Teaching Independent Eating to a Developmentally Handicapped Child Showing Chronic Food Refusal and Disruption at Mealtimes

Abstract

This report describes an intervention to establish independent eating behaviours in a 3 % year old developmentally handicapped boy with autistic-like behaviours who at the point of referral showed signs of dehydration and malwurishment resulting h chronic food rehal. A first intervention reduced screaming, food r e f w l and related disruptive mealtime behaviours and established appropriate eating msponses in a hospital-based daycare centre. Although the boy's mother received some instruction in the teaching procedures treatment effects did not generalize to the home. A second intervention successfully taught the mother to implement the teaching strategies, and independent mealtime behaviours were established at home, with maintenance reported at a 4-month and 3% year follow-up.The authors gratefully acknowledge the assistance of Shirley Holdaway and her staff at the Vera Hayward Clinic.

Behavioral Management of Feeding Disorders of Childhood

“…Punishment procedures involving highly aversive stimuli are recommended only when less intrusive procedures are not successful, the target behavior is damaging to the child or others, and when carefully monitored by trained personnel. Perhaps the most commonly used punishment technique is timeout from positive reinforcement [51]. In a feeding context, the child may be turned or moved away from the table to eliminate any reinforcement from the child's refusals.…”