amy Drayton (University of Michigan Medical School), RACHEL KNIGHT (University of Michigan Medical School), Melissa Andersen (University of Michigan Medical School)
Discussant: Michele R. Traub (St. Cloud State University)
Abstract:

Currently, 40-70% of infants born prematurely or with significant medical conditions have a severe feeding disorder, and studies have shown that 70% of children who refused to eat during infancy will continue to experience feeding problems at the age of four years. Infants quickly learn to associate formula, breast milk, and bottles with pain and danger because of the way that infants are fed in most neonatal intensive care units. This project will describe how the application of principles from classical and operant conditioning can be applied to address feeding issues during infancy. We will also present data demonstrating that behavioral treatment during infancy can prevent severe feeding disorders that require costly and intensive treatment later in childhood.

 
81. Rumination Syndrome: Review of Historical Trends and Ethical Considerations
Area: CBM; Domain: Theory
KRISTYN PETERSON (The Chicago School of Professional Psychology), Julie A. Brandt (The Chicago School of Professional Psychology )
Discussant: Michele R. Traub (St. Cloud State University)
Abstract: Rumination syndrome, where an individual regurgitates recently ingested food and then typically reingests it, presents many unique challenges for treatment. Rumination syndrome has deleterious medical side effects, including cardiovascular problems, dental concerns, endocrine dysfunction, and up to death. This indicates a large need for effective treatment. Characteristics of rumination syndrome, including incidence, comorbidities, and medical features are reviewed. Historical and current research in the behavioral intervention on rumination syndrome are examined, including occurrence in non-human analogs. Historical trends illuminate the use of intrusive punishment procedures, including taste aversion and contingent electric shock procedures. Additional historical trends include the use of Freudian explanations to drive treatment and the lack of provision of objective data. More recent research has trended toward the development and use of assessment procedures to identify when rumination is more likely to occur to inform the use of antecedent interventions, primarily in the form of manipulating aspects of food and liquid delivery, which have shown minimal to moderate success. Ethical concerns related to treatments for rumination are considered. Discussion, and finally, suggestions for future research and intervention development are presented.
 
 

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