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.


43rd Annual Convention; Denver, CO; 2017

Event Details

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Poster Session #61
Saturday, May 27, 2017
12:00 PM–3:00 PM
Convention Center, Exhibit Hall D
Chair: Allison Battaglia (UNMC)
78. An Examination of Food Preferences Before and After Treatment for a Pediatric Feeding Disorder
Area: CBM; Domain: Applied Research
JASON R. ZELENY (University of Nebraska Medical Center's Munroe-Meyer Institute), Cathleen C. Piazza (University of Nebraska Medical Center's Munroe-Meyer Institute), Vivian F Ibanez (University of Nebraska Medical Center's Munroe-Meyer Institute), Jaime Crowley (University of Nebraska Medical Center's Munroe-Meyer Institute), Caitlin A. Kirkwood (University of Nebraska Medical Center's Munroe-Meyer Institute), Valerie M. Volkert (Marcus Autism Center and Emory School of Medicine)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Exposure to noxious stimuli in the context of eating results in avoidance behavior in nonhuman animals (Garcia & Kellog, 1966), which may be the same mechanism by which feeding disorders develop in children. It is unclear, however, whether intervention for the feeding disorder results in changes in preferences for foods as a function of exposure. In the current investigation, we evaluated whether the food preferences of children with feeding disorders changed over the course of intervention. We conducted repeated free-choice preference assessments and measured approach and consume responses to foods for which we either exposed or did not expose the child to during intervention. We also conducted random-choice preference assessments that evaluated whether children who did not make choices during the free-choice preference assessment would consume a randomly selected food or would make choices if the alternative was presentation of a randomly selected food. Approach and consume responses were relatively equivalent for exposure and nonexposure foods during the free- and random-choice preference assessments for the 3 participants, suggesting that preferences for foods did not change due to intervention. We discuss other idiosyncratic patterns of responding within and between the free- and random-choice preference assessments and the implications of the findings.
79. Using a Behavioral Treatment Package to Reduce Tongue Thrust in a Child with Gastrostomy Tube Dependence
Area: CBM; Domain: Applied Research
STEPHANIE MILLER (Clinic 4 Kidz), Meeta R. Patel (Clinic 4 Kidz)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: A pediatric feeding disorder is identified when a child fails to eat or drink sufficient quantity and or variety of foods or liquids to maintain his or her nutritional status. Some children with feeding problems may eat nothing to minimal by mouth. This may be due to medical complications or even skill deficits associated with swallowing. In some of these cases, children may require tube feedings to maintain his/her weight and grow. When these children are tube dependent, they may not be exposed to opportunities to learn the proper oral motor skills needed to eat successfully. A tongue thrust is a type of oral motor deficit in children who have limited experience swallowing. A tongue thrust is where a tongue protrudes out of the mouth during a swallow response, also known as a reverse swallow. A tongue thrust may inhibit children from eating efficiently; therefore, making it more challenging to eliminate tube feedings. The purpose of this study was to use a treatment package including bolus fading, slow spoon removal, chin prompts, escape extinction, and a token economy to decrease tongue thrust in a boy with oral motor deficits. A multiple-probe design was used to evaluate treatment effectiveness. Data showed that in baseline tongue thrust during swallows of pureed/smooth food were high when the child was presented a level spoon without the treatment package. As the bolus of pureed/smooth food was faded in small increments when paired with the treatment package, tongue thrust significantly reduced. By the end of treatment, the child’s tongue thrust had significantly reduced when eating level spoons of pureed/smooth food.
80. Examining Effects of Application-based Token Delivery on Skill Acquisition of Young Children
Area: CBM; Domain: Applied Research
JORDAN DAVID LILL (Munroe-Meyer Institute, University of Nebraska Medical Center), Ray Burke (Apex Regional Program), Corey Miles Cohrs (Apex Regional Program)
Discussant: Gretchen A. Dittrich (Simmons College)

Token economies utilize the contingent delivery of tangible items that are later exchanged for backup reinforcers to either maintain, increase, or decrease behavior (Ayllon & Azrin, 1965; Hackenberg, 2009; Matson & Boisjoli, 2009). Token economies modalities offer a wide-range of both aesthetic and practical options for caregivers and teachers (i.e., sticker chart, poker chips). With the advancement of portable technology and applications, there are even more variations of token delivery. Previous studies suggested that differences token appearance positively impact behavioral change in children with autism (Charlop-Christy & Haymes, 1998; Carnett et al., 2014). However, no study has been published investigating the effect of application-based token delivery and with typically developing children. The purpose of the current experiment is to identify if application-based token economy systems have a greater positive effect on skill acquisition compared to nonapplication-based token economies (i.e., sticker chart). Six native-English-speaking children who could count were recruited from a private school consortium for students with challenging, oppositional, and aggressive behaviors. The children were taught to count to 10 in three languages (Portuguese, French, and German). An alternating-treatments design was implemented to identify the effects of the application-based token economy on skill acquisition compared to the nonapplication-based token economy. Training procedures were based on similar procedures found in Wu & Miller (2012) but modified. Training sessions consisted of 3 trials per number (30 total trials per day). The children were reinforced on a VR 3 schedule during training (May et al., 2016) and an FR 1 schedule for each number uttered in the correct sequence during probes. Acquisition probes were conducted before each training session. Interobserver agreement and procedural integrity were collected during training. Interobserver agreement was also conducted on acquisition probes by native-born speakers.

81. An Empirical Model to Determine the Bolus Size for Children with Inappropriate Mealtime Behavior
Area: CBM; Domain: Service Delivery
AARON D. LESSER (Kennedy Krieger Institute, Johns Hopkins School of Medicine), Carrie S. W. Borrero (Kennedy Krieger Institute), Amy Kate Rosenblum (Kennedy Krieger Institute)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Pediatric food or liquid refusal may be related to safety concerns, skill deficits, or noncompliance. When treatment to increase acceptance of liquids begins, bolus size is an important factor to consider, particularly in cases of skill deficits. Professionals often arbitrarily determine the bolus size based on clinical judgment and direct observation. In some cases, the selected bolus size may negatively affect a child’s success. In this study, we used an alternating treatments design to empirically determine the most appropriate bolus size for four children (range 4-8 yr) of typical development, a diagnosis of DiGeorge syndrome, or autism spectrum disorder. The data informed us of which bolus to initially present to the children and led to a treatment approach to increase acceptance with larger boluses. Latency to acceptance for one child was lowest with a 1/16 oz bolus and data suggested that repeated practice with a smaller bolus was necessary before introducing a larger bolus (i.e., ⅛, ¼). For three other children, latency to acceptance was lowest with a larger bolus suggesting that smaller boluses would result in inefficient mealtimes. These results provide evidence toward using this model to empirically determine bolus size for children that refuse liquids.
82. Effects of Within-Meal Variety on Food Consumption by Preschoolers
Area: CBM; Domain: Applied Research
JONATHAN R. MILLER (University of Colorado Denver / Children's Hospital Colorado), Richard Boles (University of Colorado School of Medicine / Children's Hospital Colorado)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Although rates of childhood obesity have begun to stabilize, continued high prevalence warrants additional investigation into approaches to decrease excessive food consumption as a means to address this issue. Previous laboratory-based research has demonstrated that repeated presentation of a food will result in diminished consumption of that food, but that this decrease can be attenuated by presenting novel food. Current evidence suggests the operative behavioral mechanism for this phenomenon is habituation. In this study, previously collected food diaries for preschoolers were analyzed regarding the manner in which food was presented—i.e., as a single dish or a multiple-component dish—to assess how within-meal variety affected caloric intake in natural settings. Food diaries for 41 preschoolers were assessed across breakfast, lunch, and dinner meals for two to three days from which data on calories consumed were calculated. Results for each meal type indicated that average calorie consumption was higher when presented in the multi-component format and that average calorie consumption was positively correlated with the proportion of meals served in the multiple-component format. These results suggest that a possible way to reduce calorie intake during meals is to capitalize on within-meal habituation by serving food in a single dish format.
83. Prevalence of Extinction Bursts During Treatment of Inappropriate Mealtime Behavior
Area: CBM; Domain: Applied Research
CHRISTOPHER W ENGLER (University of Nebraska Medical Center's Munroe-Meyer Institute), Suzanne M. Milnes (Munroe-Meyer Institute, University of Nebraska Medical Center), Vivian F Ibanez (Munroe-Meyer Institute, University of Nebraska Medical Center), Kate M. Peterson (University of Nebraska Medical Center’s Munroe-Meyer Institute), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Extinction bursts are commonly identified as a side effect of extinction when treating problem behavior (Cooper, Heron, & Heward, 2007). Lerman and Iwata (1995) found that 27 of 113 data sets (24%) in studies that included extinction as treatment for problem behavior displayed an extinction burst. In a subsequent analysis, Lerman, Iwata, and Wallace (1999) found that 39% of 41 data sets in studies that included extinction as treatment for self-injurious behavior found an extinction burst. Even though extinction is a well-established treatment for food refusal (Volkert & Piazza, 2012), no studies to date have examined the prevalence of extinction bursts during the treatment of inappropriate mealtime behavior for children with feeding disorders. The current study evaluated the presence of extinction bursts during treatment of inappropriate mealtime behavior, using the criteria delineated by Lerman and Iwata, with 82 children with food refusal, liquid refusal, or both. Results of 123 data sets (68 and 55 datasets for solid and liquid intake, respectively) indicated the overall prevalence of extinction bursts was 12%. The prevalence for solids and liquids treatment was 13% and 11%, respectively. We discuss the potential reasons for the differences in extinction burst prevalence.
84. A Retrospective Review of Transitioning from Nuk Brush to Spoon for Children With Feeding Disorders
Area: CBM; Domain: Applied Research
JAIME CROWLEY (University of Nebraska Medical Center's Munroe-Meyer Institute), Suzanne M. Milnes (Munroe-Meyer Institute, University of Nebraska Medical Center), Jennifer M. Kozisek (University of Nebraska Medical Center's Munroe-Meyer Institute), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Children with feeding disorders may exhibit behaviors that compete with consumption if the child lacks the oral-motor skills, motivation, or both to swallow. For example, the child might hold food in his or her mouth without swallowing (packing) or spit food out (expulsion). Research shows that using a Nuk brush to deposit bites directly onto the childs tongue may reduce these interfering behaviors and increase mouth clean (i.e., a product measure of swallowing; Gulotta, Piazza, Patel, & Layer, 2005; Wilkins et al., 2014). There are no data, however, to show whether these children transition to a more socially appropriate feeding utensil, such as a spoon. Thus, we conducted a retrospective chart review to evaluate the duration of time in calendar days and the total number of therapy appointments between the introduction of the Nuk procedure and the childs successful transition to the spoon (i.e., 5 consecutive sessions with 80% or better mouth clean) for 5 children who previously received intensive day services for the treatment of a feeding disorder. The mean number of days and therapy appointments before successfully transitioning to an upright spoon was 234 (range, 26-348) and 43 (range,17-67), respectively. We discuss implications, limitations, and avenues for future directions.
85. Comparison of Center and Posterior Tongue Bolus Placements in the Treatment of Packing
Area: CBM; Domain: Applied Research
ALLISON BATTAGLIA (University of Nebraska Medical Center's Munroe-Meyer Institute), Suzanne M. Milnes (Munroe-Meyer Institute, University of Nebraska Medical Center), Vivian F Ibanez (Munroe-Meyer Institute, University of Nebraska Medical Center), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center), Jennifer M. Kozisek (University of Nebraska Medical Center's Munroe-Meyer Institute)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Packing, or holding food in the mouth without swallowing, may result in decreased oral intake and long meal durations (Gulotta, Piazza, Patel, & Layer, 2005). Investigators have found using a flipped spoon (e.g., Volkert, Vaz, Piazza, Frese, & Barnett, 2011) or Nuk brush (e.g., Sharp, Harker, & Jaquess, 2010) to deposit pureed bites directly onto the child’s tongue may result in improved mouth clean (i.e., a product measure of swallowing). However, it remains unclear if placement of the bolus on a certain region of the tongue (e.g., center versus posterior) is more effective. Sharp, Harker, and Jaquess (2010) used a center tongue placement and observed modest increases in mouth clean. Alternatively, Volkert et al. (2011) found clinically significant increases in mouth clean with posterior placement. The purpose of the current study was to compare the effectiveness of using a Nuk brush to place the bolus on the center versus posterior tongue on packing and mouth clean in a 3-year-old girl with a feeding disorder. Results showed increased mouth clean and decreased packing for both center and posterior placements, with a larger increase in mouth clean and decrease in packing with the posterior placement initially.
86. Comparison of Bite Presentation Methods to Decrease Expels in One Child With Food Refusal: A Replication
Area: CBM; Domain: Applied Research
HEATHER FARLING (Marcus Autism Center), Valerie M. Volkert (Marcus Autism Center and Emory School of Medicine), Tanisha Doyle (Marcus Autism Center)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Treatment packages utilizing nonremoval procedures and reinforcement are well-established to treat food refusal, specifically to increase acceptance and decrease inappropriate mealtime behavior (e.g. Volkert, Patel, & Peterson, 2016). However, the emergence of challenging behaviors such as expelling and packing of food can occur after rapid acceptance has been established. Alternative bite presentations such as flipped spoon and Nuk brush deposit have been shown to reduce expelling and increase mouth clean in children who are not successful with an upright spoon presentation (Sharp, Harker, & Jaquess, 2010; Sharp, Odom, & Jaquess, 2012). In the current study, we sought to replicate and extend Sharp et al. (2012) with a 2-year-old boy diagnosed with total food refusal and gastrostomy-tube dependence. We compared level of expels during upright spoon, nuk, and flipped spoon presentations. Results indicated a lower level of expels during nuk presentations. However, due to a suspected carry-over effect, we were able to alternate between upright spoon and nuk presentations across sessions while keeping expels low to eventually transition back to upright spoon exclusively.
87. Demand Fading With and Without Escape Extinction in the Treatment of Pediatric Feeding Disorders
Area: CBM; Domain: Applied Research
JESSICA WOOLSON (University of North Carolina Wilmington ), Melanie H. Bachmeyer (University of North Carolina Wilmington), Jessica Ashley Keane (University of North Carolina Wilmington), Sydney Ball (University of North Carolina Wilmington), Elizabeth Gonzalez (University of North Carolina Wilmington), Lyndsay Fairchild (University of North Carolina Wilmington)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Manipulating placement and/or size of bite presentations may alter the response effort involved in eating and thus the likelihood of inappropriate mealtime behavior exhibited by children diagnosed with feeding disorders (Dolezal, 2006; Kerwin, Ahearn, Eicher, & Burd, 1995; Sharp & Jaquess, 2009). To our knowledge, no studies have systematically compared the effects of demand fading with and without escape extinction to escape extinction in isolation to treat pediatric food refusal. We conducted an assessment to determine the effects of varying bolus sizes and bite placements on the inappropriate mealtime behavior, compliance, and negative vocalizations of two children diagnosed with feeding disorders. Then, we used a combined multielement and reversal design to compare the effects of demand fading along bite placement and/or bolus size with and without escape extinction and escape extinction in isolation. Results showed that escape extinction was necessary; however, escape extinction combined with demand fading was associated with beneficial effects (i.e., more stable compliance and lower rates of inappropriate mealtime behavior and levels of negative vocalizations) for both children. Interobserver agreement was collected during at least 33% of all sessions and was above 80% for both children. Conceptual and clinical implications of these findings will be discussed.
88. The Use of Self-Monitoring Techniques to Increase Physical Activity: A Review of the Literature
Area: CBM; Domain: Applied Research
ANDREW STEVEN MASSEY (St. Cloud State University), Edward Justin Page (St. Cloud State University )
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: The current obesity epidemic and inactive lifestyles of many Americans leads to health problems and in turn millions of dollars in medical bills. One aspect of this problem is the lack of physical activity that people engage in. Self-monitoring techniques has been used in the past to increase physical activity, however to date there is no systematic review of the literature that summarizes the findings of this research. The purpose of this review was to determine how self-monitoring techniques have been applied to increase physical activity across multiple populations; in addition, the type of physical activity, the type of self-monitoring techniques, if the physical activity was maintained, and demographic information of the participants were recorded. An exhaustive review of the literature was completed which identified 12 articles. The results of the literature review indicated that goal setting was among the most popular form of self-monitoring technique used. Also, a majority of the studies used some form of technology in order to record or provide feedback to the participants. Future research should continue to examine the most effective methodologies that produce lasting behavior change in physical activity.
89. Putting Value into Research: Effects of a Brief Values Intervention on Random and Careless Survey Responses
Area: CBM; Domain: Applied Research
MAUREEN FLYNN (Metropolitan State University of Denver), Mitchell K Kusick (Metropolitan State University of Denver), Karley Kamille James (Metropolitan State University of Denver)
Discussant: Gretchen A. Dittrich (Simmons College)
Abstract: Researchers often have participants complete surveys online due to the ease and lower cost of administration. Unfortunately, the rates of careless or random responding can be fairly high (11- 42%) when conducting online surveys (e.g., Meade & Craig, 2012; Flynn, Berkout, & Bordieri, 2016). Brief interventions targeting random/careless responding may help with the integrity of data and/or the removal of fewer subjects. The aim of this study was to examine the affects of a brief values intervention on participants’ responses to attention check items in a long, online survey. Undergraduates were randomly assigned to either the values or control condition. Participants in the values intervention watched a 40-second video before completing an assessment battery. The video showed the researcher and two research assistants introducing themselves and thanking the students for taking the time participate in the study, reading each item carefully, and responding honestly and accurately. Participants in the control filled out the questionnaires only. Results showed that participants in the values condition (n = 273) did not correctly respond to more attention check items than participants in the control condition (n = 308). Implications and future directions will be discussed.



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