Association for Behavior Analysis International

Decades of research demonstrate that some behavior-analtyic procedures are empirically-supported treatments for food refusal exhibited by children diagnosed with feeding disorders. However, studies examining assessment methodologies to determine the most specific, effective, and efficient function-based interventions are lacking in the behavioral feeding literature. Further, studies demonstrating the effectiveness of function-based interventions to specifically treat varied topographies of feeding problems are scarce. This symposium will discuss recent advancements to a function-based approach of treating pediatric feeding problems. Specifically, Sean Casey will discuss the use of descriptive analyses to determine which procedures are necessary for effective treatment. Melanie Bachmeyer will discuss the correspondence of descriptive and functional analyses of inappropriate mealtime behaviors and the outcomes of interventions matched to each. Finally, Kathryn Peterson will discuss the results of a comparison study between behavior-analytic treatment and a wait-list control group with children diagnosed with Autism Spectrum Disorder who exhibit severe food selectivity.

The impact of applied behavior analysis methodologies to address feeding issues has enjoyed unparalleled success (Sharp et al., 2010). However, most of the literature has been demonstrated that treatment is most likely to occur in the medically oriented settings conducted with trained therapists. There are fewer published studies that are occurring in the naturalistic settings (i.e., schools and homes) with parents and school staff being utilized as the therapists during treatment meals (e.g., Gentry & Luiselli, 2008). Descriptive analyses (Mace & Lalli, 1991) offer the clinician the opportunity to see how each care provider responds to the childs bite acceptance and refusal behaviors which can lead to identification of the schedules of care-provider responses to the childs behaviors. This information can then be used to determine what schedule manipulations (i.e., bite acceptance, refusal, or both) to focus for treatment. The usefulness of this information can expedite and maximize treatment success and help to avid the usage of overly complex procedures and avoidance of highly intrusive procedures for some children. Such procedures may be difficult to maintain by feeders who are unlikely to have any training in applied behavior analysis (e.g., parents, school associates). In this study, descriptive analyses were used to identify the naturally occurring responses for bite acceptance and food refusal behaviors for the care-providers of several young children who possessed total food refusal or food selectivity. The results of these assessments and their concomitant treatment procedures are discussed.

Many children with autism spectrum disorder (ASD) have feeding difficulties, namely food selectivity (i.e., consumption of a limited variety of foods by type or texture). Food selectivity inevitably leads to inadequate dietary intake, which is associated with learning and behavior problems. If left untreated, children with food selectivity also may suffer from malnutrition or other health problems (e.g., constipation, Type II diabetes). Currently, treatments for pediatric feeding disorders based on ABA research have the most empirical support (Volkert & Piazza, 2012); however, there are not as many studies demonstrating the effectiveness of ABA in the treatment of food selectivity. Health professionals often recommend that caregivers wait to see if their child?s feeding difficulties resolve over time, independent of treatment, or suggest alternative treatments that do not have empirical support. In the current study, we compared ABA treatment to a wait-list control group. Independent acceptance of foods increased for children who received applied behavior analysis, but not for children in the wait-list control group. We subsequently implemented applied behavior analysis treatment with the children from the wait-list control and observed a similar increase in independent acceptance across all foods.