Descriptive Analyses of Pediatric Food Refusal and Acceptance

Abstract

Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food refusal to determine if the consequences commonly delivered during functional analyses were observed during parent-conducted meals. The conditional probabilities for the delivery of attention, tangible items, and escape following food refusal and acceptance were compared to the unconditional probabilities of each event. Results showed that attention and escape most frequently followed refusal and differed depending on the topography of refusal. Implications for further evaluations of food refusal using similar methods are discussed.

A Comparison of Descriptive and Functional Analyses of Inappropriate Mealtime Behavior

“…Descriptive Assessment Descriptive assessments were conducted using procedures described by Borrero et al (2010). Primary caregivers were instructed to conduct three meals with the child and to feed as they typically did in the home.…”

“…Following the descriptive assessment, the data were analyzed for all caregiver-fed meals to calculate the conditional probabilities of caregiver responses following IMB, using methods described by Borrero et al (2010) and similar to those described by previous researchers (Borrero & Borrero, 2008;Vollmer et al, 2001). Conditional probabilities were analyzed using Instant Analyzer ® with an interval size of 5 s, meaning that for each occurrence of child behavior, the Instant Analyzer ® program lagged forward 5 s in the raw data to determine if a specific occurrence of caregiver behavior occurred.…”

“…Descriptive assessment research has stressed the importance of having a relevant comparison when evaluating conditional probabilities (i.e., the unconditional probability of an event; Thompson & Borrero, 2011;Vollmer, Borrero, Wright, Van Camp, & Lalli, 2001). Borrero et al (2010) conducted an analysis of conditional probabilities during caregiver-fed meals to identify potential contingencies for IMB and food acceptance and to determine how frequently caregivers provided the consequences evaluated during functional analyses. This study was based on the procedures described by Thompson and Iwata (2001).…”

“…Results of the Thompson and Iwata study showed that all consequences commonly tested in a functional analysis were observed, suggesting a strong rationale for testing these conditions in a functional analysis. Borrero et al (2010), using similar analyses, evaluated how frequently specific caregiver responses (e.g., coaxing, comfort statements, escape, access to preferred food) followed topographies of IMB (disruption, expulsions, emesis). Various forms of attention and escape were observed during caregiver-fed meals, and, similar to the results reported by Thompson and Iwata, all consequences tested during functional analyses of IMB were observed.…”

“…This was accomplished by completing comparative probability analysis for descriptive assessments using procedures described by Borrero et al (2010). We then conducted functional analyses of IMB, using procedures similar to those described by Piazza, Fisher, et al (2003).…”