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| Behavioral Approaches to Feeding Disorders |
| Sunday, May 29, 2005 |
| 9:00 AM–10:20 AM |
| Williford A (3rd floor) |
| Area: CBM; Domain: Applied Research |
| Chair: Kimberly A. Schreck (Pennsylvania State University, Harrisburg) |
| Discussant: Keith E. Williams (Pennsylvania State Milton S. Hershey Medical Center Feeding Program) |
| Abstract: Research indicates that behavioral interventions successfully improve eating behavior for children. However, the field continues to develop specialized treatment methods that provide long-term results and that parents find acceptable. The first presentation in this symposium describes a specific behavioral approach to teach chewing using positive reinforcement and escape prevention. The second presentation examines a behavioral treatment package used for 3 children to eliminate pathological tongue thrusts and reduce or eliminate tube feedings. The third presentation discusses parental perception of the acceptability and effectiveness of these intensive behavioral treatments for childhood feeding problems. |
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| Chew, Chew, Chew: A Behavioral Approach to Chewing |
| KATHERINE RIEGEL (Pennsylvania State Milton S. Hershey Medical Center Feeding Program), Keith E. Williams (Pennsylvania State Milton S. Hershey Medical Center Feeding Program) |
| Abstract: This study describes a behavioral approach to teach chewing using a structured treatment plan. The participants were three children who only ate pureed foods. They exhibited maladaptive behaviors such as gagging, vomiting and refusal when presented with foods containing texture. Positive Reinforcement and escape prevention were used to teach the children to (a) bite on small pieces of dry crisp food, (b) use tongue lateralization, and (c) drink from an open cup. As the children acquired the necessary skills, bite size and variety were increased to an age appropriate level. In each case, the child was able to transition from a diet of pureed food to table food. |
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| Behavioral Treatment of Pathological Tongue Thrust |
| BRIDGET G. GIBBONS (Pennsylvania State Milton S. Hershey Medical Center Feeding Program), Keith E. Williams (Pennsylvania State Milton S. Hershey Medical Center Feeding Program) |
| Abstract: A behavioral treatment package was implemented for 3 children referred to an intensive day treatment feeding program for gastrostomy tube dependence and food refusal. Prior to treatment, participants exhibited pathological tongue thrust, resulting in the expulsion of most or all foods presented. An oral motor procedure, pushing down on the tongue with a small rubber-tipped brush, was used to reduce or eliminate the tongue thrust and facilitate movement of food through the mouth allowing it to be swallowed. This procedure was paired with positive reinforcement and escape extinction to increase oral consumption of liquids and solids. A multiple probe design was used to evaluate treatment effectiveness. By the end of treatment, tube feedings were eliminated or significantly reduced for all 3 children, demonstrating the successful combination of operant and oral motor treatments. |
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| Parent Perceptions of the Acceptability and Effectiveness of Intensive Behavioral Treatment for Childhood Feeding Disorders |
| KIMBERLY A. SCHRECK (Pennsylvania State University, Harrisburg), Keith E. Williams (Pennsylvania State Milton S. Hershey Medical Center Feeding Program) |
| Abstract: Although intensive behavioral treatment provides an appropriate intervention for pediatric feeding disorders, no studies have been conducted to determine parental acceptability, parental perception of long-term effectiveness, or the factors related to acceptability and effectiveness. This study surveyed 109 parents of children treated in a feeding program for their perception of the effectiveness and acceptability of intensive behavioral intervention for pediatric feeding disorders. Responses indicated that parents were generally satisfied with the treatment techniques and perceived long-term improvement for their children’s feeding problems. |
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