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| Examination of Variables that Affect the Development of Interventions for Pediatric Feeding Disorders |
| Sunday, May 27, 2007 |
| 3:00 PM–4:20 PM |
| Edward D |
| Area: CBM; Domain: Applied Research |
| Chair: Cathleen C. Piazza (Munroe-Meyer Institute) |
| Discussant: Michael E. Kelley (The Marcus Institute and Emory University) |
| CE Instructor: Michael E. Kelley, Ph.D. |
| Abstract: A pediatric feeding disorder is diagnosed when a child consumes an insufficient volume or variety of foods to grow. In the treatment of these disorders, a number of procedures have been shown to be effective (e.g., escape extinction). However, like other behavior disorders, the emergence and treatment of pediatric feeding disorders are often affected by idiosyncratic variables. This symposium will present data that exemplifies variables that influence the assessment and treatment of feeding disorders. The first investigation involves the application of functional analysis methods to the assessment of inappropriate mealtime behavior. In many cases, different outcomes were obtained depending on who conducted the assessment (i.e., primary caregivers or clinical staff). In the second investigation, a shaping procedure was evaluated to increase food consumption. Results showed that shaping was not effective at increasing oral intake in the absence of a negative reinforcement-based treatment. Study 3 evaluated the extent to which the response effort associated with either self feeding or non-self feeding influenced response allocation across concurrently available treatments. As predicted, response allocation varied according to manipulations in response effort. These studies will be discussed in terms of variables that influence the development of empirically derived treatments for pediatric feeding disorders. |
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| Differential Effects of Staff Conducted Functional Analysis versus Caregiver Functional Analysis. |
| HEATHER KADEY (Munroe-Meyer Institute, University of Nebraska Medical Center), Gregory K. Reed (Howard University), Melanie H. Bachmeyer (University of Iowa), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center), Kristi D. Murphy (Munroe-Meyer Institute, University of Nebraska Medical Center) |
| Abstract: Ringdahl and Sellers (2000) showed that the results of functional analyses of the destructive behavior of children with developmental disabilities identified different functions based on whether caregivers or clinical staff conducted the assessment. The results of Ringdahl and Sellers raises the question of whether (a) functional analyses of inappropriate mealtime behavior also would produce differential results based on whether caregivers or staff conducted the analyses and (b) whether treatments based on the results of the different functional analyses would be effective. The current study sought to address these questions by evaluating the differential effects of caregivers and staff members as therapists during functional analyses of inappropriate mealtime behavior. The results of the study suggested that the outcomes of the two functional analyses were identical for approximately 60% of the participants. However, functional analyses outcomes were different (i.e., identified different functions) for approximately 40% of participants. We then applied treatments that matched the different functions identified during staff and caregiver-conducted analyses and found that the treatment that was matched to the results of the caregiver functional analysis was more effective than the treatment that was matched to the results of the staff-conducted functional analysis. |
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| The Effectiveness of Shaping plus Avoidance as an Alternative to Escape Extinction to Treat Pediatric Feeding Disorders. |
| VALERIE M. VOLKERT (The Marcus Institute), Michael E. Kelley (The Marcus Institute and Emory University), Heather Kadey (Munroe-Meyer Institute, University of Nebraska Medical Center), Kristi D. Murphy (Munroe-Meyer Institute, University of Nebraska Medical Center), Crystal N. Bowen (The Marcus Institute) |
| Abstract: Previous research has shown that negative reinforcement-based procedures (e.g., escape extinction) have been effective in the treatment of a variety of behavior problems displayed by children with feeding disorders (e.g., inappropriate mealtime behavior, expulsion). However, extinction is sometimes associated with negative side effects (e.g., extinction burst; Lerman, Iwata, & Wallace, 1999). Thus, research on alternatives to escape extinction seems warranted. In the current investigation we assessed the effects of a shaping plus avoidance procedure in which we differentially reinforced successive approximations to consuming a bite of food. For example, we initially reinforced licking the presented food, then touching the presented food and so on until swallowing the presented food was the only response that was reinforced. When the shaping procedure was evaluated in a combined reversal and multiple baseline design, results showed that the shaping procedure alone did not produce increases in consumption of food. However, when a negative reinforcement-based procedure was added to the shaping procedure, increases in consumption were observed. Results are discussed in terms of the effects of shaping procedures and other interventions to treat food refusal displayed by children with feeding disorders. |
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| An Examination of a Choice Paradigm to Increase Self-Feeding in Children Diagnosed with Feeding Disorders. |
| KRISTI D. MURPHY (Munroe-Meyer Institute, University of Nebraska Medical Center), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center), Heather Kadey (Munroe-Meyer Institute, University of Nebraska Medical Center), Jeffrey H. Tiger (Munroe-Meyer Institute, University of Nebraska Medical Center) |
| Abstract: Children with feeding disorders display a number of deficits related to eating including a lack of the skills necessary to feed themselves. Previous research has shown that prompting and reinforcement procedures are effective to teach self-feeding skills to children with feeding disorders. However, most procedures utilized in this research involved a physical prompt, which may be counter-therapeutic for some children if escaping self-feeding is reinforcing. The purpose of the current study was to examine an alternative method to increase self feeding in children with feeding disorders by examining the utility of a choice paradigm. Specifically, a choice paradigm was developed to manipulate the effort associated with self feeding versus non-self feeding. Results indicated that the use of a choice paradigm was an effective treatment for increasing self feeding in all participants although the disparity in effort between the two choices that affected a change varied across participants. Interobserver agreement was obtained for over 25% of sessions and averaged over 80%. |
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