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| Clinical Treatment Evaluations for Food Selectivity and Pill Swallowing in Children |
| Monday, May 28, 2007 |
| 1:30 PM–2:50 PM |
| Douglas A |
| Area: AUT/DDA; Domain: Applied Research |
| Chair: Rachel S. F. Tarbox (Center for Autism and Related Disorders, Inc.) |
| Discussant: William H. Ahearn (New England Center for Children) |
| CE Instructor: Rachel S. F. Tarbox, Ph.D. |
| Abstract: This symposium will present innovations in procedures for treating feeding problems and teaching pill swallowing. The first presentation will present data of efforts to treat food selectivity by texture using antecedent manipulations and reinforcement-based procedures. The second presentation will present data demonstrating that stimulus fading can be used in the absence of escape extinction to teach pill swallowing to children. The third presentation will present data of a component analysis of a treatment package used to treat food selectivity by type. |
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| Treatment of Food Selectivity by Texture in a Young Boy with Autism. |
| ADEL C. NAJDOWSKI (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.), Arthur E. Wilke (Center for Autism and Related Disorders, Inc.), J. Helen Yoo (Center for Autism and Related Disorders, Inc.) |
| Abstract: Thirty-one percent of children diagnosed with autism present with food selectivity by texture (Field, Garland, & Williams, 2003). In combination with escape extinction (EE) and differential reinforcement, stimulus fading procedures have been used to treat food selectivity by texture by gradually changing antecedent stimuli from more refined textures to courser textures (Shore, Babbitt, Willams, Coe, and Snyder, 1988). However, to the current authors’ knowledge, no studies have evaluated whether escape extinction is a necessary component of a treatment package used to treat food selectivity by texture. This study is a clinical treatment evaluation of efforts to treat food selectivity by texture without the use of escape extinction. Methods used to treat food selectivity by texture included texture fading, simultaneous presentation (for chicken only), and differential reinforcement. |
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| A Component Analysis of a Multi-Component Treatment Package for Food Selectivity. |
| BECKY PENROD (University of Nevada, Reno), Michele D. Wallace (University of Nevada, Reno), Mandy J. McClanahan (University of Nevada, Reno), Brooke M. Holland (University of Nevada, Reno), Kara A. Reagon (Utah State University), Alison M. Betz (Utah State University), Thomas S. Higbee (Utah State University) |
| Abstract: Najdowski (2004) evaluated a parent-conducted treatment for food selectivity which consisted of differential reinforcement of alternative behavior combined with escape extinction (i.e., nonremoval of the spoon). Results indicated that this treatment package successfully increased food consumption of non-preferred foods. Although this study contributes to the literature on feeding disorders in a number of ways, it is not possible to determine which treatment component was responsible for behavior change in that treatment components were introduced simultaneously. Specifically, demand fading, changes in the magnitude of reinforcement, and escape extinction were all implemented at the same time. Hence, the purpose of this study was to replicate and extend previous research by conducting a sequential component analysis of the aforementioned treatment components. Results indicated that escape extinction, in the form of a nonremoval of the spoon procedure, was a necessary treatment component for two participants. For one participant, increased food consumption was observed after the magnitude of reinforcement was increased; therefore, escape extinction was not necessary. Results were maintained at a 12-week follow-up. |
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| Behavioral Management of Oral Medication Administration Difficulties. |
| J. HELEN YOO (Center for Autism and Related Disorders, Inc.), Doreen Granpeesheh (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.), Adel C. Najdowski (Center for Autism and Related Disorders, Inc.) |
| Abstract: Approximately 26% of the general population has difficulty swallowing oral medication (Anderson, Zweidorff, Hjelde, & Rodland, 1995). While the exact number is unknown, anecdotal observations indicate that swallowing difficulty is prevalent in children, and even more prevalent among children with autism and developmental disabilities, often leading to treatment noncompliance.
Some children may not have the prerequisite skills for pill swallowing, while others may have developed conditioned anxiety from unpleasant past experiences. In most cases, this is not a critical problem, because alternative preparations such as chewable or liquid medications are readily available. When alternative preparations are not readily available, other simple methods of administering medication, such as pill crushing, opening the capsule and dissolving it in a beverage, or hiding it in food (e.g., apple sauce) are often utilized. However, when oral medications are a part of the treatment for a chronic illness and the medication is not chewable and cannot be dissolved or hidden due to an unpleasant taste or alteration in release mechanisms (e.g., extended release), the importance of pill swallowing skill increases dramatically
In this multiple baseline study, several typically-developing children and children with autism were taught to swallow pills using stimulus fading and positive reinforcement. Participants learned to swallow pills in a relatively short time and parents were successfully trained to implement the procedures. |
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