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Food Selectivity: Four Unique Applications for Increasing Food Repertoire in Children With Autism |
Tuesday, May 26, 2015 |
9:00 AM–10:50 AM |
217B (CC) |
Area: AUT; Domain: Applied Research |
Chair: Sara M. Weinkauf (Easter Seals North Texas) |
Discussant: Sara M. Weinkauf (Easter Seals North Texas) |
CE Instructor: Tyla M. Frewing, M.A. |
Abstract: Food selectivity is comprised of food refusal, limited food repertoire, and high frequency single food intake (Bandini et al., 2010). Food selectivity has an estimated prevalence as high as 85% in children with autism, often leading to nutritional deficiencies (Ahearn et al., 2001). Many behavior analytic approaches to treating food selectivity in children with ASD use escape extinction techniques. (Bachmeyer et al., 2009, Paul et al., 2007, Piazza et al., 2003). The present symposium will include a study in which the effectiveness of escape extinction and application of the Premack principle in treating food selectivity in two males with ASD was evaluated. Two additional projects evaluated the effectiveness of hierarchal exposure to foods and systematic desensitization using a 12-step food hierarchy in three additional participants. The final presentation involves a constructional approach to addressing food selectivity. Over fifteen children increased sampling of diverse foods through combinations of increased access, social consequences, and directly shaping approach to foods. Expanded food repertoires were observed in each of the four studies in the symposium. Considerations when selecting treatment procedures and implications for future research will be discussed. |
Keyword(s): autism, desensitization, escape extinction, food selectivity |
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Food Selectivity in Children with Autism Spectrum Disorder: a Non-Aversive Treatment Package |
AMY E. TANNER (Monarch House Autism Centre), Bianca E Andreone (Monarch House Autism Centre) |
Abstract: Food selectivity or picky eating is often seen in children with Autism Spectrum Disorder and can lead to severe nutritional deficiencies along with various food refusal behaviours. Food selectivity can be specific to food texture, colour, shape, presentation, type, brand, or container. Often food selectivity is treated using escape extinction, which is considered an aversive procedure. A preference assessment and parent interview determined the child’s food repertoire consisted of 4 different foods in total (beefaroni, fish crackers, dry cereal, and yogurt) and the child was selective by brand and texture. A treatment package involving non-aversive procedures included shaping, systematic desensitization, paired choice, and a 12-step food hierarchy was then implemented. After 9 months of treatment, the child’s food repertoire increased from 4 items to more than 50 items, and the child is readily accepting more than 10 different dinnertime meals. Additionally, food refusal behaviour decreased to rates of 0 during intervention and significantly decreased during meal times at home. The importance of a non-aversive, interdisciplinary approach for treating food selectivity in children with autism spectrum disorder will be highlighted. |
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Yummy Starts: A guide for clinicians and supporting data for a constructional approach to food selectivity |
JOSEPH H. CIHON (University of North Texas), Sara M. Weinkauf (Easter Seals North Texas), Blanca Mendoza (University of North Texas), Nicole Zeug (Positive Behavioral Connections, Inc.), Julia Ferguson (University of North Texas), Shahla Susan Ala'i-Rosales (UNT), Jesus Rosales-Ruiz (University of North Texas) |
Abstract: When confronted with a child exhibiting mealtime difficulties in the form of food selectivity, the clinician has two broad options to her/his approach to treatment: pathological or constructional. The pathological approach leads the clinician’s focus toward the elimination of the problem (i.e., diminishing repertoires) through a variety of means, which typically include escape extinction techniques (Goldiamond, 1974). Alternatively, the constructional approach leads the clinician’s focus toward the direct development of desirable alternatives (i.e., developing repertoires) rather than an indirect side effect of an eliminative procedure (Goldiamond, 1974). Shaping offers a promising alternative to the use of eliminative procedures. Utilizing shaping allows the clinician to directly extend social repertoires within the desired context without developing unwanted distress and discomfort for the child. The present paper presents the clinician with a guide and supporting data in utilizing a constructional approach through the use of shaping when addressing food selectivity in children with autism. |
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Increasing Food Acceptance using Hierarchal Exposure |
CLAIRE E. EGAN (Semiahmoo Behaviour Analysts Inc. ), Leanne Schiedel (St. Cloud University) |
Abstract: The current experiment evaluated the effects of ‘hierarchical exposure’ on the food acceptance of two participants diagnosed with autism spectrum disorder. During baseline, the target food was placed on a spoon and presented to the participant. If the food was refused, the spoon was removed and 1:1 instruction in individualized programming commenced. In the treatment phase, a brief preference assessment was conducted prior to the presentation of a target food. Once a reinforcer was identified, the experimenter presented a verbal contingency for food acceptance (e.g., ‘First banana, then bubbles’). An instruction to respond to a target food was then presented according to a systematic hierarchical sequence. The hierarchy identified 12 food acceptance behaviours, starting with placement of an empty spoon to closed lips, and ending with consumption of a spoonful of the target food. The experimenter moved up one level in the hierarchy following 3 consecutive correct food acceptance behaviours at the target level. A reinforcer was delivered on a Fixed Ratio 1 schedule of reinforcement for food acceptance. Results showed that both participants consumed bites of the target foods following hierarchical exposure. A multiple probe design across foods will be used to further evaluate the effectiveness of this procedure. |
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The effects of the Premack principle and non-removal of the spoon on consumption of previously refused foods |
TYLA M. FREWING (University of British Columbia), Leanne Schiedel (St. Cloud University), Claire E. Egan (Semiahmoo Behaviour Analysts Inc. ) |
Abstract: The effects of the Premack principle and non-removal of the spoon on consumption of previously refused foods was evaluated in two male participants diagnosed with autism spectrum disorder. During treatment, a brief preference assessment was conducted immediately prior to each session to identify a highly preferred food. A small piece or spoonful of the target food was presented immediately in front of the participant’s mouth. Consumption of at least one small bite of the target food resulted in presentation of the highly preferred food. For participant 1, the target food was not removed until it was consumed, or 30s passed. If 30s passed, the high preference food item was removed and the procedure was implemented again after 15-20 minutes. For participant 2, the target food was not removed until it was consumed, or the 2-hour session elapsed. Preliminary data for participant 1 indicate an increasing trend to mastery (100% consumption) in percentage of bites consumed for two target foods. Participant 2 achieved mastery of the target food within experimental sessions. Further, target foods were successfully consumed during generalization probes with parents. The effectiveness of the procedure will be further evaluated for both participants using a multiple-probe design across additional foods. |
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