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| Interventions to Increase Food Acceptance With Children With Autism |
| Tuesday, June 1, 2010 |
| 10:30 AM–11:50 AM |
| 202AB (CC) |
| Area: AUT/EDC; Domain: Applied Behavior Analysis |
| Chair: Maria Saville (Bangor University) |
| Discussant: Neil T. Martin (European Association for Behaviour Analysis) |
| Abstract: Feeding disorders are prevalent amongst individuals with Autism. Feeding problems impact the child’s health, growth, and development as well as presenting difficulties for carers. Study one examines the use of positive reinforcement and escape extinction in an ABA school setting aimed at increasing acceptance of foods. The study used a changing criterion design and preferred foods as contingent consequence for acceptance of non-preferred foods. Study two investigated the use of a shaping procedure, combined with escape extinction without the use of physical guidance. The purpose of study three was to contribute to existing research by investigating the possibility of using non-intrusive interventions for food refusal. Participants were initially reinforced for imitating food-associated responses (e.g. licking), and these were strengthened through the use of positive reinforcement in a hierarchical procedure. |
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| Treatment of Pediatric Feeding Disorders: A Review of Single-Subject Research |
| DAVID L. JAQUESS (Marcus Autism Center), William G. Sharp (The Marcus Autism Center), Jane Morton (Louisiana DHH-OCDD), Caitlin V. Herzinger (Marcus Autism Center) |
| Abstract: Eating is an essential activity--necessary to sustain life--but up to 40% of toddlers and early school-age children experience mealtime difficulties with ensuing stress for caregivers (Manikam & Perman, 2000). Ten percent of children develop severe or chronic feeding issues, which are called “feeding disorders” and which may lead to severe medical complications and long-standing social disruptions (Chatoor, 2002). Feeding disorders of this magnitude involve the complex influence of organic, socio-familial, developmental and behavioral factors, and they often require structured, intensive intervention.
The frequently malignant course of feeding disorders creates a pressing need to identify evidence-based treatments. A stringent review of the literature revealed 41 single-subject studies involving behavioral intervention (e.g., escape extinction, differential reinforcement) published between 1970 and 2009 reporting outcomes on 82 participants. Results were pooled and analyzed via the meta-analytic technique of percentage of nonoverlapping data between baseline and treatment (PND; Scruggs & Mastropieri, 1998). Outcomes reflected effective to highly effective treatment outcomes with high PND values on each dependent variable: percent accepted (86.6%), percent swallowed (77.89%), and volume consumed (96.2%). Findings were confirmed (p<.01) with Wilcoxon signed-rank tests, providing non-parametric effect-size estimates. Implications for selecting treatment, research limitations and future directions are also discussed. |
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| CANCELLED Use of Differential Reinforcement to Increase Food Consumption |
| SUSAN OWENS (Saplings Ltd, Ireland), Wendi M. McDermott (Saplings Ltd, Ireland), J. Carl Hughes (Bangor University) |
| Abstract: The effects of a shaping procedure, combined with escape extinction, in increasing food consumption were examined. Four children (6yrs – 9yrs) with an Autistic Spectrum Disorder diagnosis participated in the study. Results are reported where differential reinforcement of the response classes within the complex behaviour chain of consumption was used to shape the behaviour towards the terminal behaviour of food consumption. Edible and token reinforcement was delivered contingent on completion of the desired response class. The aims of the study were to extend the literature on food refusal with individuals with different severity of feeding disorders in an applied clinical setting. Results showed that all participants exhibited closer approximations of the terminal behaviour, food consumption, suggesting that the implementation of a shaping procedure, combined with escape extinction without the use of physical guidance, may have positive effects on food consumption. Findings are discussed in the context of developing a shaping procedure combined with escape extinction as an effective procedure for increasing food consumption. |
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| CANCELLED Positive Reinforcement and Escape Extinction Procedures to Increase Food Acceptance in Children With Autism |
| ALISON A. FINN (Saplings Ltd, Ireland), Carrie McMillan (Saplings Ltd, Ireland), J. Carl Hughes (Bangor University) |
| Abstract: The combined effects of positive reinforcement and escape extinction procedures in increasing food acceptance were examined. Two children (5yrs – 8.5yrs) with Autistic Spectrum Disorder participated in the study. Results are reported for two subject AB design with a changing criterion element was utilised where preferred foods were delivered contingent on acceptance of non-preferred foods. The dependent variable measured was: food acceptance. The aims of the study were: to extend the behavioural literature on food refusal and to investigate the use of behaviour analytical procedures in seeking an effective intervention for feeding disorders in an applied clinical setting. Results show acceptance increased for both subjects across identified food groups and positive effects of combining positive reinforcement and escape extinction without the use of physical guidance. Findings are discussed in the context of developing procedures in finding a suitable intervention in increasing food acceptance, and the use of positive reinforcement and escape extinction procedures. |
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| Increasing Food Acceptance in Children With Autism Using Positive Reinforcement Procedures |
| MARIA SAVILLE (Bangor University), J. Carl Hughes (Bangor University), Corinna F. Grindle (Bangor University), Julie M. O. Maynard (Msc in ABA, Bangor University, Wales), Sandra Winkel (Msc in ABA, Bangor University, Wales), Richard P. Hastings (Bangor University) |
| Abstract: Feeding disorders are prevalent amongst individuals with Autism. Feeding problems impact the child’s health, growth, and development as well as presenting difficulties for carers. The purpose of the current research was to contribute to existing research by investigating the possibility of using non-intrusive interventions for food refusal. Most previous research has indicated that escape extinction is an important element in treatment; however, in school settings in the UK this is difficult to implement. Participants were initially expected to imitate food-associated responses that were not acceptance or ingestion (e.g. licking). These responses were strengthened through the use of positive reinforcement. In a hierarchical procedure, once a food response was consistent, reinforcement was faded, and then reinforcement was contingent on the participants imitating a closer response to the terminal response of ingestion. Results indicate that, in contrast to baseline levels, both participants now exhibit a variety of food responses (touch, pick up, lick, smell, and bite) across five foods. Crucially, both participants will also place each food item into their mouths (acceptance). Results are discussed in the context of developing feeding procedures that do not require intrusive methods. |
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