Feeding Behaviors and Pediatric Disorders

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Questions and Answers

What is a potential future direction for research on pediatric feeding disorders?

Eliminating the need for automated methods

Developing more sophisticated measures of chewing (correct)

Increasing the number of invasive diagnostic tests

Focusing solely on oral aversions

Which chronic medical problem may contribute to feeding disorders according to the research?

Asthma

Bronchopulmonary dysplasia (correct)

Diabetes

Obesity

Why might a child associate feeding items with discomfort?

Because they have never seen a spoon before

From a lack of exposure to different textures

Because they are picky eaters

Due to past experiences with invasive medical procedures (correct)

What aspect of a child's development is emphasized for evaluating feeding disorders?

Anatomical and oral-motor skills Signup and view all the answers

What might oral–motor dysfunction include?

Difficulty in managing oral hygiene Signup and view all the answers

What is the nature of the etiology of feeding disorders?

Complex and multifactorial Signup and view all the answers

What is one key aspect caregivers report regarding chronically hospitalized children?

Oral aversions affecting feeding and related activities Signup and view all the answers

What can potentially help investigators in determining a child's chewing skills?

Automated methods of assessment Signup and view all the answers

What is a unique feature of feeding behavior compared to other behaviors?

Food functions as an appetitive stimulus across species. Signup and view all the answers

Which bird species is mentioned as having a specialized beak for its diet?

Hyacinth macaw Signup and view all the answers

What physiological change can black bears undergo during hibernation?

Suppress their basal metabolic rate. Signup and view all the answers

Professionals in the United States commonly react to a poorly growing child by suggesting what?

The child will eat when hungry. Signup and view all the answers

Why is it important for some organisms to adapt their foraging behaviors?

To maintain consistent caloric acquisition. Signup and view all the answers

What is a characteristic of food motivation in organisms experiencing changes in food availability?

Motivation to feed remains unchanged. Signup and view all the answers

What adaptation do some organisms develop to cope with unpredictable changes in food availability?

Strategies to identify alternative food sources. Signup and view all the answers

What is often cited as a misconception regarding feeding behaviors in poorly growing children?

Hungry children will always eat enough. Signup and view all the answers

What negative impact do feeding disorders have on children besides nutritional deficiencies?

Missed social opportunities Signup and view all the answers

Which statement best reflects the nature of feeding disorders' etiology?

The etiology of feeding disorders is complex and multi-controlled. Signup and view all the answers

How can feeding disorders potentially affect caregivers?

Causing stress and depression Signup and view all the answers

What might occur when one behavior associated with feeding disorders is extinguished?

New behaviors may emerge to take its place. Signup and view all the answers

Which aspect of feeding disorders requires further application of behavior-analytic approaches?

Understanding the precise causes of feeding behaviors Signup and view all the answers

What was observed about the acceptance of target foods during training for feeding disorders?

It increased alongside positive caregiver interactions. Signup and view all the answers

Which is a common misconception about families dealing with feeding disorders?

They experience increased caregiver stress. Signup and view all the answers

What is one potential outcome of inadequate caloric intake due to feeding disorders before age 5?

Negative effects on brain development Signup and view all the answers

Which treatment method involves gradually changing food types to reduce food refusal?

Liquid to baby food fading Signup and view all the answers

What is the focus of empirical support in the treatment of feeding difficulties for young children?

Empirically supported treatments Signup and view all the answers

Which analysis method is cited for addressing inappropriate mealtime behavior?

Functional analysis Signup and view all the answers

Which instructional strategy is mentioned for managing food refusal?

High-probability instructional sequence Signup and view all the answers

What is one intervention used to enhance mouth cleaning in children?

Chin prompt and flipped spoon Signup and view all the answers

What condition is assessed alongside food selectivity in the studies mentioned?

Autism spectrum disorders Signup and view all the answers

What treatment is used to address adipsia in children?

Stimulus fading Signup and view all the answers

Which journal is known for publishing articles on applied behavior analysis related to feeding disorders?

Journal of Applied Behavior Analysis Signup and view all the answers

What treatment was explored for feeding refusal in children?

Spoon-to-cup fading Signup and view all the answers

Which approach was used to reduce packing in children with severe food refusal?

Food redistribution Signup and view all the answers

Which technique was used to treat total liquid refusal?

Backwards chaining and fading Signup and view all the answers

What is a common characteristic of the therapies mentioned in the content?

They are behavior analysis-based interventions. Signup and view all the answers

What is the intent of using escape extinction in treatment?

To manage inappropriate mealtime behavior Signup and view all the answers

Which of the following interventions involves neural network pattern recognition?

Neural network analysis for swallow detection Signup and view all the answers

What key factor is assessed in the behavioral economic analysis of food refusal?

Cost factors associated with eating Signup and view all the answers

Which research design is highlighted for understanding systematic biases in treatment comparisons?

Meta-analysis Signup and view all the answers

What is a key characteristic of feeding disorders that necessitates a refined functional-analysis procedure?

The complexity of feeding environments Signup and view all the answers

Which intervention focuses on using specific antecedent variables to prescribe effective feeding interventions?

Functional analysis assessments Signup and view all the answers

What outcome can be targeted to produce appropriate feeding in children with feeding disorders?

Altering stimuli associated with high acceptance Signup and view all the answers

What does the research suggest about the relationship between escape behavior and feeding interventions?

Escape extinction can improve food acceptance Signup and view all the answers

What type of reinforcement comparison was used to treat food selectivity in children with autism?

Contingent and noncontingent reinforcement Signup and view all the answers

Which of the following methods directly assesses children's mealtime behaviors according to research findings?

Structured observational assessments Signup and view all the answers

Which condition is highlighted as necessary for effective interventions involving feeding disorders?

Identification of escape stimuli Signup and view all the answers

What is a major focus when evaluating food refusal behavior in children?

Environmental factors contributing to refusal Signup and view all the answers

How is acceptance of bites or drinks measured in feeding behavior assessments?

By dividing the number of accepted bites by the number of presented bites. Signup and view all the answers

What factor is controlled for when measuring the acceptance of bites by children?

The presence of the utensil within arm's reach. Signup and view all the answers

What defines expulsion in the context of feeding behavior for liquids?

Liquid that is not swallowed and is pea size or larger. Signup and view all the answers

What is required for a child to be scored for acceptance of a bite?

The child must put the entire bite in their mouth within 8 seconds. Signup and view all the answers

How large is a bite of food presented for acceptance in behavioral assessments?

0.6 x 0.6 x 0.6 centimeters. Signup and view all the answers

In feeding behavior research, what is important to note regarding the duration of utensil presence?

It may significantly vary across different conditions. Signup and view all the answers

What measurement do observers report regarding expulsion during feeding assessments?

Expulsions per bite as a frequency count. Signup and view all the answers

What behavior is evaluated when determining if a child accepted a bite during research studies?

If the child put the entire bite into their mouth. Signup and view all the answers

Which method is utilized to enhance fluid consumption in children with feeding problems?

A fading procedure Signup and view all the answers

What aspect of food textures was systematically evaluated to manage packing issues in children with feeding disorders?

The sensory properties of food textures Signup and view all the answers

In the context of pediatric feeding disorders, what is functional analysis used to assess?

Inappropriate mealtime behaviors Signup and view all the answers

Which of the following is a potential outcome of inadequate caloric intake due to feeding disorders before age 5?

Cognitive delays or impairments Signup and view all the answers

What is a goal of caregiver training in the context of pediatric feeding protocols?

To establish mealtime routines Signup and view all the answers

Which feeding disorder treatment method involves teaching self-feeding skills to patients?

Self-feeding skill acquisition Signup and view all the answers

What was one of the findings of research on the acceptance of target foods during training for feeding disorders?

Gradual increase in acceptance over time Signup and view all the answers

What is the primary focus of interventions explored to manage food refusal in children?

Utilization of escape extinction Signup and view all the answers

What method did Volkert and Piazza use to increase self-drinking from a cup in children with feeding disorders?

Differential reinforcement of alternative behavior Signup and view all the answers

How many studies did Volkert and Piazza identify that met the inclusion criteria for their research on pediatric feeding disorders?

74 studies Signup and view all the answers

What type of reinforcement did researchers find to be well-established for interventions related to self-feeding?

Differential reinforcement of alternative behavior Signup and view all the answers

What role did immediate or delayed reinforcement play in the discussed interventions?

They were used to reinforce appropriate feeding behavior Signup and view all the answers

What was identified as a key assessment method before each session in the studies conducted by Peterson, Volkert, and Zeleny?

Multiple-stimulus-without-replacement assessment Signup and view all the answers

In the context of pediatric feeding disorders, what is the purpose of using systematic preference assessments?

To identify preferred stimuli for reinforcement Signup and view all the answers

What was a consequence of using differential reinforcement in the studies mentioned?

Increase in the amount of liquid in the cup Signup and view all the answers

Which intervention aimed to help children with feeding disorders through physical guidance?

Positive reinforcement of appropriate feeding behavior Signup and view all the answers

What is one technique used to increase food acceptance among individuals with feeding difficulties?

Gradually blending nonpreferred foods into preferred foods Signup and view all the answers

Which combination of instructional techniques was evaluated to treat food selectivity?

High-probability instructional sequence and low-probability demand fading Signup and view all the answers

What method was used to evaluate inappropriate mealtime behavior?

Caregiver-conducted experimental functional analyses Signup and view all the answers

What type of training approach was utilized in the treatment of food selectivity in home settings?

Home-based parent training approach Signup and view all the answers

Which population was specifically involved in a trial of an applied behavior analysis intervention for food selectivity?

Children with autism spectrum disorder Signup and view all the answers

What is a common outcome of inadequate caloric intake due to feeding disorders in early childhood?

Nutritional deficiencies and growth delays Signup and view all the answers

What research design is commonly highlighted for understanding biases in treatment comparisons for feeding disorders?

Randomized controlled trials Signup and view all the answers

What is the primary focus of intervention strategies aimed at addressing feeding disorders?

Enhancing food variety and acceptance Signup and view all the answers

What technique was utilized by Sevin et al. (2002) during redistribution to manage packed food?

Sevin et al. (2002) used a Nuk brush to remove packed food from the participant’s mouth. Signup and view all the answers

What is the goal of using a chaser in feeding interventions, as described by Vaz et al. (2012)?

The goal of using a chaser is to reduce packing by giving the child a liquid or solid that they consistently accepted and swallowed. Signup and view all the answers

How did Volkert et al. (2011) implement redistribution to improve feeding behavior?

Volkert et al. (2011) used a flipped spoon to remove packed food and facilitate better intake. Signup and view all the answers

Explain the process Patel et al. (2001) used to encourage a child’s intake of a calorically dense beverage.

Patel et al. (2001) gradually increased the amount of drink powder in water before replacing the water with milk. Signup and view all the answers

What feeding disorder-related behavior was specifically targeted using a flipped spoon?

The flipped spoon was used to remove packed food from the child’s mouth to improve feeding acceptance. Signup and view all the answers

What was an observed benefit of pureeing food in a blender during texture assessment?

Using a blender increased levels of mouth clean compared to other textures. Signup and view all the answers

What is the purpose of applying gentle upward pressure on a child’s chin during a modified chin prompt?

The purpose is to assist in triggering the child’s jaw to relax for better intake of liquids. Signup and view all the answers

Describe the outcome of using redistribution techniques as shared in the article.

Redistribution techniques successfully increased mouth clean and decreased packing in children. Signup and view all the answers

What method was used by researchers to encourage children to accept food or liquids?

Manipulating antecedents, such as presenting high-probability instructions, was used. Signup and view all the answers

How did Ahearn (2003) attempt to increase vegetable consumption in children?

Ahearn added condiments to vegetables to make them more appealing. Signup and view all the answers

What was the outcome when simultaneous presentation of preferred and non-preferred foods was used?

Acceptance of non-preferred food increased when presented with preferred food. Signup and view all the answers

How might caregivers respond to a child's refusal to eat during meals?

Caregivers may respond by coaxing, providing escape from the meal, or reprimanding the child for their behavior. Signup and view all the answers

What role does differential reinforcement of alternative behavior play in feeding interventions?

It reinforces behaviors that are preferred over inappropriate mealtime behaviors. Signup and view all the answers

What role does an interdisciplinary evaluation play in addressing a child's feeding disorders?

An interdisciplinary evaluation helps determine the necessary medical treatment, dietary modifications, and interventions needed for the child. Signup and view all the answers

What intervention focuses on combining preferred and non-preferred foods during mealtime?

Simultaneous presentation is the intervention that combines these food types. Signup and view all the answers

What consequences may arise from drops in blood sugar levels in children with specific dietary disorders?

Drops in blood sugar levels may lead to seizures, coma, or even death. Signup and view all the answers

How did the researchers clarify the effectiveness of positive reinforcement in feeding disorders?

They compared positive reinforcement with putative escape extinction methods. Signup and view all the answers

What is the importance of assessing a child's oral-motor skills during feeding evaluations?

Assessing oral-motor skills is essential to determine if dysfunction is contributing to feeding disorders and whether the child is a safe feeder. Signup and view all the answers

What did increasing attention and tangible rewards for mouth clean behavior aim to achieve?

It aimed to reinforce the acceptance of food and reduce inappropriate mealtime behaviors. Signup and view all the answers

What ineffective tactic was studied regarding positive reinforcement and inappropriate behavior at mealtimes?

Differential positive reinforcement of mouth clean behavior was found to be ineffective. Signup and view all the answers

In what way do caregivers typically manage inappropriate mealtime behavior?

Caregivers often manage inappropriate behavior by providing escape from bites of food, coaxing, or offering preferred items. Signup and view all the answers

What does a dietitian evaluate for a child with a feeding disorder?

A dietitian evaluates caloric, hydration, and nutritional needs to ensure the child meets their dietary requirements. Signup and view all the answers

What may result from the combination of treatment methods for feeding disorders?

The combination of treatment methods may lead to improvements in the child's feeding behavior and overall nutrition. Signup and view all the answers

What is often a characteristic response from professionals regarding children who are poorly growing?

Professionals typically suggest a thorough evaluation of the child's feeding habits and nutritional intake. Signup and view all the answers

How do parental perspectives influence the management of feeding difficulties in medically compromised children?

Parental perspectives provide insights into the emotional and practical challenges faced during feeding, guiding therapy decisions. Signup and view all the answers

What role does oral support play in improving sucking efficiency for preterm infants?

Oral support enhances sucking efficiency by providing necessary physical assistance, improving feeding outcomes. Signup and view all the answers

What is one primary objective of multicomponent procedures in treating food consumption issues?

The primary objective is to increase food consumption by addressing specific behavioral and sensory factors. Signup and view all the answers

How might tool use in hyacinth macaws relate to understanding feeding behaviors?

Tool use in hyacinth macaws may indicate cognitive abilities that influence their foraging strategies and food access. Signup and view all the answers

In what way can pediatric food refusal be descriptively analyzed?

Pediatric food refusal can be analyzed by identifying patterns in acceptance and rejection of different food types. Signup and view all the answers

What is the significance of exploring taste acceptance during interventions for feeding disorders?

Exploring taste acceptance is crucial for developing effective strategies to enhance food acceptance and reduce refuse. Signup and view all the answers

What impact can hibernation have on black bears regarding their feeding behaviors?

Hibernation can alter black bears' metabolism and feeding patterns, necessitating adaptation to food scarcity. Signup and view all the answers

What is the relationship between escape behavior and feeding interventions for children?

Escape behavior often shapes the development of feeding interventions, as caregivers must address this to promote better eating. Signup and view all the answers

What role does caregiver attention play in managing feeding disorders?

Increased positive attention from caregivers can enhance acceptance of target foods and reduce food refusal in children. Signup and view all the answers

How can feeding disorders impact a child's social development?

Feeding disorders can lead to missed social opportunities, such as birthday parties, due to the child's inability or unwillingness to eat. Signup and view all the answers

What challenges do families face due to feeding disorders in children?

Families may experience caregiver stress, depression, and financial burdens due to the complications associated with feeding disorders. Signup and view all the answers

What complexities are involved in the etiology of feeding disorders?

The etiology of feeding disorders is complex and can involve a combination of factors including oral-motor skill deficits and behavioral components. Signup and view all the answers

What is one hypothesis regarding the behavior of children with feeding disorders?

One hypothesis is that feeding disorder behaviors could be part of a chain of escape and avoidance as children respond to their feeding experiences. Signup and view all the answers

What is the focus of behavior-analytic approaches in addressing feeding disorders?

Behavior-analytic approaches aim to systematically analyze and modify the behaviors associated with feeding disorders to improve outcomes. Signup and view all the answers

How has research indicated caregivers can improve food acceptance in children?

Research suggests that specific prompts and increased offerings of target foods from caregivers can enhance food acceptance in children with feeding disorders. Signup and view all the answers

Why is it important to analyze different behaviors in feeding disorders?

Analyzing various behaviors is important to understand the heterogeneous nature of feeding disorders and tailor effective interventions. Signup and view all the answers

Study Notes

Future Research Directions

Research on pediatric feeding disorders should focus on how they impact long-term health, especially in relation to chronic medical conditions
Understanding the influence of sensory processing differences, food aversions, and environmental factors on feeding behavior

Chronic Medical Problems

Chronic gastrointestinal illnesses like gastroesophageal reflux disease (GERD) can contribute to feeding disorders

Associating Feeding with Discomfort

Children may develop aversions to specific textures, tastes, or smells due to past experiences with pain or discomfort associated with eating

Developmental Emphasis

Oral-motor development is crucial for evaluating feeding disorders, as it influences sucking, chewing, and swallowing abilities

Oral-Motor Dysfunction

Oral-motor dysfunction can include difficulties with lip closure, tongue movement, jaw coordination, and overall muscle control within the mouth

Etiology of Feeding Disorders

The etiology of feeding disorders is diverse and complex, involving a combination of biological, environmental, and psychological factors

Caregiver Reports

Caregivers of chronically hospitalized children often report difficulties with their child's feeding, reflecting the potential impact of medical interventions on feeding behaviors

Determining Chewing Skills

Videofluoroscopic swallowing study can help investigators assess a child's chewing skills by visualizing the movement of food through the mouth and throat

Feeding Uniqueness

Feeding behavior is unique because it involves a complex interplay of sensory, motor, and motivational factors, as well as environmental influences

Specialized Beak

Crossbills are birds known for their unique beak structure adapted for efficiently extracting seeds from pinecones

Physiological Changes in Hibernation

Black bears undergo a physiological shift, reducing their metabolic rate and body temperature during hibernation

Reactions to Poor Growth

Professionals in the United States often suggest calorie-dense formulas or supplements to address a poorly growing child's nutritional needs

Adapting Foraging Behaviors

Organisms need to adapt their foraging behaviors to manage unpredictable food availability to ensure survival and proper nutrition

Food Motivation

Organisms experiencing changes in food availability often exhibit increased food motivation to compensate for potential shortages

Adaptations for Food Availability

Some organisms develop adaptations to cope with unpredictable changes in food availability, such as storing food or altering their foraging strategies

Misconceptions Regarding Feeding Behaviors

One misconception about poorly growing children is that they simply lack sufficient food motivation, which is not always the case

Negative Impacts of Feeding Disorders

Beyond nutritional deficiencies, feeding disorders can negatively impact children's social-emotional development, self-esteem, and overall quality of life

Etiology Nature

Feeding disorders' etiology is multifaceted and influenced by various factors acting in a complex interplay, rather than solely arising from a single cause

Caregiver Impact

Feeding disorders can place a heavy emotional and psychological burden on caregivers, impacting their well-being and relationships with their children

Behavior Extinction

Extinguishing a behavior associated with feeding disorders, such as escape behavior (leaving the table), might lead to an increase in other problematic behaviors aimed at avoiding food

Behavior-Analytic Approaches

More research is needed to fully apply behavior-analytic approaches to address feeding disorders in children, especially regarding preventing the emergence of new problem behaviors

Acceptance of Target Foods

Studies have shown that acceptance of target foods during training for feeding disorders increases gradually, demonstrating the importance of sustained intervention

Common Misconception

A common misconception about families dealing with feeding disorders is that they are not willing to work with their children. This is often not true and a lack of knowledge about available resources can contribute to this misunderstanding

Inadequate Caloric Intake

Inadequate caloric intake due to feeding disorders before age 5 can potentially lead to long-term nutritional deficiencies, developmental delays, and health complications

Gradual Food Type Change

Food chaining involves gradually changing food types to reduce food refusal, starting with a highly preferred food and gradually introducing new ones

Treatment Focus

The focus of empirical support in the treatment of feeding difficulties for young children is on increasing acceptance of a variety of foods

Addressing Mealtime Behavior

Functional analysis is cited as a useful method for addressing inappropriate mealtime behavior by identifying underlying contributing factors

Food Refusal Management

Non-food reinforcement is suggested as an instructional strategy for managing food refusal, providing rewards for desired behaviors unrelated to food

Mouth Cleaning Enhancement

Oral-motor exercises are one intervention used to enhance mouth cleaning in children, promoting better oral hygiene and reducing food retention

Condition Assessed Alongside Food Selectivity

Adipsia (lack of thirst) is assessed alongside food selectivity in some studies, exploring its potential impact on overall fluid consumption and hydration

Adipsia Treatment

Fluid loading is used to address adipsia in children by providing them with adequate fluids to prevent dehydration

Applied Behavior Analysis Journal

Journal of Applied Behavior Analysis is known for publishing articles on applied behavior analysis related to feeding disorders

Treatment for Feeding Refusal

Positive reinforcement was explored as a treatment for feeding refusal in children, rewarding desired behaviors related to food consumption

Reducing Packing Behavior

Escape extinction was used to reduce packing (avoiding food) in children with severe food refusal, eliminating the reinforcement of escaping eating situations

Treating Total Liquid Refusal

Contingency management was used to treat total liquid refusal, linking desired behaviors to rewarding outcomes

Therapy Characteristic

The therapies mentioned in the content often involve behaviorally based strategies based on principles of reinforcement and shaping

Escape Extinction Intent

The intent of using escape extinction in treatment is to reduce the reinforcement of behaviors aimed at avoiding food by preventing escape from eating situations

Neural Network Pattern Recognition

Computer vision involves neural network pattern recognition, allowing analysis of visual information related to feeding behaviors

Food Refusal Analysis

Behavioral economic analysis of food refusal assesses the value of food for a child, understanding their preferences and motivations

Research Design for Bias Mitigation

Randomized controlled trials are highlighted for understanding systematic biases in treatment comparisons, allowing for more robust and reliable findings

Defining Acceptance

Acceptance is defined as the child using a utensil or his fingers to put the entire bite of food in his mouth within 8 seconds of presentation.
Observers do not score acceptance if the bite is placed into the mouth during re-presentation.
Observers only register acceptance if the entire bite of food is placed in the mouth.
For the study, the bite presented was one piece of food measuring 0.6 × 0.6 × 0.6 centimeters.
The feeder restricted the operant by only presenting one bite at a time.

Measuring Expulsion

Expulsion is when food or liquid exits the mouth after being presented.
Liquids are defined as a pea-sized piece or larger visible outside the lips after it passes the plane of the lips.
Solids are defined as a pea-sized piece or larger visible outside the lips after the entire bolus of food passes the plane of the lips.
Observers scored the frequency of expulsion and presented the data as expulsions per bite.

Differential Reinforcement

Researchers have used differential reinforcement in several ways for treatment.
This includes:
- Immediate (Patel, Piazza, Martinez, Volkert, & Santana, 2002)
- Delayed (Kern & Marder, 1996; Riordan et al., 1984) reinforcement,
- use of stimuli selected arbitrarily (Kern & Marder, 1996; Casey, Cooper-Brown, Wacker, & Rankin, 2006),
- systematic preference assessments (Buckley, Strunck, & Newchok, 2005),
- tokens that the child could exchange for meal discontinuation (Kahng, Boscoe, & Byrne, 2003).
Peterson, Volkert, and Zeleny (2015) used differential reinforcement for two children with a feeding disorder to increase self-drinking from a cup.
The researchers conducted a multiple-stimulus-without-replacement assessment before each session and used the three most preferred stimuli as reinforcement for self-drinking.
The researchers increased the amount of liquid in the cup after the child’s self-drinking with the smaller amount increased with differential reinforcement.
Sehgal, Prakash, Gupta, Mohan, & Anand (1990) used simultaneous presentation of different vegetable options for a child with autism.
Stark et al. (1994) used differential reinforcement to increase vegetable consumption in a mildly selective child with autism.

Analyzing Factors

The complexity of feeding disorders necessitates refining functional analysis procedures.
This is to properly analyze the characteristics of the feeding environment and identify what stimuli are acting as reinforcement such as escape.
Studies on fading suggest that the properties of stimuli can be manipulated.
This involves altering the properties of stimuli associated with high levels of acceptance and low levels of inappropriate mealtime behavior to produce appropriate feeding.
Researchers need to determine antecedent variables a priori.
Most children display some forms of appropriate behavior.
Researchers need to identify these behaviors and use this information to prescribe an effective feeding intervention.

Additional Notes

Behavior analysts have evaluated procedures to reduce expulsion and packing.
Ahearn, Kerwin, Eicher, Shantz, & Swearingin (1996) used two intensive interventions for food refusal:
- an escape contingency
- a token economy.
Kahng, Tarbox, & Wilke (2001) implemented a token economy to increase food acceptance.
Munk & Repp's (1994) work focused on the behavioral assessment of feeding problems in individuals with severe disabilities.
Najdowski, Wallace, Doney, and Ghezzi (2003) conducted parent assessments and treatments for food selectivity in natural settings.
Najdowski et al. (2008) used a caregiver-conducted experimental functional analysis to target inappropriate mealtime behavior.
Najdowski et al. (2010) focused on a home-based parent training approach to treat food selectivity.
Palmer & Horn (1978) researched feeding problems in children.
Pangborn, Borrero, & Borrero (2013) focused on training caregivers to implement pediatric feeding protocols.
Patel, Piazza, Kelley, Ochsner, & Santana (2001) experimented with a fading procedure to increase fluid consumption in children with feeding problems.
Patel, Piazza, Layer, Coleman, & Swartzwelder (2005) evaluated food textures to decrease packing and increase oral intake in children with pediatric feeding disorders.
Patel, Piazza, Martinez, Volkert, & Santana (2002) focused on increasing acceptance for bites/drinks.
Peck, Richman, et al. (1995) focused on increasing the variety of foods consumed by blending nonpreferred foods into preferred foods.
Penrod, Gardella, & Fernand (2012) investigated a progressive high-probability instructional sequence along with low-probability demand fading to treat food selectivity.
Peterson, Piazza, Ibañez, & Fisher (2019) conducted a randomized controlled trial to assess the efficacy of an applied behavior analysis intervention for food selectivity in children with autism spectrum disorder.
Peterson, Piazza, & Volkert (2016) compared a modified sequential oral sensory approach to an applied behavior analytic approach in treating food selectivity in children with autism spectrum disorders.
Peterson, Volkert, & Zeleny (2015) examined strategies to improve self-drinking for children with feeding disorders.
Piazza, Anderson, & Fisher (1993) researched teaching self-feeding skills to patients with Rett syndrome.
Piazza & Carroll-Hernandez (2004) provided information about the assessment and treatment of pediatric feeding disorders.
Piazza, Fisher, Brown, Shore, Patel, Katz, et al. (2003) focused on the functional analysis of inappropriate mealtime behaviors.
Piazza, Patel, Gulotta, Sevin, & Layer (2003) examined factors contributing to the treatment of pediatric feeding disorders.

Behavior-Analytic Approach to Feeding Disorders

Oral-motor dysfunction in children may contribute to eating disorders.
Speech or occupational therapists can identify and evaluate oral-motor dysfunction.
Caregivers often provide immediate attention, removal of the spoon, or preferred items when children refuse food, shaping their behaviors.
Differential Reinforcement of Alternative Behavior (DRA) is a proven intervention for decreasing food refusal and increasing acceptance.
High-probability instructions followed by desired behavior can increase acceptance.
Simultaneous presentation of desired food and non-preferred food can help increase consumption.
Escape extinction can reduce inappropriate eating behaviors and increase acceptance.
Redistribution is used to reduce packing by removing food from the mouth and encouraging chewing.
Chasers help reduce packing by offering an immediately accepted food or liquid after the target food.
Fading is a technique to gradually increase acceptance of target foods.
Feeding disorders can impact a child’s physical, mental, and social development, leading to medical complications.
Impact of feeding disorders can be significant on families, causing stress, depression, and financial burdens.
The etiology (causation) of feeding disorders is complex with several possible reasons including:
- Learned behaviors (escape and avoidance)
- Oral-motor skill deficits
- A combination of factors

Impact on Development and Families

Children with feeding disorders are at risk for medical complications as insufficient calorie intake and poor nutrition can be dangerous before age 5 during rapid brain development.
Feeding disorders can isolate children socially, hindering participation in events.
Families of children with feeding disorders can experience caregiver stress, depression, and high financial costs.

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Description

Explore the unique behaviors associated with feeding across species and understand the complexities of pediatric feeding disorders. This quiz delves into how organisms adapt their feeding mechanisms and the multifactorial influences on feeding difficulties in children. It highlights the impact of oral-motor dysfunction and environmental factors.