Association for Behavior Analysis International

Children are diagnosed with a feeding disorder when they do not eat an adequate quantity or variety of foods, sustain an appropriate weight, or grow (Palmer & Horn, 1978; Piazza & Carroll-Hernandez, 2004). Applied behavior analytic interventions have proven effective in the treatment of pediatric feeding disorders (Volkert & Piazza, 2012). Preference for flavors develop in a variety of ways in typical eating individuals (Capaldi, 1996), however, if and how preference occurs for individuals with feeding disorders is less known. The current symposium includes two studies that evaluated preference for nonpreferred foods and examined shifts in preference before, during, and after applied behavior analytic intervention in children with feeding disorders. An additional study used preferred foods during treatment involving a high-probability sequence with and without escape extinction to increase consumption of healthy, nonpreferred foods. The effectiveness of applied behavior analytic interventions to treat feedings problems may be influenced by treatment integrity. The final study examines various components of behavior skills training in isolation and in combination to increase correct implementation of feeding protocols.

Board Certified Behavior Analysts

The high-probability (high-p) instructional sequence is a non-intrusive procedure that involves the presentation of a series of high-p requests followed by 1 low-probability request. To date, only 9 studies have examined its effectiveness to treat food selectivity in children, and results of these studies have been mixed. In the current study, we used a multielement design to compare the effectiveness and efficiency of 2 iterations of the high-p sequence to increase the consumption of healthy food in picky eaters. One iteration of the high-p instructional sequence consisted of the researcher presenting 3 bites of a preferred food on a spoon to the child and the other consisted of the researcher presenting 3 bites of an empty spoon to the child. Preliminary results show that nonremoval of the spoon may be necessary to increase consumption for some children. We will discuss the results within the context of treatment implications, limitations, and suggestions for future research.

Pediatric feeding problems are present in approximately 50% of the general population and 90% of children with autism spectrum disorder. Much research has been conducted to evaluate behavioral interventions aimed at addressing these problems. In research and clinical protocols, it’s reported that trained staff implement the treatments. However, it’s unclear how much of the variability observed in the results of behavioral interventions for feeding is a result of differences in the therapist's ability to implement the treatment reliably. This study evaluated different training packages containing all of or some of the following components: written instructions, verbal instructions, video modeling, rehearsal, feedback, and task clarification. Three groups were evaluated across staff members and two groups were evaluated across caregivers. It is expected that the use of these treatment components will increase protocol adherences across novel staff and caregivers with varying levels of acquisition conditional to the group they are exposed to.