Utensil manipulation during initial treatment of pediatric feeding problems.

Children with feeding disorders exhibit a variety of problem behaviors during meals. One method of treating problem mealtime behavior is to implement interventions sequentially after the problem behavior emerges (e.g.

Analysis of self-feeding in children with feeding disorders.

In the current investigation, we evaluated a method for increasing self-feeding with 3 children with a history of food refusal. The children never (2 children) or rarely (1 child) self-fed bites of food when the choice was between self-feeding and escape from eating. When the choice was between self-feeding 1 bite of food or being fed an identical bite of food, self-feeding was low (2 children) or variable (1 child).

Syringe fading as treatment for feeding refusal.

The efficacy of nonremoval of the cup or spoon as treatment for feeding refusal is dependent on prevention of escape from presentations. In the current investigation, 1 child with feeding refusal escaped presentations during nonremoval of the cup and spoon by clenching his teeth. Therefore, we used a syringe to deposit liquids and solids, increased the volume of liquids and solids in the syringe, and conducted syringe-to-cup and syringe-to-spoon fading.

Using a chaser to decrease packing in children with feeding disorders.

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During the chaser procedure, the therapist presented the chaser immediately for 2 children or 15 s after each bite presentation for 1 child.

A flipped spoon and chin prompt to increase mouth clean.

We treated the liquid refusal of a 15-month-old girl using 2 antecedent manipulations: flipped spoon and chin prompt. Use of the chin prompt in the absence of the flipped spoon failed to produce increases in mouth clean (a product measure of swallowing). By contrast, modest increases in mouth clean resulted from the implementation of the flipped spoon alone.

Spoon-to-cup fading as treatment for cup drinking in a child with intestinal failure.

We treated a child with intestinal failure who consumed solids on a spoon but not liquids from a cup. We used spoon-to-cup fading, which consisted of taping a spoon to a cup and then gradually moving the bowl of the spoon closer to the edge of the cup. Spoon-to-cup fading was effective for increasing consumption of liquids from a cup.

Chin prompt plus re-presentation as treatment for expulsion in children with feeding disorders.

Expulsion (spitting out food) is a problem behavior observed in many children with feeding disorders. In the current investigation, we identified 4 children diagnosed with a feeding disorder who exhibited high rates of expulsion. Treatment with re-presentation (placing expelled liquids or solids back into the child's mouth) was not effective in reducing expulsion.