Inappropriate mealtime behavior (IMB) is a type of feeding challenge within the broader class of food refusal. The purpose of this study was to critically analyze the efficacy of interventions for the treatment of IMB through a meta-analysis of research using single-case experimental designs. We examined the extent to which different interventions…

We evaluated the effects of redistribution and swallow facilitation with a flipped spoon on packing in 2 children with a feeding disorder. For both participants, packing decreased when we implemented the flipped spoon treatment package. Mechanisms responsible for behavior change and areas of future research are discussed. (Contains 1 figure.)

The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements…

Studies have evaluated a range of interventions to treat food selectivity in children with autism and related developmental disabilities. The high-probability instructional sequence is one intervention with variable results in this area. We evaluated the effectiveness of a high-probability sequence using 3 presentations of a preferred food on…

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During…

This paper reviews recent studies on behavioral interventions for children with autism and feeding problems. The applicability of interventions that have been tested with other populations of children with feeding problems is discussed, as well as directions for future research.

Little is known about the characteristics of meals that serve as motivating operations (MOs) for escape behavior. In the current investigation, we showed that the distance at which a therapist held a spoon from a child's lips served as an MO for escape behavior. Based on these results, we implemented spoon distance fading, compared fading with and…

We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…

Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food…

Positive- and negative-reinforcement-based procedures typically have targeted acceptance for children with severe food refusal; however, these procedures do not always result in successful swallowing. Once acceptance is achieved, some children expel the food repeatedly or pack (hold or pocket) it in their mouths for extended periods of time. This…

This study examined packing (pocketing or holding accepted food in the mouth) in 3 children who were failing to thrive or had inadequate weight gain due to insufficient caloric intake. The results of an analysis of texture indicated that total grams consumed were higher when lower textured foods were presented than when higher textured foods were…

In this study of a 12-year-old boy with autism, mental retardation, and a history of severe gastrointestinal problems, who refused liquids and food, backward chaining was used to shape drinking from a cup and a fading procedure was used to increase the water he was required to drink. (Author/CR)

A behavioral assessment procedure was evaluated with five children with severe/profound mental retardation who exhibited feeding problems of limited intake. Subjects were fed various types of foods. Results indicated each subject fit into one of four categories: (1) total food refusal, (2) food type selectivity, (3) food texture selectivity, or…

The effects of a common multiple vitamin on the pica of a 9-year-old with severe mental retardation and anemia were evaluated. A BAB design revealed that pica was decreased by the vitamin. Further research investigating the generality of this finding and effects of combining biological and behavioral interventions are discussed. (Contains five…