Association for Behavior Analysis International

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.

Beginner

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.

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.