Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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47th Annual Convention; Online; 2021

All times listed are Eastern time (GMT-4 at the time of the convention in May).

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Symposium #63
CE Offered: BACB
Research Trends, Practical Considerations, and Future Directions in Pediatric Feeding Disorders
Saturday, May 29, 2021
11:00 AM–11:50 AM
Online
Area: CBM; Domain: Applied Research
Chair: Valdeep Saini (Brock University)
Discussant: Caitlin A. Kirkwood (Center for Pediatric Behavioral Health)
CE Instructor: Caitlin A. Kirkwood, Ph.D.
Abstract:

Pediatric feeding disorders (also termed avoidant/restrictive food intake disorders) are characterized by food refusal or extreme food selectivity by type, texture, brand, shape, or color. Some children develop feeding problems due to a medical condition such as reflux or a severe illness. Some have poor oral motor skills and have difficulty chewing and swallowing, which impacts their diet. This symposium will explore issues related to the assessment and treatment of feeding disorders and provide overviews of recent advances in the area of behavioral interventions for children who engage in food refusal, food selectivity, or inappropriate mealtime behavior. Topics such as treating liquid expulsion, interpreting functional assessment results, multidisciplinary approaches to feeding tube dependence, and indices of child happiness and unhappiness during treatment will be explored. This symposium will be suitable for researchers and practitioners alike and will be valuable for those new to the area of pediatric feeding disorders as well as experts in the field.

Instruction Level: Basic
Keyword(s): feeding disorders
Target Audience:

Beginner

Learning Objectives: At the conclusion of the presentation, participants will be able to (1) identify the difference between re-presentation and modified chin prompt when treating liquid expulsion; (2) describe reasons for why children become tube dependent; (3) state what ongoing visual inspection is and how it relates to interpreting functional analysis; (4) describe how environmental enrichment affects child happiness during treatment of a feeding disorder.
 

An Evaluation of Environmental Enrichment on Indices of Happiness and Unhappiness During Treatment of Pediatric Feeding Disorders

LAURA E PHIPPS (Munroe-Meyer Institute, University of Nebraska Medical Center), Kathryn M. Peterson (Rutgers University and Children's Specialized Hospital), Cathleen C. Piazza (Rutgers University)
Abstract:

Caregivers may discount the clinical benefits of an effective intervention if it does not appear to lead to positive changes in their child’s affective behavior (Dillon & Carr, 2007). Some researchers suggest that when children appear to enjoy teaching procedures, caregivers may be more likely to seek out the treatment for their child and adhere to implementing the procedures (Green et al., 2005; Kazdin, 1980). Escape extinction, an empirically supported intervention for the treatment of pediatric feeding disorders, is often necessary to improve consumption of healthy, targeted foods for children with feeding disorders. However, extinction may occasionally be associated with undesirable side effects (e.g., bursts, increased emotional responding) (Bachmeyer, 2009; Woods & Borrerro, 2019). In the current study, we evaluated the effects of environmental enrichment (i.e., noncontingent reinforcement) combined with escape and attention extinction procedures on treatment effectiveness and behavioral indices of happiness and unhappiness in the treatment of pediatric feeding disorders. We will discuss these findings and address future directions of the study in terms of intervening on child happiness or unhappiness during treatment.

 

Intensive Multidisciplinary Intervention for Patients With Feeding Tube Dependence: An Electronic Medical Record Review

ADDAM J WAWRZONEK (The Marcus Autism Center and Emory School of Medicine; Michigan State University), William G. Sharp (The Marcus Autism Center), Valerie M. Volkert (Marcus Autism Center and Emory School of Medicine), Rashelle Berry (Marcus Autism Center), Kathryn Holman Stubbs (Marcus Institute), Carla Luevano (Marcus Institute), Courtney McCracken (Marcus Institute), Lawrence Scahill (Marcus Institute)
Abstract:

The extant literature on pediatric feeding disorders indicates intensive, multidisciplinary treatment holds benefits for children with severe feeding difficulties, such as patients relying on enteral nutrition (e.g., gastrostomy tube). The most common methodology documenting outcomes for these programs are Nonrandomized Studies (NRS). Although NRS represents a valuable tool for providing insight to intervention, prior research utilizing NRS included potential bias concerning data abstraction. Additionally, there is a lack of standardization across studies regarding uniformity of outcome measures, and description of patient characteristics and treatment protocols. The purpose of the present study was to examine the clinical presentations, intervention characteristics, and treatment outcomes in a sample of children receiving intensive, multidisciplinary intervention for feeding tube dependence. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria to plan the study, guide data abstraction and structure the study’s methodology. We conducted a retrospective electronic medical review to gather outcome data for patients admitted to an intensive day treatment feeding program. The review included 81 individuals dependent on enteral nutrition. We will describe treatment setting and protocols and outcome measures including demographics, anthropometrics, meal-time behaviors, oral/enteral intake and caregiver satisfaction at admission, discharge and follow-up.

 

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