Redistribution for Regular Texture Bites for Clinical Pediatric Feeding Cases In-Home

Abstract

Research has shown effectiveness of redistribution procedures for decreasing packing and increasing swallowing. Redistribution has been done using lower manipulated-texture foods on an infant gum brush in specialized U.S. hospitals. We extended this by using regular texture bites of food in a short-term (1-2 weeks) home-based program in Australia, showing decreased then absent use of the procedure, and following up. Two children with autism spectrum disorder participated. We used a modified withdrawal/reversal design. Latency to swallow decreased. Participants increased variety to 90 and 122 regular texture foods across food groups. All goals were met including increasing independence in self-feeding. Both parents were trained. Gains maintained to 6 months and redistribution was no longer needed.

Avoidant/restrictive food intake disorder (ARFID) in New Zealand and Australia: a scoping review

“…At 3-year follow-up treatment gains were maintained Burton (Melbourne, Australia) [ 58 ] J Can Acad Child Adolesc Psychiatry Clinical cases, ARFID, ASD Application of Family Based Treatment (FBT) + Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) Paediatric psychology FBT + UP-C/A Treatment goals (no objective outcome measures used) 2 F (6y) F (11y) Not stated Application of FBT + UP-c/A for ARFID with comorbid ASD appeared to contribute towards increased oral intake and food variety, and reduced reliance on NGT feeding Taylor (Australia) [ 45 ] Behav Change Clinical case, ARFID, ASD Effectiveness of move-on treatment component Paediatric feeding Behaviour-analytic treatment Measures of consumption of food across food preference groups, procedural integrity, interobserver agreement, social acceptability, and caregiver satisfaction 1 F (5y) Asian Australian Move-on component added to treatment package resulted in increased consumption and decreased time to consume foods Taylor 2022 (Australia) [ 46 ] Behav Modif Clinical case, ARFID, ASD Medication administration in children with feeding disorders Paediatric feeding Behaviour-analytic treatment Behaviour frequency, latency duration, procedural integrity, interobserver agreement, social validity and treatment acceptability 1 1 M (5y) M (8Y) East Asian Australian South Asian Australian Both participants demonstrated 100% increase in medication consumption with reduced inappropriate mealtime behaviour and quicker consumption. Treatment results were rapid (within 10 min of session 1) Taylor (Australia) [ 37 ] Infants & Young Children Clinical case, ARFID*, ASD Redistribution treatment (movement of food in mouth ...…”

“…Sources in this study were published in journals with a range of intended audiences. A focus on eating disorders (5 studies [27][28][29][30][31]), psychiatry (4 studies [32][33][34][35]), and paediatrics (4 studies [36][37][38][39]) commonly featured. In addition, journals relating to adolescence [40]; gastroenterology [41]; learning and motivation [42]; behaviour change [43][44][45][46]; speech, language, and hearing [47]; disability [48]; and autism and developmental disorders [49] were used to disseminate ARFID research among others, with the journal often being closely relating to the setting in which the sample was investigated.…”

Continuous Saliva Packing Resulting in Feeding Tube Dependence: In-Home Behaviour-Analytic Treatment

“…Caregivers reported maximum social validity and satisfaction (M = 7 out of 7, range 7; 280 out of 280, 100%) in written discharge surveys based on Anderson et al (2021) and Hoch et al (1994), and treatment acceptability (7 out of 7 for all items) on the separate treatment approaches (based on Taylor & Taylor, 2022) except for slightly lower ratings on earning money as reinforcement (5 out of 7) and move-on to the next bite/drink as a treatment component for packing (6 out of 7). Full text surveys are available in .…”

“…These interventions were effective in increasing acceptance and independence with a wide variety of targets. However, packing of saliva and feeding targets persisted (Figure 1) even when we added highly specialised components such as NUK ® (infant gum brush) redistribution and swallow facilitation [REDIS/SF] with lower textures (Gulotta et al, 2005; Hoch et al, 1995; Sevin et al, 2002), involving holding the NUK ® brush horizontally and perpendicular to the tongue, and brushing the bolus directly onto his tongue by rolling the brush down and out with downward pressure to deposit it in place (midline for redistribution; posterior of tongue for swallow facilitation (as described in Taylor, 2021, 2022). Once added to the treatment package, these escape extinction and differential reinforcement components remained in place for the entire remainder of the treatment evaluation.

Figure 3.Volume and weight per day.

…”