A Clinical Protocol to Increase Chewing and Assess Mastication in Children With Feeding Disorders

Abstract

Children with feeding disorders often cannot or do not chew when presented with table food. Children with chewing deficits also often swallow the bite before masticating it appropriately, which we will refer to as early swallowing. In the current study, we evaluated a clinical protocol to increase chews per bite, assess mastication, and eliminate early swallowing with three children with feeding disorders. The current study adds to a small body of literature on chewing and mastication of children with feeding disorders. Suggestions for future research are also discussed.

Using telehealth to provide outpatient follow‐up to children with avoidant/restrictive food intake disorder

“…Future research could also examine whether behavior analysts could deliver feeding services via telehealth to address skill deficits. Volkert et al (2014) used telehealth and coached a caregiver to teach her child with a feeding disorder to chew, but more research is needed. Maintaining a child's safety may be particularly challenging during intervention for an oral‐motor‐skill deficit.…”

“…Although behavior‐analytic interventions for feeding disorders are well supported by the empirical literature (Kerwin, 1999; Sharp et al, 2017; Volkert & Piazza, 2012), few studies have evaluated whether these interventions are equally effective when a behavior analyst delivers them via telehealth. Notable exceptions include studies by Rivas et al (2014), Volkert et al (2014), Peterson et al (2015), and Bloomfield et al (2019), which used different methods of delivering feeding intervention through telehealth. For example, Peterson et al coached the caregivers of two children to use differential reinforcement to increase self‐drinking.…”

Further evaluation of modified‐bolus‐placement methods during initial treatment of pediatric feeding disorders

“…Deficits in motivation or skill may not be as apparent because she consumed some table‐textured food, and thus, exhibited some level of oral‐motor behavior. However, children with these types of diets might swallow bites early (either before the feeder can check for mastication or in the absence of any chewing and mastication; Volkert et al, 2014) or compensate for the absence of age‐appropriate chewing skills. Therefore, based on preexperimental assessments and in consultation with a speech language pathologist, we planned for Zara's clinical course of treatment to start with pureed food before introducing a separate chewing protocol.…”

A Multi-Component Treatment to Reduce Packing in Children With Feeding and Autism Spectrum Disorders

“…The focus of this study is on packing; therefore, we provide a brief overview of the chewing procedure, with the primary focus on the packing treatment. (Contact the author for chewing-treatment details and see Volkert, Peterson, Zeleny, & Piazza, 2014). The feeder used nonremoval of the tube to present Nick with a 0.6-cm × 0.6-cm piece of chicken inside an approximately 5.1-cm length of clear, flexible aquarium airline tubing that was 0.6 cm in diameter.…”