What is a feeding program, and how can it help my child?

Written by Catherine Ganem, M.A., BCBA

One of the core services offered at Behavioral Consulting of Tampa Bay is conducting intensive feeding therapy with children who have limited diets.  Feeding issues are common with children who are on the autism spectrum, but may happen with other children as well.  Indicators of a child who displays feeding problems include:

·         A limited number of foods that the child will eat

·         A drastic reduction in the number of foods the child now eats compared to previous eating habits

·         Being brand specific (i.e. only eating a specific brand of chips or only eating shoe string French fries)

·         Tolerating only certain textures (i.e. only crunchy things or soft things), colors, or food groups (i.e. only starches)

·         Rigidity regarding some or all foods (i.e. will only drink from a certain cup, refuse to touch foods with sauces, or refuse to independently feed him/herself)

·         Problem behaviors or refusal when asked to consume a non-preferred food (i.e. crying, hitting, running from the table, throwing up, etc.)

What is a feeding program?

Research shows that one of the most effective ways at combating feeding problems is through the use of a feeding program that incorporates escape extinction.  As I noted in my blog on extinction, seen here, extinction occurs when a reinforcer for a particular behavior is no longer delivered following the behavior.  In this case, escape is no longer allowed for refusing to eat.

How does a feeding program work?

Your child will be presented with an appropriate amount of food and he/she will only be allowed to escape the feeding area once the food is consumed.  Positive reinforcement/rewards are delivered in the forms of preferred items, foods, or activities based on compliance.  This process will be repeated throughout the feeding session.

After an initial meeting with the child’s parents or caregivers, the first few feeding sessions will focus on teaching your child how the feeding process works (i.e. first you eat, then you go play).  Therefore, the first few sessions will involve foods that your child already eats.  Next, slight variations to those foods will be made.  If your child only eats Honey Nut Cheerios, plain Cheerios may be worked on.  If your child only eats McDonald’s chicken nuggets, we may work on Burger King chicken nuggets.  After working on variations to foods currently tolerated as well as moving through foods previously eaten, we will work on new foods.

Is a feeding program right for your child?

First and foremost, it is important to rule out any medical conditions that may be impacting issues with your child’s diet.  Ensure that all allergies and gastrointestinal problems are identified.  It is also important to consider your child’s fine motor or oral motor skills, as these can impact how well he or she is able to chew, swallow, or manipulate utensils. 

Considerations

Because the feeding process is systematic, progress may be slow at first.  Understand that your child has learned an effective way at avoiding eating non-preferred foods, and an extinction burst is likely to occur and last for one to several feeding sessions.  Once the initial extinction burst occurs, progress is typically much quicker.

Generalization should be taken into consideration when addressing any behavior.  In ideal situations, the behavior of food acceptance will generalize to the home and school settings as well as to family members and caregivers.   As foods are mastered at Behavioral Consulting, we will ask that you work on these foods at home to promote generalization.  In some cases, special programming for generalization must occur when it is difficult.  Options include:

·         Including the parents or caregivers in the feeding session

·         Conducting feeding sessions at home or in school

How have you overcome feeding difficulties with your child?  Please leave tips in the comments section below.  If you think a feeding program is right for your child, contact Behavioral Consulting at (813) 814-2000 to set up a meeting with one of our behavior analysts.