Treatment outcomes for children with chronic food refusal in a community behavioral health center
Corresponding Author
Rinita L. Roberts
The Harris Center for Mental Health and IDD, Houston, Texas, USA
Correspondence
Rinita L. Roberts, The Harris Center for Mental Health and IDD, 9401 Southwest Freeway, 2nd Floor, Houston, TX 77074, USA.
Email: [email protected]
Search for more papers by this authorGeorgina J. Sakyi
Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
Search for more papers by this authorScott Hickey
The Harris Center for Mental Health and IDD, Houston, Texas, USA
Search for more papers by this authorStacey C. Grebe
Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
Kennedy Krieger Institute, Baltimore, Maryland, USA
Search for more papers by this authorCorresponding Author
Rinita L. Roberts
The Harris Center for Mental Health and IDD, Houston, Texas, USA
Correspondence
Rinita L. Roberts, The Harris Center for Mental Health and IDD, 9401 Southwest Freeway, 2nd Floor, Houston, TX 77074, USA.
Email: [email protected]
Search for more papers by this authorGeorgina J. Sakyi
Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
Search for more papers by this authorScott Hickey
The Harris Center for Mental Health and IDD, Houston, Texas, USA
Search for more papers by this authorStacey C. Grebe
Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
Kennedy Krieger Institute, Baltimore, Maryland, USA
Search for more papers by this authorAbstract
Abnormal patterns of feeding behavior are seen in children with and without developmental disabilities; if not treated early, these patterns may lead to a diagnosis of avoidant/restrictive food intake disorder (ARFID). A multitude of treatments for ARFID varying in theoretical orientation, intensity, and modality exist in the literature. Given the potential for complexity in the clinical presentation of ARFID, intensive interdisciplinary treatment programs are often the preferred intervention choice. However, due to the limited availability of these highly controlled settings, underserved populations are often limited to any outpatient feeding therapy that is available locally. This study focused on examining the outcomes of a behavioral outpatient feeding program in a community behavioral health center. Results show that there were statistically significant treatment outcomes when comparing observable feeding behaviors and caregiver satisfaction measures from admission to discharge. Moreover, these gains were maintained at follow-up supporting the treatment efficacy of such programs.
CONFLICT OF INTEREST STATEMENT
There are no financial interests associated with this research, nor do the authors have any conflicts of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
REFERENCES
- Ahearn, W. H. (2003). Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism. Journal of Applied Behavior Analysis, 36(3), 361–365. https://doi.org/10.1901/jaba.2003.36-361
- Ahearn, W. H., Kerwin, M. E., Eicher, P. S., Shantz, J., & Swearingin, W. (1996). An alternating treatments comparison of two intensive interventions for food refusal. Journal of Applied Behavior Analysis, 29(3), 321–332. https://doi.org/10.1901/jaba.1996.29-321
- American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders ( 5th ed.). APA.
10.1176/appi.books.9780890425596 Google Scholar
- Bachmeyer, M. H. (2009). Treatment of selective and inadequate food intake in children: A review and practical guide. Behavior Analysis in Practice, 2(1), 43–50. https://doi.org/10.1007/BF03391736
- Benestante, J. (2022). Medicaid coverage for ABA begins 2/1/22!. Autism Society of Texas. Retrieved April 13, 2022, from Retrieved from https://www.texasautismsociety.org/medicaid-coverage-for-aba-begins-2-1-22/
- Borrero, C. S. W., Joseph Schlereth, G., Rubio, E. K., & Taylor, T. (2013). A comparison of two physical guidance procedures in the treatment of pediatric food refusal. Behavioral Interventions, 28(4), 261–280. https://doi.org/10.1002/bin.1373
- Budd, K. S., McGraw, T. E., Farbisz, R., Murphy, T. B., Hawkins, D., Heilman, N., & Werle, M. (1992). Psychosocial concomitants of children’s feeding disorders. Journal of Pediatric Psychology, 17(1), 81–94. https://doi.org/10.1093/jpepsy/17.1.81
- Casey, S. D., Cooper-Brown, L. J., Wacker, D. P., & Rankin, B. e. (2006). The use of descriptive analysis to identify and manipulate schedules of reinforcement in the treatment of food refusal. Journal of Behavioral Education, 15(1), 16–28. https://doi.org/10.1007/s10864-005-9001-7
10.1007/s10864-005-9001-7 Google Scholar
- Casey, S. D., Perrin, C. J., Lesser, A. D., Perrin, S. H., Casey, C. L., & Reed, G. K. (2009). Using descriptive assessment in the treatment of bite acceptance and food refusal. Behavior Modification, 33(5), 537–558. https://doi.org/10.1177/0145445509341457
- Clark, R. R., Fischer, A. J., Lehman, E. L., & Bloomfield, B. S. (2019). Developing and implementing a telehealth enhanced interdisciplinary pediatric feeding disorders clinic: A program description and evaluation. Journal of Developmental and Physical Disabilities, 31(2), 171–188. https://doi.org/10.1007/s10882-018-9652-7
- Cooper, L. J., Wacker, D. P., Brown, K., McComas, J. J., Brown, K., Peck, S. M., Drew, J., Frischmeyer, P., & Millard, T. (1995). Use of component analyses to identify active variables in treatment packages for children with feeding disorders. Journal of Applied Behavior Analysis, 28(2), 139–153. https://doi.org/10.1901/jaba.1995.28-139
- Field, D., Garland, M., & Williams, K. (2003). Correlates of specific childhood feeding problems. Journal of Paediatrics and Child Health, 39(4), 299–304. https://doi.org/10.1046/j.1440-1754.2003.00151.x
- Fischer, E., & Silverman, A. (2007). Behavioral conceptualization, assessment, and treatment of pediatric feeding disorders. Seminars in Speech and Language, 28(3), 223–231. https://doi.org/10.1055/s-2007-984728
- Gouge, A. L., & Ekvall, S. W. (1975). Diets of handicapped children: Physical, psychological, and socioeconomic correlations. American Journal of Mental Deficiency, 80, 149–157. https://europepmc.org/article/med/1163560
- Greer, A. J., Gulotta, C. S., Masler, E. A., & Laud, R. B. (2007). Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program. Journal of Pediatric Psychology, 33(6), 1–9. https://doi.org/10.1093/jpepsy/jsm116
- Hoch, T. A., Babbitt, R. L., Ccoe, D. A., Krell, D. M., & Hackbert, L. (1994). Contingency contacting: Combining positive reinforcement and escape extinction procedures to treat persistent food refusal. Behavior Modification, 18(1), 106–128. https://doi.org/10.1177/01454455940181007
- Johnson, C. R., & Babbitt, R. L. (1993). Antecedent manipulation in the treatment of primary solid food refusal. Behavior Modification, 17(4), 510–521. https://doi.org/10.1177/01454455930174006
- Kazdin, A. E. (2000). Perceived barriers to treatment participation and treatment acceptability among antisocial children and their families. Journal of Child and Family Studies, 9(2), 157–174. https://doi.org/10.1023/A:1009414904228
10.1023/A:1009414904228 Google Scholar
- Kerwin, M. E., Ahearn, W. H., Eicher, P. S., & Burd, D. M. (1995). The costs of eating: A behavioral economic analysis of food refusal. Journal of Applied Behavior Analysis, 28(3), 245–260. https://doi.org/10.1901/jaba.1995.28-245
- Kulas, J. T., Roji, R. G. P. P., & Smith, A. M. (2021). IBM SPSS essentials: Managing and analyzing social Sciences data. John Wiley and Sons.
10.1002/9781119417453 Google Scholar
- Kurz, S., Van Dyck, Z., Dremmel, D., Munsch, S., & Hilbert, A. (2015). Early-onset restrictive eating disturbances in primary school boys and girls. European Child and Adolescent Psychiatry, 24(7), 779–785. https://doi.org/10.1007/s00787-014-0622-z
- Kuschner, E. S., Eisenberg, I. W., Orionzi, B., Simmons, W. K., Kenworthy, L., Martin, A., & Wallace, G. L. (2015). A preliminary study of self-reported food selectivity in adolescents and young adults with autism spectrum disorder. Research in Autism Spectrum Disorders, 15–16, 53–59. https://doi.org/10.1016/j.rasd.2015.04.005L
- Laud, R. B., Girolami, P. A., Boscoe, J. H., & Gulotta, C. S. (2009). Treatment outcomes for severe feeding problems in children with autism spectrum disorder. Behavior Modification, 33(5), 520–536. https://doi.org/10.1177/0145445509346729
- Linscheid, T. R. (2006). Behavioral treatments for pediatric feeding disorders. Behavior Modification, 30(1), 6–23. https://doi.org/10.1177/0145445505282165
- Luiselli, J. L. (2000). Cueing, demand fading, and positive reinforcement to establish self-feeding and oral consumption in a child with chronic food refusal. Behavior Modification, 24(3), 348–358. https://doi.org/10.1177/0145445500243003
- Lukens, C. T., & Silverman, A. H. (2014). Systematic review of psychological interventions for pediatric feeding problems. Journal of Pediatric Psychology, 39(8), 903–917. https://doi.org/10.1093/jpepsy/jsu040
- Lyon, A. R., & Budd, K. S. (2010). A community mental health implementation of parent–child interaction therapy (PCIT). Journal of Child and Family Studies, 19(5), 654–668. https://doi.org/10.1007/s10826-010-9353-z
- Olson, C. L. (1974). Comparative robustness of six tests in multivariate analysis of variance. Journal of the American Statistical Association, 69(348), 894–907. https://doi.org/10.1080/01621459.1974.10480224
- Piazza, C. C., Ibañez, V. F., Kirkwood, C. A., Crowley, J. G., & Haney, S. D. (2020). Pediatric feeding disorders. In Functional analysis in clinical treatment (pp. 151–175). Academic Press.
10.1016/B978-0-12-805469-7.00007-3 Google Scholar
- Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. M., & Layer, S. A. (2003). On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behavior Analysis, 36(3), 309–324. https://doi.org/10.1901/jaba.2003.36-309
- Piazza, C. C., Patel, M. R., Santana, C. M., Goh, H.-L., Delia, M. D., & Lancaster, B. M. (2002). An evaluation of simultaneous and sequential presentation of preferred and nonpreferred food to treat food selectivity. Journal of Applied Behavior Analysis, 35(3), 259–270. https://doi.org/10.1901/jaba.2002.35-259
- Rancaño, K. M., Bandini, L. G., Curtin, C., Eliasziw, M., Odoms-Young, A., & Must, A. (2021). Gender and racial/ethnic differences in food selectivity in children with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 34(6), 1511–1520. https://doi.org/10.1111/jar.12895
- Reed, G. K., Piazza, C. C., Patel, M. R., Layer, S. A., Bachmeyer, M. H., Bethke, S. D., & Gutshall, K. A. (2004). On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behavior Analysis, 37(1), 27–42. https://doi.org/10.1901/jaba.2004.37-27
- Rosenbrock, G. J., Jellinek, E. R., Truong, D. M., McKee, S. L., Stewart, C. M., & Mire, S. S. (2021). Treatment acceptability in parent-mediated interventions: Considerations for maximizing outcomes for children with autism. Practice Innovations, 6(4), 236–250. https://doi.org/10.1037/pri0000157
10.1037/pri0000157 Google Scholar
- Rubio, E. K., Borrero, C. S. W., & Taylor, T. (2015). Use of a side deposit to increase consumption in children with food refusal. Behavioral Interventions, 30(3), 231–246. https://doi.org/10.1002/bin.1404
- Rubio, E. K., McMahon, M. X. H., & Volkert, V. M. (2021). A systematic review of physical guidance procedures as an open-mouth prompt to increase acceptance for children with pediatric feeding disorders. Journal of Applied Behavior Analysis, 54(1), 144–167. https://doi.org/10.1002/jaba.782
- Saini, V., Kadey, H. J., Paszek, K. J., & Roane, H. S. (2019). A systematic review of functional analysis in pediatric feeding disorders. Journal of Applied Behavior Analysis, 52(4), 1161–1175. https://doi.org/10.1002/jaba.637
- Schreck, K. A., Williams, K., & Smith, A. F. (2004). A comparison of eating behaviors between children with and without autism. Journal of Autism and Developmental Disorders, 34(4), 433–438. https://doi.org/10.1023/B:JADD.0000037419.78531.86
- Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric feeding disorders: A quantitative synthesis of treatment outcomes. Clinical Child and Family Psychology Review, 13(4), 348–365. https://doi.org/10.1007/s10567-010-0079-7
- Sharp, W. G., Jaquess, D. L., Morton, J. F., & Miles, A. G. (2009). Focus on autism and other developmental disabilities. Focus on Autism and Other Developmental Disabilities, 26(1), 37–48. https://doi.org/10.1177/1088357609349245
10.1177/1088357609349245 Google Scholar
- Ura, A. (2023). Hispanics officially make up the biggest share of Texas’ population, new census numbers show. Retrieved from https://www.texastribune.org/2023/06/21/census-texas-hispanic-population-demographics
- Wilder, D. A., Normand, M., & Atwell, J. (2005). Noncontingent reinforcement as treatment for food refusal and associated self-injury. Journal of Applied Behavior Analysis, 38(4), 549–553. https://doi.org/10.1901/jaba.2005.132-04
- Williams, K., & Seiverling, L. (2023). Behavior analytic feeding interventions: Current state of the literature. Behavior Modification, 47(4), 983–1011. https://doi.org/10.1177/01454455221098118
- Woods, J. N., & Borrero, C. S. (2019). Examining extinction bursts in the treatment of pediatric food refusal. Behavioral Interventions, 34(3), 307–322. https://doi.org/10.1002/bin.1672