Association for Behavior Analysis International

Researchers collect data in a variety of ways when working with children with pediatric feeding disorders, from frequency of the occurrences of problem behavior, to consumption data supported by grams consumed or volume of emesis, i.e., vomiting. While data analysis is one of the foundations of Applied Behavior Analysis, taking a novel approach to the measurement of behavior can provide valuable insights into underlying maintaining and confounding variables, thus providing a novel perspective and analysis of the target behaviors. This symposium focuses on the practical applications of cumulative graphing and the behavioral evaluation of emesis for children with pediatric feeding disorders. By comparing information obtained from across session graphs to cumulative graphs, a variety of variables may be analyzed within session to better inform treatment decisions. In the case study of a participant with emesis, hypotheses about the reason or function of the emesis will be analyzed and discussed. Wherein results indicate that emesis occurred most frequently with novel foods of taste and texture, but abated with exposure.

Emesis (i.e., vomiting) during meal time may result from various factors, including volume sensitivity, structural/anatomical anomalies, and environmental factors related to food novelty and texture. This study focuses on Chase, a 6-year-old boy with spina bifida, during his admission to an intensive feeding program to decrease gastrointestinal-tube dependence and frequency of emesis. Hypotheses about the reason or function of the emesis were developed based upon assessment, observation, and caregiver report. The results of this study indicated that Chase was more likely to have emesis when presented with foods of novel taste and texture. However, with exposure, emesis decreased more quickly for novel puree foods compared to the same food at a higher texture. With exposure, rates of emesis decreased across both type and texture of food. There were no significant differences found for environmental differences with observer reaction to emesis or volume sensitivity. The methods utilized in this study may be useful to practitioners to evaluate the variables maintaining emesis, and warrants further evaluation in future research.

Data are often graphed across multiple sessions to assess change in a target behavior over time. Still, this level of data analysis may not be sensitive enough to detect important information regarding behavior, stimuli, and motivating operations. Across session data analysis may mask changes in rate of responding over the course of time, in the presence of a specific stimulus, and in response to a change in contingencies. Cumulative graphs can identify changes in allocation of behavior, rate of behavior, and motivating operations as well as onset of behavior within a session. This presentation will illustrate the use of cumulative graphs to analyze and inform treatment decisions in interventions for children diagnosed with pediatric feeding disorders, and by comparing information obtained from across session graphs to cumulative graphs. Volume sensitivity, fidelity of parent training, and response effort within a session, as well as other topics, will be analyzed using cumulative graphs.