The Assessment and Treatment of Inappropriate Self-Feeding

Abstract

Pediatric feeding disorders encompass an array of problematic feeding behaviors observed in early childhood. The effects of these behaviors range from mild (e.g., delayed social and developmental outcomes) to severe (e.g., significant weight loss, failure to thrive). Inappropriate self-feeding is one topography of pediatric feeding disorders with side effects considered mild, but these may worsen if left untreated, particularly for those diagnosed with developmental disabilities and certain health predispositions. Because assessment and treatment of pediatric feeding disorders often does not occur until the child exhibits severe health problems, there remains limited research on pediatric feeding disorders with mild and delayed effects such as inappropriate self-feeding. We evaluated the effects of response blocking as an assessment procedure to identify skill or motivation deficits for inappropriate self-feeding. We validated assessment results with differential treatment procedures matched to the deficit identified during the assessment. The matched treatment for a skill deficit included response blocking with backward chaining; the matched treatment for a motivation deficit included response blocking with and without differential reinforcement of alternative behavior. The assessment identified a skill deficit for four participants, a motivation deficit for two participants, and a potential interaction between a skill and motivation deficit for one participant. Overall, matched treatments validated assessment results. We discuss these results relative to the importance for a complete approach to assessment and treatment of all pediatric feeding disorders including future avenues of research to accomplish this.