Skip to main content
SpringerLink
Log in

Brief Report: Packing Treatment Comparison and Use of a Chaser to Increase Swallowing for a Clinical Case

  • Brief Report
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Packing involves not swallowing solids or liquids in the mouth. It is a significant mealtime behaviour to treat. Research has shown effectiveness of redistribution, but only two studies in highly specialised hospital settings in the United States have evaluated the use of a chaser. We extended this literature by conducting treatment in the home setting, and comparing a liquid and puree chaser separately to infant gum brush redistribution and a move-on to the next bite presentation component. A 4-year-old male with autism spectrum disorder and gastrostomy tube dependence participated in his home. We used a multielement single-case experimental design. With the liquid chaser, consumption increased to 100%. Swallowing latency was significantly lower with the liquid chaser compared to other packing treatments.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Babbitt, R. L., Hoch, T. A., Coe, D. A., Cataldo, M. F., Kelly, K. J., Stackhouse, C., & Perman, J. A. (1994). Behavioral assessment and treatment of pediatric feeding disorders. Journal of Developmental and Behavioral Pediatrics, 15(4), 278–291. https://doi.org/10.1097/00004703-199408000-00011

    Article  PubMed  Google Scholar 

  • Bullock, C. E., Fisher, W. W., & Hagopian, L. P. (2017). Description and validation of a computerized behavioral data program: “BDataPro.” The Behavior Analyst, 40(1), 275–285. https://doi.org/10.1007/s40614-016-0079-0

    Article  PubMed  PubMed Central  Google Scholar 

  • 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(1), 39–50. https://doi.org/10.1901/jaba.2005.168-03

    Article  PubMed  PubMed Central  Google Scholar 

  • Hoch, T. A., Babbitt, R. L., Coe, D. A., Ducan, A., & Trusty, E. M. (1995). A swallow induction avoidance procedure to establish eating. Journal of Behavior Therapy and Experimental Psychiatry, 26(1), 41–50.

    Article  Google Scholar 

  • Hoch, T. A., Babbitt, R. L., Coe, 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

    Article  PubMed  Google Scholar 

  • Kerwin, M. L. 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

    Article  PubMed  PubMed Central  Google Scholar 

  • Kozlowski, A. M., Taylor, T., González, M. L., & Girolami, P. A. (2015). Feeding disorders. In J. L. Matson & M. L. Matson (Eds.), Comorbid conditions in individuals with intellectual disabilities (pp. 109–143). Springer.

  • Levin, D. S., Volkert, V. M., & Piazza, C. C. (2014). A multi-component treatment to reduce packing in children with feeding and autism spectrum disorders. Behavior Modification, 38(6), 940–963. https://doi.org/10.1177/0145445514550683

    Article  PubMed  Google Scholar 

  • Milnes, S. M., & Piazza, C. C. (2013). Intensive treatment of pediatric feeding disorders. In D. D. Reed, F. D. Reed, & J. K. Luiselli (Eds.), Handbook of crisis intervention and developmental disabilities (pp. 393–408). Springer.

  • Sevin, B. M., Gulotta, C. S., Sierp, B. J., Rosica, L. A., & Miller, L. J. (2002). Analysis of response covariation among multiple topographies of food refusal. Journal of Applied Behavior Analysis, 35(1), 65–68. https://doi.org/10.1901/jaba.2002.35-65

    Article  PubMed  PubMed Central  Google Scholar 

  • Taylor, T. (2018). Intensive paediatric feeding treatment and the use of a side deposit for a clinical case within the home setting in Australia. European Journal of Behavior Analysis, 19(2), 208–227. https://doi.org/10.1080/15021149.2018.1472852

    Article  Google Scholar 

  • Taylor, T. (2021). Use of move-on for packing for a clinical paediatric feeding case within the home setting. Behaviour Change.

  • Taylor, T., Blampied, N., & Roglić, N. (2020). Consecutive controlled case series demonstrateshow parents can be trained to treat paediatric feeding disorders at home. Acta Paediatrica. https://doi.org/10.1111/apa.15372

    Article  PubMed  Google Scholar 

  • Vaz, P. C. M., Piazza, C. C., Stewart, V., Volkert, V. M., Groff, R. A., & Patel, M. R. (2012). Using a chaser to decrease packing in children with feeding disorders. Journal of Applied Behavior Analysis, 45(1), 97–105. https://doi.org/10.1901/jaba.20l2.45-97

    Article  PubMed  PubMed Central  Google Scholar 

  • Volkert, V. M., Patel, M. R., & Peterson, K. M. (2016). Food refusal and selective eating. In J. K. Luiselli (Ed.), Behavioral health promotion and intervention in intellectual and developmental disabilities (pp. 137–161). Springer.

  • Yeung, K. A., Taylor, T., Scheimann, A., Carvalho, R., Reinhardt, E., Girolami, P., & Wood, R. (2015). The prevalence of food allergies in children referred to a multidisciplinary feeding program. Clinical Pediatrics, 54(11), 1081–1086. https://doi.org/10.1177/0009922815593499

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This case history was conducted in the context of a treatment evaluation for a clinical case where progress monitoring and data indicated that additional procedures were needed and is a retrospective report of existing non-identifiable data. Participant name was changed to protect confidentiality. This report did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This report was performed in accordance with ethical standards laid out in the 1964 Declaration of Helsinki and its later amendments and the American Psychological Association (APA) ethical standards in the treatment of humans. Caregivers provided written informed consent. The case in this report (initial admission) has been included in a group outcome study (Taylor et al., 2020).

Author information

Authors and Affiliations

  1. Paediatric Feeding International, Double Bay, Sydney, NSW, Australia

    Tessa Taylor

  2. University of Canterbury/Te Whare Wānanga o Waitaha, Private Bag 4800, Christchurch, 8140, New Zealand

    Tessa Taylor

Authors
  1. Tessa Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TT performed the clinical case, developed the study concept and design, analysed the data, and drafted the paper.

Corresponding author

Correspondence to Tessa Taylor.

Ethics declarations

Conflict of interest

The author reports no conflicts of interest or funding sources.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Taylor, T. Brief Report: Packing Treatment Comparison and Use of a Chaser to Increase Swallowing for a Clinical Case. J Autism Dev Disord 52, 3280–3285 (2022). https://doi.org/10.1007/s10803-021-05176-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-021-05176-5

Keywords

Search

Navigation