Journal of Autism and Developmental Disorders

, Volume 24, Issue 5, pp 619–629 | Cite as

Behavioral medicine treatment of ruminative vomiting and associated weight loss in an adolescent with autism

  • James K. Luiselli
  • JoAnn Medeiros
  • Carol Jasinowski
  • Ann Smith
  • Michael J. Cameron
Article

Abstract

Treated persistent ruminative vomiting of a 15-year-old boy with autism using a multicomponent behavioral medicine program within a residential facility. Preceding intervention the boy had lost 15 pounds associated with high-rate ruminating. The treatment program included a combination of dietary, nutritional, and behavioral procedures that emphasized food restrictions, satiation, and setting condition manipulations. Ruminative vomiting was reduced to near-zero levels and weight gain was achieved following treatment implementation. These therapeutic gains were sustained during a maintenance programming phase and at 1- through 4-month follow-up assessments. Issues related to functional assessment and treatment formulation in behavioral medicine intervention for ruminative vomiting are discussed.

Keywords

Food Restriction Functional Assessment Behavioral Medicine Treatment Formulation Treatment Implementation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ammerman, R. T., Hersen, M., Van Hasselt, V. B., Forster, J., & Simon, J. (1989). Behavioral and psychiatric consultation services for children with visual impairments and multiple disabilities in an educational setting: A program description.Journal of the Multihandicapped Person, 2, 225–240.Google Scholar
  2. Becker, J. V., Turner, S. M., & Sajwaj, T. E. (1978). Multiple effects of the use of lemon juice with a ruminating toddler-age child.Behavior Modification, 2, 267–278.Google Scholar
  3. Danford, D. E., & Huber, A. M. (1981). Eating dysfunctions in an institutionalized population.Appetite: Journal for Intake Research, 2, 281–292.Google Scholar
  4. Foxx, R. M., Snyder, N. S., & Schroeder, F. (1979). A food satiation and oral hygiene punishment program to suppress chronic rumination by retarded persons.Journal of Autism and Develomental DIsorders, 9, 399–412.Google Scholar
  5. Hersen, M., & Barlow, D. H. (1984).Single-case experimental designs: Strategies for studying behavior change. New York: Pergamon.Google Scholar
  6. Kanner, L. (1957).Child psychiatry. Springfield, IL: Charles C Thomas.Google Scholar
  7. Luiselli, J. K. (Ed.). (1989).Behavioral medicine and developmental disabilities. New York: Springer Verlag.Google Scholar
  8. Luiselli, J. K., Haley, S., & Smith, A. (1993). Evaluation of a behavioral medicine consultative treatment for chronic, ruminative vomiting.Journal of Behavior Therapy & Experimental Psychiatry, 24, 27–36.Google Scholar
  9. Luckey, R., Watson, C. M., & Musick, J. K. (1972). Aversive conditioning as a means of inhibiting vomiting and rumination.American Journal of Mental Deficiency, 24, 47–56.Google Scholar
  10. Murray, M. E., Keele, D. K., & McCarver, J. W. (1977). Treatment of ruminations with behavioral techniques: A case report.Behavior Therapy, 8, 999–1003.Google Scholar
  11. O'Neil, P. M., White, J. L., King, C. R., & Carek, D. J. (1979). Controlling childhood rumination through differential reinforcement of other behavior.Behavior Modification, 3, 355–377.Google Scholar
  12. Rast, J., & Johnston, J. (1986). Social versus dietary control of ruminating by mentally retarded persons.American Journal of Mental Deficiency, 90, 464–467.PubMedGoogle Scholar
  13. Rast, J., Johnston, J., & Drum, C. (1984). A parametric analysis of the relationship between food quantity and rumination.Journal of the Experimental Analysis of Behavior, 41, 125–134.Google Scholar
  14. Rast, J., Johnston, J., Ellinger-Allen, J., & Drum, C. (1985). Effects of nutritional and mechanical properties of food on ruminative behavior.Journal of the Experimental Analysis of Behavior, 44, 195–206.PubMedGoogle Scholar
  15. Russo, D. C., & Kedesdy, J. H. (Eds.). (1988).Behavioral medicine with the developmentally disabled. New York: Plenum Press.Google Scholar
  16. Sajwaj, T., Libet, J., & Agras, S. (1974). Lemon juice therapy: The control of life-threatening rumination in a six-month old infant.Journal of Applied Behavior Analysis, 7, 557–563.PubMedGoogle Scholar
  17. Singh, N. N., & Dawson, M. J. (1980).The prevalence of rumination in institutionalized mentally retarded children. Unpublished data, Mangere Hospital and Training School, Auckland, N.Z.Google Scholar
  18. Singh, N. N., Manning, P. J., & Angell, M. J. (1982). Effects of an oral hygiene punishment procedure on chronic rumination and collateral behaviors in monozygous twins.Journal of Applied Behavior Analysis, 15, 309–314.PubMedGoogle Scholar
  19. Sleisenger, J. H., & Fordtran, J. S. (1978). Rumination in adults.Gastrointestinal disease: Vol 1. Pathophysiology, diagnosis, and management. New York: D. W. Saunders.Google Scholar
  20. Sugai, D., & Luiselli, J. K. (1989). Behavioral medicine consultation. In J. K. Luiselli (Ed.),Behavioral medicine and developmental disabilities. New York: Springer-Verlag.Google Scholar
  21. Watkins, J. T. (1972). Treatment of chronic vomiting and extreme emaciation by an aversive stimulus: Case study.Psychological Reports, 31, 803–805.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • James K. Luiselli
    • 2
  • JoAnn Medeiros
    • 1
  • Carol Jasinowski
    • 1
  • Ann Smith
    • 1
  • Michael J. Cameron
    • 1
  1. 1.The Evergreen Center, Inc.USA
  2. 2.Psychological and Educational Resource AssociatesConcord

Personalised recommendations