Posted: September 7th, 2022

Autism and Food Selectivity

Autism and Food Selectivity
Vaz, P. C., Volkert, V. M., & Piazza, C. C. (2011). Using negative reinforcement to increase self‐feeding in a child with food selectivity. Journal of Applied Behavior Analysis, 44(4), 915-920.
Goals of the Research
The research aimed at examining the negative reinforcement-based treatment while self-feeding a child with food selectivity by type and texture. In a typical setting, children tend to acquire feeding skills in a relatively predictable manner, which culminates in them learning how to feed themselves. Nutrition is very important to the growth and development of children. Parents promote the feeding progress by providing a child with an opportunity to self-feed, initially with finger foods and eventually using utensils (Vaz et al., 2011). Nevertheless, for children that have feeding issues, such a progression may not be witnessed, even when proper strategies to self-feed are provided. Therefore, parents need to formulate intervention strategies that will enable the children to self-feed themselves. The reason that children with such feeding issues may not undergo the typical sequence of development regarding feeding behavior is that they may not have the motivation to eat. Therefore, parents need to provide them with an appropriate drive that will promote their feeding habits. One probable approach of utilizing negative reinforcement in an attempt to treat the problem of feeding among children is to manipulate the thresholds of reinforcement along different dimensions. In Vaz et al.’s (2011) study, the researchers manipulated the impacts linked to self-feeding relative to those associated with being fed along with the aspects of response effort and quality. Therefore, the entire focus was to determine the impacts of having negative reinforcement-based intervention on the process of self-feeding among children who have food selectivity issues by type and texture.
Participants
The study involved only one participant. Jerod was a 6-years-old boy. The child had been admitted to a pediatric feeding disorders outpatient program to receive treatment for having shown major signs of food selectivity based on type and texture. In this case, Jerod did not have a significant medical history or any form of associated diagnoses. Most importantly, he received 100% of all the calories from feeding himself stage 2 baby foods and mil. Moreover, he had a few preferred table-texture foods, including soy nuts and granola bars (Vaz et al., 2011). Nevertheless, the boy refused to take or self-feed any other type or texture of foodstuff. Jerod also had the capacity and skills to self-feed, chew, and swallow table-texture food based on an assessment by a speech therapist. During the study, sessions were undertaken in a room with a one-way trial that encompassed a table, a chair containing arms, big maroon spoons, bowls, along with Nuk brush. Such manipulation was selected with Jerod since previous treatments with diverse response efforts and quality manipulations with the Nuk had not been deemed effective for heightening his self-feeding process.
Dependent Variables
The dependent variable included in this study was the acceptance by the child. Trained observers proceeded to score acceptance, which was described as Jerod utilizing a spoon or his fingers in relaying the bite of food into his mouth within a period of five seconds of presentation. The presentation happened when the feeder placed the bowl of food before the participant. From the onset, observers gathered data on laptop computers. Most importantly, data focusing on acceptance was converted to a percentage after dividing the acceptance number by that of the bites presented in every session. On another note, the second observer concurrently but solely measured a mean of 22% of sessions. Moreover, the interobserver mean was later determined by totaling occurrence and nonoccurrence acceptances. The process was done by dividing by the total of occurrence agreements, nonoccurrence agreements, and disagreements, and changing the ration to a realizable percentage.
Baseline Condition
The study assessed the impacts of avoidance procedure on the acceptance level of three target foods in ABAB designs. The A stage was deemed as the baseline. At this point, the therapist reviewed the event contingencies indicating that he was going to place a bite of food in a bowl before the child and state “take a bite” (Vaz et al., 2011). In case the child succeeded in feeding himself the bite on the spot, the therapist was to utter the words “good job taking your bite.” If Jerod failed to accept the food bite in 30 seconds of being presented with the dish, the therapist was to remove the bite and give the next one. In this situation, the therapist was not supposed to give differential consequences for expulsion.
Independent Variables
Certain independent variables were used in the study, including negative reinforcement and parental training. Negative reinforcement was known as the avoidance treatment process. The therapist reviewed the session contingencies indicating that if the child did not take the bite by himself, then he was to feed him the target food and other five bites of the avoidance food. It meant that in case Jerod failed to accept the target bite within a period of five seconds, the therapist utilized a Nuk to feed him the bite of the target food accompanied by five fed bites of the avoidance stuff. Most importantly, the bolus size associated with the avoidance food was half of a large maroon spoon of peas or peanut butter accompanied by a jelly sandwich (Vaz et al., 2011). The other independent variable was parent training. After it was demonstrated that the treatment was effective, the researchers trained Jerod’s mother through the application of written and verbal guidelines, modeling, response, and role play. Jerod’s mother indicated that he had started eating table-texture apples on his own at home after the treatment. His mother was not trained with apples.
Procedure for Treatment
The treatment for food selectivity that was chosen for this setting was negative reinforcement in an attempt to heighten self-feeding in a child. Using the intervention, the researchers manipulated the effects linked to self-feeding relative to the ones associated with being fed, especially on the dimensions of reaction effort and quality. The manipulation was on the number of bites that the feeder presented to the child compared to the ones the child was able to self-feed. The quality was determined by the child’s preference for the foodstuff. Most importantly, the negative reinforcement process and manipulation encompassed providing the child the chance to self-feed a single bite of the target food to avoid receiving another of the target food in addition to five others of another food category (Vaz et al., 2011). The latter was referred to as avoidance food in the study. The rationale for selecting such manipulation procedures with Jerod in the research was because past treatments with diverse response initiatives and quality manipulations with the use of Nuk had not been proven as effective in the increment of his self-feeding capability.
Experimental Design
The experimental design used for this study was observation. Using the approach, sessions were conducted in a room with single-way observation consisting of a table, a chair consisting of arms, big maroon spoons, bowls, and a Nuk brush. The researchers assessed the impacts of the avoidance procedure on acceptance of three target stuff in ABAB designs. In this case, the A phase was deemed the baseline, and B was the avoidance procedure (Vaz et al., 2011). The study presented data on Jerod’s acceptance of 3 table-texture target stuff, including apples, oranges, and oatmeal. Most importantly, the avoidance foods included pureed peas at a time of treatment using apples and table-texture peanut butter alongside jelly sandwich at a time of treatment using oatmeal and oranges. Before the evaluation process, the researchers heightened Jerod’s consumption of pureed foods and started pilot work on self-feeding avoidance examination. They also conducted a paired-choice preference evaluation in an attempt to determine oatmeal as the least preferred of the pureed foods. Pureed oatmeal was presented as the avoidance food using procedures that were defined by the researchers. In the course of the pilot, acceptance associated with pureed peas did not heighten when the researchers applied pureed oatmeal as the avoidance food. Therefore, they had to use the pureed peas to represent the first avoidance food in their study.
Relationship between Dependent and Independent Variable
A relationship was established between dependent and independent variables in the study. It was determined that self-feeding heightened when the child could select to either self-feed one bite of a target food or be fed another of the target food together with five bites of another stuff (Vaz et al., 2011). The qualitative manipulation as that self-feeding was linked to consuming the more favored target foods and being fed was related to the less ideal avoidance stuffs. In the present study’s choice structures, the effects of self-feeding were more favorable than those of being fed.
Results
The results indicated that during baseline, the mean acceptance was zero. However, the figure rose to high levels during avoidance treatment for apples. The same results were replicated at a time of reversal to baseline and return to treatment. At a time of baseline, mean acceptance was determined to be zero and remained to be so during the avoidance treatment for peanut butter and jelly sandwich. Purred peas were also not found effective as the avoidance stuff (Vaz et al., 2011). The interesting finding was that Jerod’s food preferences emanated from repeated exposure. Furthermore, his increase in self-feeding was a function of evasion of the Nuk instead of the target and the evading-food handlings.
Generalizability
The results have great generalizability. The findings can be used to make inferences for future investigations on the evaluation of the individual contributions of reaction effort and quality manipulations. Future studies can also assess the extent to which response-effect manipulation heightens self-feeding. Such negative reinforcement procedures can also be used for the treatment of other conditions in children suffering from autism. The condition refers to a wide range of problems in a child’s development journey.

Reference
Vaz, P. C., Volkert, V. M., & Piazza, C. C. (2011). Using negative reinforcement to increase self‐feeding in a child with food selectivity. Journal of Applied Behavior Analysis, 44(4), 915-920.

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