Intensive Behavioral Treatment for Severe Feeding Problems: A Cost-effective Alternative to Tube Feeding?

Williams, KA Kevin; Riegel, Katherine; Gibbons, Bridget; Field, Douglas G.

doi:10.1007/s10882-007-9051-y

Cited by 64 publications

(58 citation statements)

References 11 publications

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“…Indeed, over a relatively short treatment period of 5–10 days, oral feeding was established in 90% of the patients. The small percentage of patients in whom rapid weaning failed was similar to or smaller than the failure rates of other treatment modalities 3 4 6 7. Over the long term, the programme was associated with a marked decrease in the frequency of the predominant symptoms of FTP.…”

Section: Discussionmentioning

confidence: 78%

“…The rigorous selection process may have influenced the outcome but a recent follow-up study with less rigorous selection methods did not observe different outcomes 16. While it has been questioned whether weaning programmes have to be intense,9 studies show that a high treatment intensity is associated with a higher success rate,5 8 less weight loss5 and more rapid tube withdrawal5 8 16 than programmes with a lower treatment intensity 3 6 7 9…”

Section: Discussionmentioning

confidence: 99%

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Rapid home-based weaning of small children with feeding tube dependency: positive effects on feeding behaviour without deceleration of growth

Wilken¹,

Cremer²,

Berry³

et al. 2013

Archives of Disease in Childhood

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Rapid home-based weaning of small children with feeding tube dependency: positive effects on feeding behaviour without deceleration of growth

Wilken¹,

Cremer²,

Berry³

et al. 2013

Archives of Disease in Childhood

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show abstract

“…On the other hand, a small number of randomized controlled studies supporting behavioral intervention (Benoit et al 2000;Stark et al 1996, Turner et al 1994) and recent program evaluations of multidisciplinary feeding treatment programs (Greer et al 2009;Williams et al 2007) provide some evidence against the general suppression of negative findings among singlecase reports analyzed in the present review. For example, Benoit et al randomly assigned a sample of 64 child/feeder dyads involving children with tube dependence and food refusal to either a treatment group involving behavioral intervention (n = 32) or a treatment group involving nutritional education (n = 32).…”

Section: Discussionmentioning

confidence: 80%

“…Treatment was also associated with significant declines (p \ .001) in caregivers stress compared with pre-treatment values. Similarly, in a study focusing on the treatment outcomes of 46 children with complete tube dependence, Williams et al (2007) assessed the percent of the sample successfully removed from supplemental tube feedings after discharge from a day treatment program. Treatment was described as involving intensive behavioral therapy with input from a multidisciplinary team.…”

Section: Discussionmentioning

confidence: 99%

“…The present meta-analysis focused on combining findings from studies involving single-case designs. Other group studies consisted of program evaluations that lacked experimental control or involved a single demonstration of positive outcomes (e.g., Berger-Gross et al 2004;Greer et al 2009;Kindermann et al 2008;Williams et al 2007). Outcomes from group studies will be discussed below in relation to the results of the metaanalysis.…”

Section: Study Identification and Eligibility Criteriamentioning

confidence: 99%

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Pediatric Feeding Disorders: A Quantitative Synthesis of Treatment Outcomes

Sharp

Jaquess

Morton

et al. 2010

Clin Child Fam Psychol Rev

241

165

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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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Accumulated‐ and distributed‐reinforcer arrangements in the treatment of challenging mealtime behavior

Chen

Borrero

Frank‐Crawford

et al. 2022

Behavioral Interventions

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Treatment for inappropriate mealtime behavior often includes extinction and differential reinforcement of alternative behavior (DRA) in a distributed arrangement in which delivery of brief reinforcer access immediately follows each appropriate mealtime response. Alternatively, DRA may be arranged using accumulated reinforcement wherein delivery of longer, continuous access to reinforcers follows the consumption of multiple consecutive bites. Research has suggested that individuals prefer and perform better under accumulated arrangements in academic settings; however, no research to date has evaluated the efficacy of accumulated arrangements with children with feeding disorders. We compared preference for and efficacy of distributed and accumulated (with and without tokens) reinforcement with nonremoval of the spoon. All three treatments effectively reduced inappropriate mealtime behavior and increased acceptance for two participants and decreased packing and increased mouth clean for one participant. Two participants preferred distributed reinforcement and one preferred accumulated reinforcement without tokens. Findings differ from some previous research, which demonstrated that participants favored accumulated arrangements in academic contexts.

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Intensive Behavioral Treatment for Severe Feeding Problems: A Cost-effective Alternative to Tube Feeding?

Cited by 64 publications

References 11 publications

Rapid home-based weaning of small children with feeding tube dependency: positive effects on feeding behaviour without deceleration of growth

Rapid home-based weaning of small children with feeding tube dependency: positive effects on feeding behaviour without deceleration of growth

Pediatric Feeding Disorders: A Quantitative Synthesis of Treatment Outcomes

Accumulated‐ and distributed‐reinforcer arrangements in the treatment of challenging mealtime behavior

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