Children with feeding disorders may pack food when they lack the oral‐motor skills, the motivation, or both to swallow. Presenting bites on the tongue with a Nuk brush, or redistribution, replacing ...packed food on the tongue, are two treatments whose relative efficacy is untested. In the current study, we compared the effects of (a) presenting on an upright spoon, (b) presenting on a Nuk, and (c) redistributing with a Nuk on two product measures of swallowing, which we refer to as 15‐s and 30‐s mouth clean, for three children with feeding disorders. Nuk presentation produced the highest levels of 15‐s mouth clean relative to Nuk redistribution and upright‐spoon presentation across participants. Levels of 30‐s mouth clean were higher during Nuk presentation and Nuk redistribution relative to upright‐spoon presentation for two participants. We discuss the oral‐motor skills and motivational deficits that might account for the findings.
In the current investigation, we compared and evaluated the effects of two intervention procedures, a modified chin prompt and reclined seating, on the liquid expulsion of 2 children with feeding ...disorders. For both participants, expulsion decreased to clinically meaningful levels when we added the modified chin prompt or reclined seating to a treatment package consisting of differential reinforcement of acceptance, nonremoval of the cup, and re‐presentation. We discuss possible mechanisms underlying the effects of the 2 interventions and areas for future research.
Children with feeding disorders exhibit a variety of problem behaviors during meals. One method of treating problem mealtime behavior is to implement interventions sequentially after the problem ...behavior emerges (e.g., Sevin, Gulotta, Sierp, Rosica, & Miller, 2002). Alternatively, interventions could target problem behavior in anticipation of its emergence. In the current study, we implemented nonremoval and re‐presentation of bites either on a spoon or on a Nuk for 12 children with feeding problems. The nonremoval and re‐presentation treatment improved feeding behavior for 8 of 12 children. Of those 8 children, 5 had lower levels of expulsions, and 4 of the 8 children had higher levels of mouth clean with the Nuk than with the spoon. We describe the subsequent clinical course of treatment and present follow‐up data for 7 of the 8 children who responded to the nonremoval and re‐presentation treatment with the spoon or Nuk. The data are discussed in terms of potential reasons why the utensil manipulation improved feeding behavior for some children.
We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that ...EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory integration for both children. The results are discussed in terms of the challenges of evaluating sensory‐integration‐based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important.
Self-drinking is an important skill for children to acquire as they transition from infancy to early childhood; however, the literature is limited (e.g., Collins, Gast, Wolery, Holcombe, & Leatherby,
...1991
; Peterson, Volkert, & Zeleny,
2015
). We manipulated the consequences associated with self-drinking relative to those associated with being fed along the dimension of response effort. Results demonstrated that self-drinking increased when the child could either choose to self-feed one drink or be fed one drink and 5 practice trials with an empty cup.
Objective: The present study was designed to compare response rates on a standard self-report questionnaire that was nominally anonymous to an unmatched count questionnaire that allowed for true ...anonymity in responding. Method: Four hundred and fifty-four college students were asked about several topics, including attitudes towards weight and shape, dieting, and eating disordered behavior using one of two response formats; either a standard questionnaire in true-false format or an unmatched count questionnaire that did not require participants to directly answer sensitive questions. Results: Both males and females had significantly different rates of endorsement between the two methods of assessment on the majority of the eating-related questions. Conclusion: Response format and degree of anonymity affect endorsement of eating-related thoughts and behaviors. Understanding response bias is critical to determining accurate rates of eating disordered thoughts and behaviors.
Increased demand for applied behavior analysis (ABA) services has increased the need for additional masters-level practitioners and doctoral-level academicians and clinical directors. Based on these ...needs, the University of Nebraska Medical Center’s (UNMC) Munroe-Meyer Institute has developed a PhD program. The academic structure at UNMC allowed us to create our PhD program in a relatively quick and efficient manner. Our PhD program has many unique features, including (a) close integration of didactic instruction with clinical and research training provided by leading experts in ABA in which students immediately apply concepts introduced in the classroom during coordinated clinical and research practica; (b) structured grant writing training in which students learn to write and submit an NIH-level grant; (c) financial support in the form of a stipend of $23,400 per year, free health benefits, and a full-tuition waiver for up to 12 credits per semester for UNMC courses (a benefits package worth approximately $50,000 per year for an out-of-state student); and (d) encouragement and financial support to present papers at local, regional, and national behavior analysis conferences.
The purpose of the current study was to extend and replicate the procedures used by Gentry and Luiselli (2008) and evaluate whether their parent-implemented treatment package was effective in ...increasing food acceptance in children with an autism spectrum disorder. Additionally, this study evaluated whether food acceptance generalized to foods and mealtimes not targeted during intervention. A secondary purpose of the current study was to evaluate the impact of the same treatment package on each child’s inappropriate mealtime behavior. Parents conducted all sessions in a naturalistic setting (i.e., the home) and parent training took place via a consultative model. The primary investigator evaluated food acceptance using a changing criterion with a partial reversal design and evaluated inappropriate mealtime behavior using a non-concurrent multiple baseline across project completers design. Five parent-child dyads were enrolled in the project. Two parent-child dyads dropped out of the project early in the intervention phase. One child’s participation resulted in initial, systematic increases in acceptance of target foods, followed by a drop to variable and low levels of acceptance following a 9 and 10 bite criterion. Systematic decreases in bite criterion failed to result in recovered acceptance. Two children’s participation resulted in systematic increases in acceptance of target foods during intervention and maintenance phases and decreases in targeted inappropriate mealtime behavior during the maintenance phase. A social validity measure suggested that all parents, including two parent-child dyads that did not complete the project, would recommend this intervention to other parents having the same difficulties. The benefits of this behavioral intervention, implications of the above findings, limitations, and avenues for future research are discussed.
Emphasizing continuum-of-care options and evidence-based best practices, this book examines crisis interventions across diverse treatment settings, including public and private schools, nonacademic ...residential settings and outpatient and home-based programs.
Behavioral treatments are perhaps the cornerstone of modern obesity treatment. Maintenance of weight lost via behavioral treatments has been less than hoped for, however. Weight regain is the result ...of complex interactions between physiological, behavioral, cognitive, and environmental factors; in this paper we review some of these factors and discuss current efforts to improve the long-term outcome of behavioral weight loss treatments
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