Association for Behavior Analysis International

Approximately 25-35% of typically developing children and up to 80-90% of children with autism may experience persistent feeding difficulties which require intensive feeding interventions (Sharp et al., 2017). Research on treatments of feeding difficulties has a high focus on consequence-based interventions and the use of extinction-based procedures (Berth et al., 2019). This symposium will focus on recent research on low-intensity and antecedent-based strategies to address feeding problems in children. The first presentation will focus on replicating and extending a choice-based intervention (Crowley et al., 2020) adapted to a lower level of intensity of procedures with the goal of increasing consumption of a variety of foods for individuals displaying resistance to change around feeding behaviors. The second presentation will focus on the use of a mealtime-structure protocol to increase consumption of foods and systematically increase the bite size of foods presented at a time. The third presentation will review the feasibility of measuring child behavior during daily transitions into clinic while receiving behavioral feeding services. Overall, these talks will provide the audience with examples of lower intensive and antecedent-based interventions for treating children with feeding difficulties. Findings and implications will also be discussed for practicing behavior analysts.

Target audience should be practicing BCBAs.

Transitioning between activities is an inevitable part of daily life (i.e., driving to and from work) as well as within structured contexts (i.e., going from your desk to a meeting room; Sterling-Turner & Jordan, 2007). Transitioning between activities is a crucial skill for children to learn as they spend 25% of their time transitioning between activities and places (Schmit et al., 2000; Schmit et al. 2000), and having difficulties with transitions may evoke disruptive behavior (Sainato et al., 1987). Previous studies have found that resistance with transitions occurs when the upcoming component following the transition includes a possibly undesirable or novel event or activity (Jessel et al., 2016). In the current study, we investigated the feasibility of measuring child behavior during daily transitions into clinic while receiving behavioral feeding services. So far, results indicate that our measurement strategy is practical, reliable, and sheds light on how successful transitions impact social validity.

Fisher et al. (2011) describes food selectivity to be a common feature among individuals diagnosed with autism spectrum disorder (ASD). For instance, food selectivity can be observed as rigidity around what foods one eats or the location of mealtime, and sensitivity to textures, amongst other things (Peterson & Ibañez, 2018). To treat individuals with ASD with feeding difficulties, practitioners typically use methods such as escape extinction (Ibañez et al., 2022). Before using escape extinction to treat food selectivity, clinicians should assess whether the conditions call for such an intrusive intervention (Peterson & Ibañez, 2018). Being that the intensity of food selectivity can vary amongst the ASD population, some individuals may respond to less intrusive treatments; however, there is limited research to evaluate this. Ibañez et al. (2022) introduced the idea of mealtime structure manipulations and implemented a procedure where the size of the target food gradually increased as mastery criteria were met during sessions. In this project, we evaluated the addition of mealtime structure as a less intrusive treatment for food selectivity. We used mealtime structure with a child with ASD and food selectivity to investigate if his acceptance of food and volume of food consumed increased. We found that sessions with mealtime structure increased acceptance of bites and volume of food consumed, versus sessions where he was presented with his whole portion of food in a typical format. Additionally, we systematically manipulated the bite size and amount of food presented at a time, until we were able to present the child’s full portion in a typical format. It was concluded that the manipulation of mealtime structure played a significant role in increasing the volume of food consumed during mealtime. Implications for future research and practice will be discussed.