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| Incorporating Choice During Intervention and Training Within Pediatric Feeding Disorders |
| Sunday, May 26, 2024 |
| 10:00 AM–10:50 AM |
| Convention Center, 100 Level, 114 |
| Area: AUT/DDA; Domain: Applied Research |
| Chair: Laura Quintero (Marcus Autism Center, Emory University School of Medicine
) |
| Discussant: Caitlin A. Kirkwood (Center for Pediatric Behavioral Health) |
| CE Instructor: Laura Quintero, Ph.D. |
| Abstract: In this symposium, presenters will discuss incorporating choice to increase consumption of target foods as well as the impact of choice on treatment integrity when implementing a pediatric feeding protocol. Presenters will begin with an overview of existing literature on choice-based interventions and applicability. Presenters will then transition to discuss the impact of choice-based interventions with various programmed differential reinforcement contingencies and how this impacts food consumption. This study will also discuss how it extends the literature by examining preference for bite sequences and if participants chose a bite sequence beginning with a highly preferred food as opposed to a less preferred food. Outcomes of this will be discussed followed by further implications for choice arrangement and differential reinforcement. Additionally, presenters will discuss how choice affects treatment integrity when therapists choose from components of behavioral skills training to learn protocol implementation versus when training components are assigned. Ultimately, these presentations will address the utility of choice-based strategies across intervention and training as it relates to pediatric feeding disorders. |
| Instruction Level: Intermediate |
| Keyword(s): Choice-based interventions, Feeding Disorder |
| Target Audience: Researchers and clinicians interested in learning more choice-based procedures in the treatment of pediatric feeding disorders and how choice-based procedures impact treatment integrity as it relates to implementation of a feeding protocol. |
| Learning Objectives: (1) Discuss the existing research on the choice-based research and pediatric feeding disorders; (2) Explain how arranging choice and incorporating differential reinforcement impacts food consumption (3) Incorporating choice-based practices with therapists and how this relates to protocol implementation |
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An Evaluation of Choice-Based Interventions Among Children With Feeding Disorders |
| NICOLE PERRINO (University of Florida, Florida Autism Center), Ronald J. Clark (University of Florida), Angie Van Arsdale (University of Florida), Vivian F Ibanez (University of Florida) |
| Abstract: Crowley et al. (2020) used a choice-based intervention to increase consumption of target foods among children with autism and food selectivity. Children chose between the change-resistant food and a target food, when no reinforcement (free choice), positive-reinforcement (preferred edible or toy at the table; asymmetrical choice), or negative-reinforcement (single choice) contingencies were programmed. In the first study, we extended Crowley et al. by adding an asymmetrical choice condition in which children could leave the mealtime area (referred to as mealtime exit). One participant did not require escape extinction and target-food consumption increased regardless of consequences during asymmetrical choice conditions. However, access to leaving the mealtime area produced higher levels of target-food consumption for another participant who required one exposure to escape extinction. To further our understanding of choice-based intervention, we also extended Borrero et al. (2021) in a second study by evaluating child preference for a specific sequence of bites (e.g., least to most preferred) during portion-based meals. Like some of the children in Borrero et al., our participant preferred sequences that began with a highly preferred food. These outcomes have implications for arranging choice and differential reinforcement in specific ways for children with feeding disorders. |
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| The Impact of Choice on Treatment Integrity |
| JULIA JOANNA HOWARD (Rutgers University & Children's Specialized Hospital), Jaime Crowley-Zalaket (Children's Specialized Hospital), Kathryn M. Peterson (Rutgers University, Department of Pediatrics and Children's Specialized Hospital), Emma Auten (Children’s Specialized Hospital—Rutgers University Center for Autism Research, Education, and Services (CSH—RUCARES)), Casey Toutoungi (Caldwell University) |
| Abstract: Behavioral skills training is a multicomponent package consisting of instructions, modeling, rehearsal, and feedback (DiGennaro Reed et al., 2018). Several studies have demonstrated behavioral skills training as an effective procedure for teaching others how to implement interventions for children with feeding disorders (Bachmeyer-Lee et al., 2020). Research has shown that providing choice may increase participation in an activity and may lead to better task performance and outcomes (Kosiewicz et al., 1981; Parsons et al., 1988). The purpose of the current study was to evaluate the impact of therapist choice on treatment integrity when implementing a pediatric feeding protocol. Six participants were randomly assigned to either a choice or no-choice group. Participants in the choice group had the opportunity to learn by selecting one component of behavioral skills training (i.e., modeling, role-play with delayed feedback, or in-vivo feedback). Participants in the no-choice group were randomly assigned to one type of training component (e.g., modeling). Results demonstrated on average, participants in the choice group reached appropriate levels of treatment integrity faster than those in the no-choice group. However, participants in both groups reached and maintained appropriate levels of treatment integrity during post-training. |
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