 Cathleen C. Piazza, Ph.D., is a professor of pediatrics and director of the Pediatric Feeding Disorders Program at the University of Nebraska Medical Center in Omaha. She previously directed similar programs at the Marcus Institute in Atlanta and at the Johns Hopkins University School of Medicine in Baltimore. Dr. Piazza and her colleagues have examined various aspects of feeding behavior and have developed a series of interventions to address one of the most common health problems in children. Her research in this area has been among the most systematic in the field and has firmly established behavioral approaches as preferred methods for assessment and treatment. In her roles as clinical, research, and training director, Dr. Piazza has mentored a large number of interns and fellows who have gone on to make significant contributions to the field. Highly regarded for her general expertise in research methodology, Dr. Piazza is a former editor of the Journal of Applied Behavior Analysis.
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| Abstract: Previous research has demonstrated that escape extinction (EE) is a necessary component of treatment for pediatric feeding disorders in most cases (e.g., Ahearn, Kerwin, Eicher, Shantz, & Swearingin, 1996; Patel, Piazza, Martinez, Volkert, & Santana, 2001; Reed, Piazza, Patel, Layer, Bachmeyer, Bethke, & Gutshall, 2004). Our clinical experience is that EE is not always effective when used alone, which necessitates the use of alternative and/or additional procedures. Although researchers have evaluated the effectiveness of treatment procedures individually, the overall effectiveness of these procedures has not been evaluated on a large scale. In the present paper, we examined 135 data sets from children referred for treatment of a pediatric feeding disorder. We analyzed how often EE-based procedures were effective inincreasing acceptance and mouth clean (a product measure of swallowing) and decreasing inappropriate mealtime behavior. We also analyzed how often it was necessary to use alternative and/or additional procedures when EE was not effective. Weidentified the procedures that were used and evaluated their effectiveness in treating the target behaviors noted above. With Valerie M. Volkert, Rebecca Groff, and Suzanne Milnes |