Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


50th Annual Convention; Philadelphia, PA; 2024

Event Details

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Symposium #323
CE Offered: BACB
Investigations of Simultaneous Presentation During Treatment for Pediatric Feeding Disorders
Sunday, May 26, 2024
4:00 PM–4:50 PM
Convention Center, 100 Level, 113 B
Area: AUT/CBM; Domain: Applied Research
Chair: Delanie Fetzner Platt (Kennedy Krieger Institute )
Discussant: Sean D. Casey (Hartland Feeding)
CE Instructor: Sean D. Casey, Ph.D.

Consequence-based interventions are commonly used in the treatment of pediatric feeding disorders; however, these interventions may be accompanied by an increase in additional challenging behaviors after food enters the mouth. Simultaneous presentation, the presentation of preferred and nonpreferred or target foods together, has been used to increase acceptance, but less is known about the efficacy of other mealtime behaviors like packing. The following presentations will demonstrate how simultaneous presentation may be used to increase acceptance, decrease packing, and affect food preference. The first presentation will describe how simultaneous presentation was used to reduce packing of nonpreferred foods by one child with autism spectrum disorder using a multiple baseline design across foods. The second presentation will review shifts in preferences for preferred and nonpreferred foods before and throughout intervention with simultaneous presentation with two participants using a multiple baseline design across foods. Results demonstrated that simultaneous presentation may reduce packing and increase acceptance of nonpreferred foods. Additionally, acceptance of preferred foods may decrease following intervention, suggesting further research is needed to evaluate preference shifts. Conclusions and future directions regarding simultaneous presentation as a treatment approach will be shared based on the collective outcomes across both presentations.

Instruction Level: Intermediate
Keyword(s): feeding disorders, food refusal, food selectivity, simultaneous presentation
Target Audience:

Graduate students; BCaBAs/BCBAs/BCBA-Ds; practitioners who have experience with or an interest in assessing and treating pediatric feeding disorders

Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) define simultaneous presentation in the context of treating feeding disorders; (2) describe the general procedures used when implementing simultaneous presentation; (3) identify potential advantages and limitations of implementing simultaneous presentation when treating feeding disorders.
Using Simultaneous Presentation to Increase Consumption for a Combined Food
MIA ROSE GOODWIN (Little Leaves Behavioral Services), Lauren Cacciatore (Little Leaves Behavioral Services), Lisa Guerrero (Little Leaves Behavioral Services )
Abstract: Most research on the treatment of feeding problems focuses on consequence-based interventions and the use of extinction-based procedures (Berth et al., 2019). At times, after non-removal of the spoon (i.e., escape extinction) is implemented effectively, other mealtime-related problem behaviors arise, such as packing or expulsion (Sevin et al. 2002). Research investigating interventions to reduce packing is limited relative to the investigation of non-removal of the spoon. Piazza et al. (2002) compared the use of simultaneous and sequential presentation to increase the consumption of non-preferred foods in children with feeding problems. They found that simultaneous presentation increased consumption of the target foods; however, escape extinction was required at times. Similarly, Ahearn (2003) evaluated the use of simultaneous presentation to increase the acceptance of vegetables in a child with autism spectrum disorder. In this study, we implemented a protocol that used simultaneous presentation to reduce packing in one child with autism spectrum disorder. Our results showed that we effectively reduced packing with the use of simultaneous presentation. Additionally, we will describe how the high-preferred food was not faded out in this protocol, as we incorporated all the target foods and the high-preferred food into a mixed food.

Assessment of Preference Shift When Treating Food Selectivity With Simultaneous Presentation Method

SARA STOTT (The University of Kansas; St. Gerard House), Thomas L. Zane (University of Kansas)

In the treatment of food selectivity, simultaneous presentation, the physical pairing of a nonpreferred and preferred food, has been shown to increase acceptance of the nonpreferred food for children with autism spectrum disorder. Although the pairing of the two foods has often increased the acceptance of the nonpreferred foods, there are no research data on the effect of such pairing on the preference of the preferred food. The current study evaluated the preferences of several foods prior to treatment, and then the simultaneous presentation method was implemented for each nonpreferred food within a multiple baseline across foods design with two children with autism spectrum disorder. Preferences for the foods were periodically assessed during the intervention phase. The results showed that acceptance of the nonpreferred foods increased while selection of the previously preferred foods decreased. The current study provides some initial and tentative data to suggest that there may be preference shifts not only for the nonpreferred foods but also for the preferred foods used in this intervention. Future research should explore this phenomenon more completely to ensure that individuals with food restriction do not avoid eating the limited number of foods they may have in their repertoires.




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