Abstract
This study compared a behavioral feeding intervention with and without pre-meal sensory integration therapy (SIT) in two boys with autism spectrum disorder and severe food selectivity. For both participants, child bite and drink consumption and total intake increased to similar levels with corresponding decreases in inappropriate mealtime behavior (IMB) in both conditions. The SIT condition was then discontinued and both participants continued to exhibit high levels of bite and drink consumption with corresponding low levels of IMB during a non-SIT phase. Caregivers of both participants were then trained in the behavioral feeding intervention. Follow-up data were collected for one participant for two months following intervention and showed maintenance of treatment gains over time. Limitations of the current study and directions for future research comparing the effects of behavioral feeding interventions with and without SIT are discussed.
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References
Addison, L. R., Piazza, C. C., Patel, M. R., Bachmeyer, M. H., Rivas, K. M., Milnes, S. M., & Oddo, J. (2012). A comparison of sensory integrative and behavioral therapies as treatment of pediatric feeding disorders. Journal of Applied Behavior Analysis, 45, 455–471.
Case-Smith, J., & Humphry, R. (2005). Feeding intervention. In J. Case-Smith (Ed.), Occupational therapy for children (pp. 481–520). St. Louis, MO: Mosby.
Curtin, C., Hubbard, K., Anderson, S. E., Mick, E., Must, A., & Bandini, L. G. (2015). Food selectivity, mealtime behavior problems, spousal stress, and family food choices in children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 3308–3315.
Dunn, W. (2014). Sensory Profile™ 2. San Antonio, TX: Pearson.
Fisher, W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491–498.
Kerzner, B., Milano, K., MacLean, W. C., Berall, G., Stuart, S., & Chatoor, I. (2015). A practical approach to classifying and managing feeding difficulties. Pediatrics, 135, 344–353.
Kimball, J. G., Lynch, K. M., Stewart, K. C., Williams, N. E., Thomas, M. A., & Atwood, K. D. (2007). Using salivary cortisol to measure the effects of a Wilbarger protocol-based procedure on sympathetic arousal: A pilot study. American Journal of Occupational Therapy, 61, 406–413.
Lydon, H., Healy, O., & Grey, I. (2017). Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism. Behavioral Interventions, 32, 297–310.
Marshall, J., Hill, R. J., Ziviani, J., & Dodrill, P. (2014). Features of feeding difficulty in children with Autism Spectrum Disorder. International Journal of Speech-Language Pathology, 16, 151–158.
McIntosh, D. N., Miller, L. J., & Shyu, V. (1999). Development and validation of the Short Sensory Profile. In W. Dunn (Ed.), Sensory Profile manual (pp. 59–73). San Antonio, TX: Psychological Corporation.
Nadon, G., Feldmann, D. E., Dunn, W., & Gisel, E. (2011). Association of sensory processing and eating problems in autism spectrum disorders. Autism Research and Treatment, 2011, 1–8.
Peterson, K. M., Piazza, C. C., & Volkert, V. M. (2016). A comparison of a modified sequential oral sensory approach to an applied behavior-analytic approach in the treatment of food selectivity in children with autism spectrum disorder. Journal of Applied Behavior Analysis, 49, 485–511.
Phalen, J. (2013). Managing feeding problems and feeding disorders. Pediatrics in Review, 34, 549–557.
Schaaf, R. C., Benevides, T., Mailloux, Z., Faller, P., Hunt, J., van Hooydonk, E., et al. (2014). An intervention for sensory difficulties in children with autism: A randomized trial. Journal of Autism and Developmental Disorders, 44, 1493–1506.
Schaaf, R. C., & Miller, L. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 11, 143–148.
Seiverling, L. J., Harclerode, W., & Williams, K. (2014). The effects of a modified treatment package with and without feeder modeling on one child’s acceptance of novel foods. Education and Treatment of Children, 37, 477–493.
Silverman, A. (2015). Behavioral management of feeding disorders of childhood. Annals of Nutrition and Metabolism, 66, 33–42.
Williams, K. E., Field, D. G., & Seiverling, L. (2010). Food refusal in children: A review of the literature. Research in Developmental Disabilities, 31, 625–633.
Yi, S. H., Joung, Y. S., Choe, Y. H., Kim, E. H., & Kwon, J. Y. (2015). Sensory processing difficulties in toddlers with nonorganic failure-to-thrive and feeding problems. Journal of Pediatric Gastroenterology and Nutrition, 60, 819–824.
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LS conceived the research question, developed the design, and assisted with implementation of the feeding protocols and SIT activities. KA assisted with implementation of the feeding protocols, SIT activities, and data collection. CR assisted with the occupational therapy components of the project (i.e., initial screening for participants, consultations, development of SIT activities, observation of therapists implementing SIT activities). CA assisted with data collection, scoring IOA, and the write up of the manuscript. PA assisted with the written manuscript. JP assisted with data collection and IOA for this project. All authors read and approved the final manuscript.
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This study has been approved by the appropriate institutional and/or national research ethics committee and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Informed consent was obtained from caregivers of each participant included in the study.
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Seiverling, L., Anderson, K., Rogan, C. et al. A Comparison of a Behavioral Feeding Intervention With and Without Pre-meal Sensory Integration Therapy. J Autism Dev Disord 48, 3344–3353 (2018). https://doi.org/10.1007/s10803-018-3604-z
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DOI: https://doi.org/10.1007/s10803-018-3604-z