|Treatment of Food Selectivity in Children With an ASD: Clinical Applications in an Educational Setting|
|Tuesday, May 29, 2012|
|9:00 AM–10:20 AM |
|Area: AUT/DDA; Domain: Service Delivery|
|Chair: Rachel N.S. Cavalari (Binghamton University)|
|Discussant: Courtney A. Aponte Pooler (Binghamton University)|
Although feeding problems occur in both typical and clinical populations, the prevalence of food selectivity in children with an autism spectrum disorder (ASD) is elevated compared to their typically developing peers. More specifically, children with an ASD are often described as picky eaters who refuse to eat a variety of foods necessary for sufficient dietary balance. Due to ongoing family concerns about nutritional intake and related health problems, parents are often referred to specialty feeding clinics. While controlled clinical settings ensure high levels of internal validity, there are only a few locations across the country that can provide these interventions with high degrees of expertise. In addition, translating the treatments developed in these specialty clinics to naturalistic settings can be a challenge. This symposium will present and review group-based peer-modeling and individual exposure-based approaches to the treatment of food selectivity in children with an ASD as implemented in an educational setting. Challenges to maintenance and generalization of treatment gains across educational staff, home, and community settings will be presented. Finally, a discussion will be offered outlining the advantages and disadvantages of conducting feeding interventions in specialty clinics versus educational settings.
|Keyword(s): autism, exposure-based intervention, food selectivity, peer modeling|
Peer-Modeling and Exposure-Based Interventions for Food Selectivity in an Educational Setting
|RACHEL N.S. CAVALARI (Binghamton University), Stephanie Lockshin (Institute for Child Development, Binghamton University), Dawn Marie Birk (Institute for Child Development, Binghamton University), Courtney A. Aponte Pooler (Binghamton University)|
Food selectivity, defined as consuming a limited repertoire of foods, can result in significantly deficient nutritional balance (Cermak et al., 2010). Previous research has demonstrated that children with an ASD demonstrate greater food selectivity compared to typically developing children, with texture, taste, presentation, and idiosyncratic behavior anecdotally reported as common reasons for restricted food preferences (Bandini et al., 2010; Shreck & Williams, 2006). The purpose of this presentation is to present and review the application of peer-modeling and exposure-based interventions for food selectivity as implemented with seven children with autism in an educational setting. Emphasis will be placed on the integration of social awareness skills with peer modeling of desirable behavior in the context of group-based food selectivity interventions conducted at regularly scheduled mealtimes during the school day. Results suggest that students with prerequisite social skills might benefit from group feeding interventions to expand existing food repertoires. Discussion will focus on advantages and disadvantages of group-based interventions, with particular attention to peer modeling of escape from non-preferred food item presentation. Finally, recommendations will be offered for determining necessary prerequisite skills for group participation, as well as referral for individual intensive intervention in a one-to-one setting with clinical staff.
Intensive Individualized Feeding Interventions for Increasing Novel Food Tolerance in an Educational Setting
|LAUREN BETH FISHBEIN (Binghamton University), Dawn Marie Birk (Institute for Child Development, Binghamton University), Stephanie Lockshin (Institute for Child Development, Binghamton University)|
Feeding challenges have been reported in about one third of children with developmental disabilities. These challenges can be broken into four different categories: lack of independent eating skills, disruptive behavior, consuming too much or not enough food, and food selectivity by type or texture. Feeding problems are typically examined in a clinical setting; however, given that most meals take place within the home setting, the success of feeding interventions should be evaluated by the extent to which caregivers are able to implement a program consistently and effectively. This component of the symposium will describe one type of food selectivity, specifically food texture selectivity, in two, school-age male children diagnosed with autism. Individualized exposure-based interventions designed to target food texture selectivity were utilized to address restricted food repertoires. Additionally, parent training with practice and feedback was conducted in a one-to-one setting for one participant and his family to increase food acceptance and independent eating skills across home and school settings. Results indicate successful expansion of food texture acceptance with consistent implementation of individualized food selectivity protocols. Considerations and challenges to implementing intensive food selectivity interventions in an educational setting, specifically with regard to training educational staff and parents, will be discussed.
Challenges to the Implementation of Feeding Interventions in Educational Settings: Logistical and Training Issues
|STEPHANIE LOCKSHIN (Institute for Child Development, Binghamton University)|
Children with autism frequently exhibit restricted food repertoires (e.g., preferences based on the visual characteristics, texture, taste, brand, temperature, etc.), inflexibility regarding the order in which foods are consumed, dinnerware and/or utensils used during mealtime, preferred locations and schedules for food consumption, and method of ingesting food (self-feeding or insistence on being fed by others). While severe feeding problems may best be treated in specialty clinics, center-based school programs that provide ABA services can serve as alternative settings within which mild to moderate feeding problems can be addressed. These programs are unique in that they generally have comparatively high staff to child ratios, staff who are trained in ABA methodology (i.e., they specialize in addressing problem behaviors, developing individualized sequential and systematic teaching programs, monitoring of child progress, and engaging in data-driven decisions about programmatic changes). The school setting also provides opportunities to expand feeding repertoires within the context of a social milieu that may facilitate generalization of skills to other social settings (i.e., home and community). This presentation will outline important issues to consider when implementing feeding interventions within the school setting. These will include identification of students, specific targets for intervention, and staff, staff training, and family involvement.