Intensive Treatment of Pediatric Feeding Disorders

Chapter
Part of the Issues in Clinical Child Psychology book series (ICCP)

Abstract

Children who are failing to consume enough calories to maintain adequate growth are at risk for a number of negative health consequences (e.g., dehydration, malnutrition, and long-term behavioral and cognitive consequences). Although crisis management (e.g., placement of a feeding tube) may be necessary in some cases, participation in an interdisciplinary, evidence-based feeding program that provides goal-oriented, data-based assessment and treatment is often a necessary avenue to increase oral feeding. Interdisciplinary programs using applied behavior analytic techniques are able to address the most difficult feeding problems and progress the child until he or she is eating at a developmentally appropriate level. This current chapter provides an overview of an evidence-based and interdisciplinary approach to the treatment of pediatric feeding disorders.

Keywords

Starch Microwave Hydration Barium Dehydration 

References

  1. Adelinis, J. D., Piazza, C. C., Fisher, W. W., & Hanley, G. P. (1997). The establishing effects of client location on self-injurious behavior. Research in Developmental Disabilities, 18, 383–391.PubMedCrossRefGoogle Scholar
  2. Bachmeyer, M. H., Piazza, C. C., Fredrick, L. D., Reed, G. K., Rivas, K. D., & Kadey, H. J. (2009). Functional analysis and treatment of multiply controlled inappropriate mealtime behavior. Journal of Applied Behavior Analysis, 42, 641–658.PubMedCrossRefGoogle Scholar
  3. Bazyk, S. (1990). Factors associated with transition to oral feeding in infants fed by nasogastric tubes. American Journal of Occupational Therapy, 44, 1070–1078.PubMedCrossRefGoogle Scholar
  4. Benoit, D., Wang, E. L., & Zlotkin, S. H. (2000). Discontinuation of enterostomy tube feeding by behavioral treatment in early childhood: A randomized controlled trial. The Journal or Pediatrics, 137, 498–503.CrossRefGoogle Scholar
  5. Blackman, J. A., & Nelson, C. L. A. (1985). Reinstituting oral feedings in children fed by gastrostomy tube. Clinical Pediatrics, 24, 434–438.PubMedCrossRefGoogle Scholar
  6. Cohen, S. A., Piazza, C. C., & Navathe, A. (2006). Feeding and nutrition. In I. L. Rubin & A. C. Crocker (Eds.), Medical care for children and adults with developmental disabilities (pp. 295–307). Baltimore, MD: Paul H. Brooks.Google Scholar
  7. Dawson, J. E., Piazza, C. C., Sevin, B. M., Gulotta, C. S., Lerman, D., & Kelley, M. L. (2003). Use of the high-probability instructional sequence and escape extinction in a child with food refusal. Journal of Applied Behavior Analysis, 36, 105–108.PubMedCrossRefGoogle Scholar
  8. Dellert, S. F., Hyams, J. S., Treem, W. R., & Geertsma, M. A. (1993). Feeding resistance and gastroesophageal reflux in infancy. Journal of Pediatric Gastroenterology and Nutrition, 17, 66–71.PubMedCrossRefGoogle Scholar
  9. Dempsey, J., Piazza, C. C., Groff, R. A., & Kozisek, J. M. (2011). A flipped spoon and chin prompt to increase mouth clean. Journal of Applied Behavior Analysis, 44, 961–965.PubMedCrossRefGoogle Scholar
  10. Derrickson, J. G., Neef, N. A., & Cataldo, M. F. (1993). Effects of signaling invasive procedures on a hospitalized infant’s affective behaviors. Journal of Applied Behavior Analysis, 26, 133–134.PubMedCrossRefGoogle Scholar
  11. Essex, C., & Wooliscroft, K. (2011). Children with feeding difficulties: medical and nursing perspectives. In A. Southall & C. Martin (Eds.), Feeding problems in children: A practical guide (2nd ed., pp. 29–52). Oxford: Radcliffe Publishing Ltd.Google Scholar
  12. Fisher, W., Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with a systematic choice assessment to enhance reinforcer identification. American Journal of Mental Retardation, 101, 15–25.PubMedGoogle Scholar
  13. 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 person with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491–498.PubMedCrossRefGoogle Scholar
  14. Freeman, K. A., & Piazza, C. C. (1998). Combining stimulus fading, reinforcement, and extinction to treat food refusal. Journal of Applied Behavior Analysis, 31, 691–694.PubMedCrossRefGoogle Scholar
  15. Geertsma, M. A., Hyams, J. S., Pelletier, J. M., & Reiter, S. (1985). Feeding resistance after parenteral hyperalimentation. American Journal of Diseases of Children (1960), 139, 255–256.Google Scholar
  16. Greer, A. J., Gulotta, C. S., Masler, E. A., & Laud, R. B. (2008). Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program. Journal of Pediatric Psychology, 33(6), 612–620.PubMedCrossRefGoogle Scholar
  17. Groff, R. A., Piazza, C. C., Zeleny, J. R., & Dempsey, J. R. (2011). Spoon-to-cup fading as treatment for cup drinking in a child with intestinal failure. Journal of Applied Behavior Analysis, 44, 949–954.PubMedCrossRefGoogle Scholar
  18. Gulotta, C. S., Piazza, C. C., Patel, M. R., & Layer, S. A. (2005). Using food redistribution to reduce packing in children with severe food refusal. Journal of Applied Behavior Analysis, 38, 39–50.PubMedCrossRefGoogle Scholar
  19. Kelley, M. E., Piazza, C. C., Fisher, W. W., & Oberdorff, A. J. (2003). Acquisition of cup drinking using previously refused foods as positive and negative reinforcement. Journal of Applied Behavior Analysis, 36, 89–93.PubMedCrossRefGoogle Scholar
  20. Kerwin, M. E. (1999). Empirically supported treatments in pediatric psychology: Severe feeding problems. Journal of Pediatric Psychology, 24, 193–214.PubMedCrossRefGoogle Scholar
  21. LaRue, R. H., Stewart, V., Piazza, C. C., Volkert, V. M., Patel, M. R., & Zeleny, J. (2011). Escape as reinforcement and escape extinction in the treatment of feeding problems. Journal of Applied Behavior Analysis, 44, 719–735.PubMedCrossRefGoogle Scholar
  22. 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.PubMedCrossRefGoogle Scholar
  23. Luiselli, J. K. (2006). Pediatric feeding disorders. In J. K. Luiselli (Ed.), Antecedent assessment and intervention: Supporting children and adults with developmental disabilities in community settings (pp. 165–185). Baltimore, MD: Brookes.Google Scholar
  24. Luiselli, J. K., & Evans Luiselli, T. (1995). A behavior analysis approach toward chronic food refusal in children with gastrostomy-tube dependency. Topics in Early Childhood Special Education, 15, 1–18.CrossRefGoogle Scholar
  25. 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 pediatric feeding protocols. Journal of Applied Behavior Analysis, 36, 545–562.PubMedCrossRefGoogle Scholar
  26. Mueller, M. M., Piazza, C. C., Patel, M. R., Kelley, M. E., & Pruett, A. (2004). Increasing variety of foods consumed by blending nonpreferred foods into preferred foods. Journal of Applied Behavior Analysis, 37, 159–170.PubMedCrossRefGoogle Scholar
  27. Munk, D. D., & Repp, A. C. (1994). Behavioral assessment of feeding problems of individuals with severe disabilities. Journal of Applied Behavior Analysis, 27, 241–250.PubMedCrossRefGoogle Scholar
  28. Nucci, A. M., Barksdale, E. M., Jr., Yaworski, J. A., Beserock, N., & Reyes, J. (2002). Enteral formula use in children after small bowel transplant. Nutrition in Clinical Practice, 17, 113–117.PubMedCrossRefGoogle Scholar
  29. Patel, M. R., Piazza, C. C., Kelly, M. L., Ochsner, C. A., & Santana, C. M. (2001). Using a fading procedure to increase fluid consumption in a child with feeding problems. Journal of Applied Behavior Analysis, 34, 357–360.PubMedCrossRefGoogle Scholar
  30. Patel, M. R., Piazza, C. C., Layer, S. A., Coleman, R., & Swartzwelder, D. M. (2005). A systematic evaluation of food textures to decrease packing and increase oral intake in children with pediatric feeding disorders. Journal of Applied Behavior Analysis, 38, 89–100.PubMedCrossRefGoogle Scholar
  31. Patel, M. R., Piazza, C. C., Martinez, C. J., Volkert, V. M., & Santana, C. M. (2002). An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal. Journal of Applied Behavior Analysis, 35, 363–374.PubMedCrossRefGoogle Scholar
  32. Patel, M. R., Piazza, C. C., Santana, C. M., & Volkert, V. M. (2002). An evaluation of food type and texture in the treatment of a feeding problem. Journal of Applied Behavior Analysis, 35, 183–186.PubMedCrossRefGoogle Scholar
  33. Patel, M. R., Reed, G. K., Piazza, C. C., Bachmeyer, M. H., Layer, S. A., & Pabico, R. S. (2006). An evaluation of a high-probability instructional sequence to increase acceptance of food and decrease inappropriate behavior in children with pediatric feeding disorders. Research in Developmental Disabilities, 27, 430–442.PubMedCrossRefGoogle Scholar
  34. Patel, M. R., Reed, G. K., Piazza, C. C., Mueller, M., Bachmeyer, M. H., & Layer, S. A. (2007). Use of a high-probability instructional sequence to increase compliance to feeding demands in the absence of escape extinction. Behavioral Interventions, 22(4), 305–310.CrossRefGoogle Scholar
  35. Piazza, C. C., Anderson, C., & Fisher, W. W. (1993). Teaching self-feeding skills to patients with Rett syndrome. Developmental Medicine and Child Neurology, 35, 991–996.PubMedCrossRefGoogle Scholar
  36. Piazza, C. C., & Carroll-Hernandez, T. A. (2004). Assessment and treatment of pediatric feeding disorders. Encyclopedia on early childhood development, pp. 1–7.Google Scholar
  37. Piazza, C. C., Fisher, W. W., Brown, K. A., Shore, B. A., Patel, M. R., Katz, R. M., et al. (2003). Functional analysis of inappropriate mealtime behaviors. Journal of Applied Behavior Analysis, 36, 187–204.PubMedCrossRefGoogle Scholar
  38. 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, 309–324.PubMedCrossRefGoogle Scholar
  39. 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, 259–270.PubMedCrossRefGoogle Scholar
  40. 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 noncontingent reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behavior Analysis, 37, 27–42.PubMedCrossRefGoogle Scholar
  41. Rivas, K. R., Piazza, C. C., Kadey, H. J., Volkert, V. M., & Stewart, V. (2011). Sequential treatment of a feeding problem using a pacifier and flipped spoon. Journal of Applied Behavior Analysis, 44, 387–391.PubMedCrossRefGoogle Scholar
  42. Rivas, K. D., Piazza, C. C., Patel, M. R., & Bachmeyer, M. H. (2010). Spoon distance fading with and without escape extinction as treatment for food refusal. Journal of Applied Behavior Analysis, 43, 673–683.PubMedCrossRefGoogle Scholar
  43. Rommel, N., De Meyer, A. M., Feenstra, L., & Veereman-Wauters, G. (2003). The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. Journal of Pediatric Gastroenterology and Nutrition, 37, 75–82.PubMedCrossRefGoogle Scholar
  44. Rossi, T., Brodsky, L., & Arvedson, J. (2002). Pediatric gastroenterology. In J. C. Arvedson & L. Brodsky (Eds.), Pediatric swallowing and feeding assessment and management (2nd ed., pp. 186–232). Clifton Park, NY: Delmar Cengage Learning.Google Scholar
  45. Vantini, I., Benini, L., Bonfante, F., Talamini, G., Sembenini, C., Chiarioni, G., et al. (2004). Survival rate and prognostic factors in patients with intestinal failure. Digestive and Liver Disease, 36, 46–55.PubMedCrossRefGoogle Scholar
  46. Vaz, P. C. M., Volkert, V. M., & Piazza, C. C. (2011). Using negative reinforcement to increase self-feeding in a child with food selectivity. Journal of Applied Behavior Analysis, 44, 915–920.PubMedCrossRefGoogle Scholar
  47. Volkert, V. M., & Piazza, C. C. (2012). Empirically supported treatments for pediatric feeding disorders. In P. Sturmey & M. Herson (Eds.), Handbook of evidence based practice in clinical psychology. Hoboken, NJ: Wiley.Google Scholar
  48. Volkert, V. M., Vaz, P. C. M., Piazza, C. C., Frese, J., & Barnett, L. (2011). Using a flipped spoon to decrease packing in children with feeding disorders. Journal of Applied Behavior Analysis, 44, 617–621.PubMedCrossRefGoogle Scholar
  49. Wilkins, J. W., Piazza, C. C., Groff, R. A., & Vaz, P. C. M. (2011). Chin prompt plus re-presentation as treatment for expulsion in children with feeding disorders. Journal of Applied Behavior Analysis, 44, 513–522.PubMedCrossRefGoogle Scholar
  50. Williams, K. E., Riegel, K., Gibbons, B., & Field, D. G. (2007). Intensive behavioral treatment for severe feeding problems: A cost-effective alternative to tube feeding? Journal of Developmental and Physical Disabilities, 19(3), 227–235.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Munroe-Meyer Institute, UNMC985450 Nebraska Medical CenterOmahaUSA

Personalised recommendations