Skip to main content
Log in

Functional Assessment and Behavioural Intervention for Eating Difficulties in Children with Autism: A study Conducted in the Natural Environment Using Parents and ABA Tutors as Therapists

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Two functional assessments (interview and direct observation) were used with three children with autism to identify the functions maintaining mealtime behaviour including acceptance, mouth clean, refusal, and other disruptive behaviours such as crying and pushing the spoon. Based on results of the functional assessments it was hypothesized that appropriate and disruptive mealtime behaviour was maintained by different contingencies. A non-concurrent multiple baseline design across participants was utilized to validate the effectiveness of the intervention. Intervention for all participants included presentation of food on a spoon for 30 s unless acceptance occurred. Acceptance resulted in putative reinforcement. The meal ended after 20 presentations. For all participants, acceptance and mouth cleans increased while disruptive behaviour decreased, and effects were maintained at follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Ahearn, W. H. (2003). Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism. Journal of Applied Behaviour Analysis, 36, 361–365.

    Article  Google Scholar 

  • 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 Behaviour Analysis, 29, 321–332.

    Article  Google Scholar 

  • Barlow, D. H., & Hersen, M. (1984). Single case experimental designs. Strategies for studying behaviour change. New York: Pergamon Press Inc.

    Google Scholar 

  • Brown, J. E., Davis, E., & Flemming, P. L. (1979). Nutritional assessment of children with handicapping conditions. Mental Retardation, 17, 129–132.

    PubMed  Google Scholar 

  • Chatoor, I., & Surles, J. (2004). Eating disorders in mid-childhood. Primary Psychiatry, 11, 34–39.

    Google Scholar 

  • Coe, D. A., Babbit, R. L., Williams, K. E., Hajimihalis, C., Snyder, A. M., Ballard, C., et al. (1997). Use of extinction and reinforcement to increase food consumption and reduce expulsion. Journal of Applied Behaviour Analysis, 30, 581–583.

    Article  Google Scholar 

  • Cooper, L. J., Wacker, D. P., McComas, J. J., Brown, K., Peck, S. M., Richman, D., et al. (1995). Use of component analyses to identify active variables in treatment packages for children with feeding disorders. Journal of Applied Behaviour Analysis, 28, 139–153.

    Article  Google Scholar 

  • Durand, V. M., & Crimmins, D. (1992). The motivational assessment scale. Topeka, KS: Monaco & Associates.

    Google Scholar 

  • Girolami, P. A., & Scotti, J. R. (2001). Use of analog functional analysis in assessing the function of mealtime behaviour problems. Education and Training in Mental Retardation and Developmental Disabilities, 36, 207–223.

    Google Scholar 

  • Gutentag, S., & Hammer, D. (2000). Shaping oral feeding in a gastronomy tube-dependent child in natural settings. Behaviour Modification, 24, 395–410.

    Article  Google Scholar 

  • Hayward, D. W., Gale, C. M., & Eikeseth, S. (2009a). Intensive behavioural intervention for young children with autism: A research-based service model. Research in Autism Spectrum Disorders, 3(3), 571–580.

    Article  Google Scholar 

  • Hayward, D., Eikeseth, S., Gale, C., & Morgan, S. (2009b). Assessing progress during treatment for young children with autism receiving intensive behavioural interventions. Autism, 13, 613–633.

    Article  PubMed  Google Scholar 

  • Howard, R. B., & Cronk, C. (1983). Nutrition and development. In M. D. Levine, W. B. Carey, A. C. Crocker, & R. T. Gross (Eds.), Developmental-behavioural paediatrics (pp. 412–426). Philadelphia: Saunders.

    Google Scholar 

  • Iwata, B. A. (1987). Negative reinforcement in applied behaviour analysis: An emerging technology. Journal of Applied Behaviour Analysis, 20, 361–378.

    Article  Google Scholar 

  • Iwata, B. A., Riordan, M. M., Wohl, M. K., & Finney, J. W. (1982). Pediatric feeding disorders: Behavioural analysis and treatment. In P. J. Accardo (Ed.), Failure to thrive in infancy and early childhood: A multidisciplinary team approach (pp. 297–329). Baltimore: University Park Press.

    Google Scholar 

  • Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional assessment of self-injury. Journal of Applied Behaviour Analysis, 27, 197–209. (Reprinted from Analysis and Intervention in Developmental Disabilities, 2:3–20, 1982).

    Article  Google Scholar 

  • Kahng, S. W., Tarbox, J., & Wilke, A. E. (2001). Use of a multicomponent treatment for food refusal. Journal of Applied Behaviour Analysis, 34, 93–96.

    Article  Google Scholar 

  • Kern, L., & Marder, T. J. (1996). A comparison of simultaneous and delayed reinforcement as treatments for food selectivity. Journal of Applied Behaviour Analysis, 29, 243–246.

    Article  Google Scholar 

  • Lalli, J. S., Vollmer, T. R., Progar, P. R., Wright, C., Borrero, J., Daniel, D., et al. (1999). Competition between positive and negative reinforcement in the treatment of escape behaviour. Journal of Applied Behaviour Analysis, 32, 285–296.

    Article  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism Developmental Disorders, 24, 659–685.

    Article  Google Scholar 

  • Martin, H. P. (1973). Nutrition: Its relationship to children’s physical, mental and emotional development. American Journal of Clinical Nutrition, 16, 766–775.

    Google Scholar 

  • Matson, J. L., & Kuhn, D. E. (2001). Identifying feeding problems in mentally retarded persons: Development and reliability of the screening tool of feeding problems (STEP). Research in Developmental Disabilities, 21, 165–172.

    Article  Google Scholar 

  • Mueller, M. M., Piazza, C. C., Moore, J. W., Kelley, M. E., Bethke, S. A., Pruett, A. E., et al. (2003). Training parents to implement paediatric feeding protocols. Journal of Applied Behaviour Analysis, 36, 545–562.

    Article  Google Scholar 

  • Najdowski, A. C., Wallace, M. D., Doney, J. K., & Ghezzi, P. M. (2003). Parental assessment and treatment of food selectivity in natural settings. Journal of Applied Behaviour Analysis, 36, 383–386.

    Article  Google Scholar 

  • O’Neill, R. E., Horner, R. H., Albin, R. W., Sprague, J. R., Storey, K., & Newton, J. S. (1997). Functional assessment and program development for problem behaviour. A practical hand book (2nd ed.). Brooks/Cole: Pacific Grove.

    Google Scholar 

  • Palmer, S., Thompson, R. J., & Linscheid, T. R. (1975). Applied behaviour analysis in the treatment of childhood feeding problems. Developmental Medicine and Child Neurology, 17, 333–339.

    Article  PubMed  Google Scholar 

  • Patel, M. R., Piazza, C. C., Santana, C. M., & Volkert, V. M. (2002a). An evaluation of food type and texture in the treatment of a feeding problem. Journal of Applied Behaviour Analysis, 35(2), 183–186.

    Article  Google Scholar 

  • Patel, M. R., Piazza, C. C., Martinez, C. J., Volkert, V. M., & Santana, C. M. (2002b). An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal. Journal of Applied Behaviour Analysis, 35, 183–186.

    Article  Google Scholar 

  • Perske, R., Clifton, A., McClean, B. M., & Stein, J. I. (Eds.). (1977). Mealtimes for severely and profoundly handicapped persons: New concepts and attitudes. Baltimore: University Park Press.

    Google Scholar 

  • 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 non preferred food to treat food selectivity. Journal of Applied Behaviour Analysis, 35(3), 259–270.

    Article  Google Scholar 

  • Piazza, C. C., Fisher, W. W., Brown, K. A., Shore, B. A., Patel, M. R., Katz, R. M., et al. (2003a). Functional analysis of inappropriate mealtime behaviours. Journal of Applied Behaviour Analysis, 36, 187–204.

    Article  Google Scholar 

  • Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. S., & Layer, S. A. (2003b). The relative contribution of positive reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behaviour Analysis, 36, 309–324.

    Article  Google Scholar 

  • Polan, H. J., Kaplan, M. D., Kessler, D. B., Shindledecker, R., Newmark, M., Stern, D. N., et al. (1991). Psychopathology in mothers of children with failure to thrive. Infant Mental Health Journal, 12, 55–64.

    Article  Google Scholar 

  • Reed, G. K., Piazza, C. C., Patel, M. R., Layer, S. A., Bachmeyer, M. H., Bethke, S. D., et al. (2004). On the relative contributions of non contingent reinforcement and escape extinction in treatment of food refusal. Journal of Applied Behaviour Analysis, 37, 27–42.

    Article  Google Scholar 

  • Riordan, M. M., Iwata, B. A., Wohl, M. K., & Finney, J. W. (1980). Behavioural treatment of food refusal and selectivity in developmentally disabled children. Applied Research in Mental Retardation, 1, 95–112.

    Article  PubMed  Google Scholar 

  • Riordan, M. M., Iwata, B. A., Finney, J. W., Wohl, M. K., & Stanley, A. E. (1984). Behavioural assessment and treatment of chronic food refusal in handicapped children. Journal of Applied Behaviour Analysis, 17, 327–341.

    Article  Google Scholar 

  • Rogers, B., Stratton, P., Msall, M., & Andres, M. (1994). Long-term morbidity and management strategies of tracheal aspiration in adults with severe developmental disabilities. American Journal on Mental Retardation, 98, 490–498.

    PubMed  Google Scholar 

  • Rosso, P., & Winick, M. (1973). Relation of nutrition to physical and mental development. Paediatric Annals, 1, 33–43.

    Google Scholar 

  • Sisson, K. A., & Van Hasselt, V. B. (1989). Feeding disorders. In J. K. Luiselli (Ed.), Behavioural medicine and developmental disabilities (pp. 45–73). New York: Springer.

    Google Scholar 

  • Sprague, J., Flannery, B., & Szidon, K. (1998). Functional analysis and treatment of mealtime problem behaviour for a person with developmental disabilities. Journal of Behavioural Education, 8, 381–392.

    Article  Google Scholar 

  • Werle, M. A., Murphy, T. B., & Budd, K. S. (1993). Treating chronic food refusal in young children: Home based parent training. Journal of Applied Behaviour Analysis, 26, 421–433.

    Article  Google Scholar 

  • Williams, P. G., Darymple, N., & Neal, J. (2000). Eating habits of children with autism. Paediatric Nursing, 26(3), 259–264.

    Google Scholar 

  • World Health Organization (1993) International Classification of Diseases (ICD-10). Geneva: WHO.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Catherine M. Gale.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gale, C.M., Eikeseth, S. & Rudrud, E. Functional Assessment and Behavioural Intervention for Eating Difficulties in Children with Autism: A study Conducted in the Natural Environment Using Parents and ABA Tutors as Therapists. J Autism Dev Disord 41, 1383–1396 (2011). https://doi.org/10.1007/s10803-010-1167-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-010-1167-8

Keywords

Navigation