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Juan CY. The Mealtime Behavior Problems of Children with Developmental Disabilities and the Teacher’s Stress in Inclusive Preschools. CHILDREN 2023; 10:children10030441. [PMID: 36979999 PMCID: PMC10047340 DOI: 10.3390/children10030441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/08/2023] [Accepted: 02/20/2023] [Indexed: 03/03/2023]
Abstract
With an increasing number of children with developmental disabilities entering inclusive preschools, preschool teachers face more behavioral problems in class. Preschool teachers typically attempt to address mealtime behavior problems of children with and without developmental disabilities simultaneously in class. This study used qualitative research to identify the stress triggers of preschool teachers addressing the mealtime behavior problems of children with developmental disabilities. Five preschool teachers attended semi-structured interviews. The results indicated that most children with developmental disabilities had problems with eating only preferred foods, using eating utensils appropriately during mealtime, becoming distracted from eating, and becoming frustrated with the classroom routine. Although solving these problems triggered stress in the preschool teachers, their stress was mainly in response to the children’s parents, other children’s imitation of inappropriate mealtime behaviors, and classroom schedule time management. Most of the preschool teachers stated that they had insufficient support. Preschool teachers require specialized information and strategies for improving the mealtime behaviors of children with developmental disabilities.
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Affiliation(s)
- Chen-Ya Juan
- Center of Teacher Education, Minghsin University of Science and Technology, Hsinchu 30401, Taiwan
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Berth DP, Bachmeyer MH, Kirkwood CA, Mauzy CR, Retzlaff BJ, Gibson AL. Noncontingent and differential reinforcement in the treatment of pediatric feeding problems. J Appl Behav Anal 2019; 52:622-641. [DOI: 10.1002/jaba.562] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 02/21/2019] [Indexed: 11/06/2022]
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Olive ML. Assessment & Intervention for Young Children With Nonphysiological Feeding Concerns Melissa L. Olive, Ph.D., University of Texas at Austin. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/109625060400700402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Weber J, Gutierrez A. A Treatment Package without Escape Extinction to Address Food Selectivity. J Vis Exp 2015:e52898. [PMID: 26325108 DOI: 10.3791/52898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including autism. Behavior analytic interventions for the treatment of feeding difficulties oftentimes include escape extinction as a primary component of treatment. The use of escape extinction, while effective, may be problematic as it is also associated with the emergence of challenging behavior (e.g., extinction burst). Such challenging behavior may be an acceptable side effect in treatment cases where feeding problems are severe and chronic (e.g., failure to thrive). However, in more acute cases (e.g., selective eating), the negative side effect may be unwarranted and undesired. More recent research on the behavioral treatment of food selectivity has begun to evaluate treatments for feeding difficulties that do not include escape extinction (e.g., demand fading, behavioral momentum), with some success. However, research to date reveals individual differences in responsiveness to such treatments and no clear preferable treatment has emerged. This manuscript describes a multi-component treatment package that includes shaping, sequential presentation and simultaneous presentation, for the treatment of food selectivity in four young children with developmental delays. This treatment package extends the literature on the behavioral treatment for food selectivity and offers a multi-component treatment protocol that may be clinically applicable across a range of treatment scenarios and settings.
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Affiliation(s)
- Jessica Weber
- Department of Psychology and the Center for Children and Families, Florida International University
| | - Anibal Gutierrez
- Department of Psychology and the Center for Children and Families, Florida International University;
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Rivas KM, Piazza CC, Roane HS, Volkert VM, Stewart V, Kadey HJ, Groff RA. Analysis of self-feeding in children with feeding disorders. J Appl Behav Anal 2014; 47:710-22. [DOI: 10.1002/jaba.170] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 05/05/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Kristi M. Rivas
- University of Nebraska Medical Center's Munroe-Meyer Institute
| | | | - Henry S. Roane
- University of Nebraska Medical Center's Munroe-Meyer Institute
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Bachmeyer MH. Treatment of selective and inadequate food intake in children: a review and practical guide. Behav Anal Pract 2012; 2:43-50. [PMID: 22477695 DOI: 10.1007/bf03391736] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Treatment of highly selective or low overall eating by children may prevent the development of more complicated feeding difficulties, which can result in compromised health status and developmental concerns as well as the need for more intensive interventions. Caregiver-friendly intervention strategies that can be implemented with children in their community environments (e.g., in the child's home or school) may reduce the need for tertiary care. A small but growing number of studies have found that certain behavioral procedures can be effective in the absence of escape extinction with children who have established eating patterns (i.e., inadequate intake, selectivity by food type). This article reviews these procedural variations within the behavioral pediatric feeding literature and provides a practical guide for individuals who develop behavioral interventions for children in community settings.
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Sharp WG, Jaquess DL, Morton JF, Herzinger CV. Pediatric feeding disorders: a quantitative synthesis of treatment outcomes. Clin Child Fam Psychol Rev 2011; 13:348-65. [PMID: 20844951 DOI: 10.1007/s10567-010-0079-7] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A systematic review of the literature regarding treatment of pediatric feeding disorders was conducted. Articles in peer-reviewed scientific journals (1970-2010) evaluating treatment of severe food refusal or selectivity were identified. Studies demonstrating strict experimental control were selected and analyzed. Forty-eight single-case research studies reporting outcomes for 96 participants were included in the review. Most children presented with complex medical and developmental concerns and were treated at multidisciplinary feeding disorders programs. All studies involved behavioral intervention; no well-controlled studies evaluating feeding interventions by other theoretical perspectives or clinical disciplines met inclusion criteria. Results indicated that behavioral intervention was associated with significant improvements in feeding behavior. Clinical and research implications are discussed, including movement toward the identification of key behavioral antecedents and consequences that promote appropriate mealtime performance, as well as the need to better document outcomes beyond behavioral improvements, such as changes in anthropometric parameters, generalization of treatment gains to caregivers, and improvements in nutritional status.
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Casey SD, Perrin CJ, Lesser AD, Perrin SH, Casey CL, Reed GK. Using descriptive assessment in the treatment of bite acceptance and food refusal. Behav Modif 2009; 33:537-58. [PMID: 19675310 DOI: 10.1177/0145445509341457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The feeding behaviors of two children who maintained failure to thrive diagnoses and displayed food refusal are assessed in their homes. Descriptive assessments are used to identify schedules of consequence provided by each child's care providers for bite acceptance and food refusal behaviors. Assessments reveal rich schedules of praise and access to social interaction and preferred activities for bite acceptance and escape for food refusal. These schedule arrangements result in hypotheses that modifications to the schedule of praise and access to social interaction and preferred activities for bite acceptance would result in little to no effect and that modifications to the schedule of escape for food refusal would be necessary for treatment success. Successful interventions are subsequently implemented by manipulating the existing schedules of escape for food refusal by each child's care providers. Implications for the use of descriptive assessments for feeding problems are discussed.
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Affiliation(s)
- Sean D Casey
- The Pennsylvania State University, 30 East Swedesford Road, Malvern, PA, USA.
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Reed GK, Piazza CC, Patel MR, Layer SA, Bachmeyer MH, Bethke SD, Gutshall KA. On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal. J Appl Behav Anal 2004; 37:27-42. [PMID: 15154213 PMCID: PMC1284475 DOI: 10.1901/jaba.2004.37-27] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In the current investigation, we evaluated the relative effects of noncontingent reinforcement (NCR), escape extinction, and a combination of NCR and escape extinction as treatment for the feeding problems exhibited by 4 children. For each participant, consumption increased only when escape extinction was implemented, independent of whether NCR was present or absent. These results were consistent with prior research suggesting that positive reinforcement alone is insufficient for increasing consumption, and that escape extinction often is necessary to increase and maintain food acceptance. However, NCR appeared to decrease inappropriate behavior for some participants.
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Affiliation(s)
- Gregory K Reed
- Marcus Institute, 1920 Briarcliff Road, Atlanta, Georgia 30329, USA
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Mueller MM, Piazza CC, Moore JW, Kelley ME, Bethke SA, Pruett AE, Oberdorff AJ, Layer SA. Training parents to implement pediatric feeding protocols. J Appl Behav Anal 2004; 36:545-62. [PMID: 14768672 PMCID: PMC1284468 DOI: 10.1901/jaba.2003.36-545] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Four different multicomponent training packages were evaluated to increase the treatment integrity of parents implementing pediatric feeding protocols. In Study 1 we exposed 3 parents to a training package that consisted of written protocols (baseline), verbal instructions, therapist modeling, and rehearsal training. Results suggested that the package was successful in increasing treatment integrity of the feeding protocols to high levels. Study 2 investigated three different parent-training packages comprised of components used in Study 1. Two parents were exposed to written protocols, verbal instructions, and modeling; 2 parents were exposed to written protocols, verbal instructions, and rehearsal; and 2 parents were exposed to written protocols and verbal instructions. Results of Study 2 showed that each parent-training package produced very high treatment integrity. Follow-up data in the clinic and home for 5 participants suggested that the results were durable for up to 3 months. These results demonstrate a first step in the transfer and application of research findings into routine clinical practice because we evaluated several methods for training parents to implement behavioral feeding protocols, and we demonstrated that these methods resulted in high levels of treatment integrity in a controlled clinical setting.
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Piazza CC, Patel MR, Gulotta CS, Sevin BM, Layer SA. On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal. J Appl Behav Anal 2004; 36:309-24. [PMID: 14596572 PMCID: PMC1284445 DOI: 10.1901/jaba.2003.36-309] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We compared the effects of positive reinforcement alone, escape extinction alone, and positive reinforcement with escape extinction in the treatment of the food and fluid refusal of 4 children who had been diagnosed with a pediatric feeding disorder. Consumption did not increase when positive reinforcement was implemented alone. By contrast, consumption increased for all participants when escape extinction was implemented, independent of the presence or absence of positive reinforcement. However, the addition of positive reinforcement to escape extinction was associated with beneficial effects (e.g., greater decreases in negative vocalizations and inappropriate behavior) for some participants.
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Piazza CC, Fisher WW, Brown KA, Shore BA, Patel MR, Katz RM, Sevin BM, Gulotta CS, Blakely-Smith A. Functional analysis of inappropriate mealtime behaviors. J Appl Behav Anal 2003; 36:187-204. [PMID: 12858984 PMCID: PMC1284432 DOI: 10.1901/jaba.2003.36-187] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of the current investigation was to apply the functional analysis described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) to the inappropriate mealtime behaviors of 15 children who had been referred to an intensive program for the assessment and treatment of severe feeding disorders. During Study 1, we conducted descriptive assessments of children and parents during meals. The results of Study 1 showed that parents used the following consequences for inappropriate mealtime behaviors: coaxing and reprimanding, allowing the child to periodically take a break from or avoid eating, and giving the child preferred food or toys following inappropriate behavior. The effects of these consequences were tested systematically in Study 2 when we conducted analogue functional analyses with the children. During alternating meals, one of the consequences typically used by parents consistently followed inappropriate child behavior. Results indicated that these consequences actually worsened behavior for 10 of the 15 children (67%). These results suggested that the analogue functional analysis described by Iwata et al. may be useful in identifying the environmental events that play a role in feeding disorders.
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