Assessment of Parental Acceptability and Preference for Behavioral Interventions for Feeding Problems

Abstract

The present study evaluates the treatment acceptability and preference for behavioral interventions for feeding problems with parents of children with Autism Spectrum Disorder and other developmental disabilities. The impact of behavioral severity on acceptability and preference was also evaluated by comparing results of parents who responded with respect to a vignette of a child with food refusal with those who responded to a vignette of a child with food selectivity. Overall, parents rated differential reinforcement of alternative behavior as the most preferred and most acceptable strategy across both food selectivity and food refusal groups. Escape extinction was the least acceptable and least preferred across both groups, and the severity of the behavior had no impact on acceptability or preference scores. Implications for future research on the social validity of feeding interventions are provided.

Evaluation of a finger prompt variation in the treatment of pediatric feeding disorders

“…This study contributed to the literature by assessing social validity of a potentially invasive behavior‐analytic feeding intervention. Previous research has suggested that when given a choice, parents select less invasive interventions (e.g., Vazquez, Fryling, & Hernandez, ). This could be problematic in the treatment of pediatric feeding disorders, as more invasive interventions (e.g., escape extinction, physical guidance) may be necessary to treat food refusal.…”

Examining extinction bursts in the treatment of pediatric food refusal

“…The preponderance of existing literature on the treatment of food selectivity and refusal has shown that escape extinction is an effective, and often necessary, intervention (Ahearn et al, ; Bachmeyer, ; Cooper et al, ). However, treatments involving extinction may result in unwanted side effects such as extinction bursts, making continued implementation of treatment difficult and negatively impacting social acceptance of extinction as a treatment component (Vazquez et al, ). An examination of 10 cases in which severe food refusal was treated with escape extinction revealed a burst of IMB during the initiation of extinction procedures for 40% of cases.…”

“…Although escape extinction is an empirically validated procedure to reduce food refusal and increase food intake, it may be associated with several unwanted side effects similar to those observed when extinction procedures are implemented with other topographies of problem behavior (e.g., aggression and crying). A recent study by Vazquez, Fryling, and Hernández () suggests that parents may find the use of escape extinction procedures unacceptable in the treatment of food refusal. The most common side effect of extinction procedures reported in the applied literature is an extinction burst (Lerman, Iwata, & Wallace, ; Lerman & Iwata, ).…”

“…Results of this study showed that the children exposed to the modified sequential oral sensory did not increase their consumption of novel foods whereas the applied behavioral analytic approach consisting of an escape extinction procedure did increase their consumption of the novel foods. These results may place practitioners in a difficult situation in which the most effective intervention may be one that is less socially acceptable (Vazquez et al, ). Although the necessity of escape extinction procedures has been demonstrated repeatedly in the pediatric feeding literature, to date, we are not aware of any study focusing on the likelihood of extinction bursts in treating food refusal.…”

Pilot Study of the Just Right Challenge Feeding Protocol for Treatment of Food Selectivity in Children

“…However, this approach has the potential to be invasive and may be inappropriate for some children (Sharp et al, 2010;Williams et al, 2010). For example, a study by Vazques et al (2019) asked parents to rate the acceptability of feeding treatments when given a hypothetical example. These parents rated escape extinction as the least acceptable.…”