Feeding Problems in Children with Autism: CARD’s Feeding Program<=
/span>
Adel Najdowski, Ph.D., BCBA
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Center for Autism and Related Disorders, Inc.
Introduction
<=
span
style=3D'font-size:93%'>¢Purpose
of distinguished lecturer series
<=
span
style=3D'font-size:71%'>lO=
pen and
free to all
<=
span
style=3D'font-size:71%'>lO=
utreach
and education for parents and professionals
<=
span
style=3D'font-size:71%'>lF=
ounded
in 1990 by Dr. Granpeesheh
lProvides ABA services to close to 1,000 children w=
ith
autism and r=
elated
disorders
<=
span
style=3D'font-size:71%'>l17
offices worldwide
lAdel Najdowski, Research and Development Manager o=
f CARD
lMy job is to develop and research methods used to
improve behav=
ior in
the children we service
lPrior to CARD, I was involved in the development o=
f the feeding clinic at NCSBP
<=
span
style=3D'font-size:71%'>lI=
am not
an M.D.
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Objectives
¢Prevalence
of feeding problems
¢Definition
of feeding problems
¢Types
and characteristics
¢Etiology
of feeding problems
¢Introduce
CARD’s feeding program
¢=
Overview some of the empirically based <=
span
lang=3DEN-US>interventions we use
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Overview
¢Prevalence
of Feeding Problems
l2=
5% of
typically developing children=
lUp to 80% of children with developmental disabilities
=
lUp to 72% of children with autism reported to engage in food selectivity by type
¢General
Definition of Feeding Problems
lI=
nsufficient
intake of solids or fluids
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Types and Characteristics
<=
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style=3D'font-size:64%'>lR=
umination
<=
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style=3D'font-size:64%'>lP=
ica
<=
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style=3D'font-size:64%'>lF=
ood
Refusal (all or most foods)
<=
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style=3D'font-size:64%'>lF=
ood
Selectivity (most common in children with autism)
<=
span
style=3D'font-size:67%'>•By Texture
<=
span
style=3D'font-size:67%'>•By Type
<=
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style=3D'font-size:67%'>•By Commercial Brand
<=
span
style=3D'font-size:64%'>lT=
antruming
<=
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style=3D'font-size:64%'>lE=
xpelling
food
<=
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style=3D'font-size:64%'>lG=
agging
<=
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style=3D'font-size:64%'>lV=
omiting
<=
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style=3D'font-size:64%'>lP=
ushing/throwing
food/utensils away
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Characteristics
<=
span
style=3D'font-size:80%'>¢Health
Concerns of Untreated Feeding Problems
<=
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style=3D'font-size:71%'>lF=
ailure
to Thrive
<=
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style=3D'font-size:71%'>lW=
eight
loss
<=
span
style=3D'font-size:71%'>lM=
alnutrition
<=
span
style=3D'font-size:71%'>lU=
nintentional
vomiting
<=
span
style=3D'font-size:71%'>lD=
iarrhea
<=
span
style=3D'font-size:71%'>lS=
hock
<=
span
style=3D'font-size:71%'>lP=
ossibly
death
¢Interpersonal Concerns of Untreated F=
eeding Problems
lChildren are more passive, depressed, anxious, disorganized, easily distracted, emot=
ional,
and dependent on adults
<=
span
style=3D'font-size:71%'>lC=
hildren
are less active with respect to objects and people
<=
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style=3D'font-size:71%'>lS=
train on
family practices and interactions
<=
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style=3D'font-size:75%'>•Eating meals together <=
/div>
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Etiol=
ogy of
Feeding Problems
<=
span
style=3D'font-size:71%'>lB=
iological
variables
=
<=
span
style=3D'font-size:71%'>lE=
nvironmental
variables
•Medical conditions (e.g., gastroesoph=
ageal
reflux, constipation, diarrhea)
<=
span
style=3D'font-size:75%'>•Physiological abnormalities (e.g., cl=
eft
palate)
<=
span
style=3D'font-size:75%'>•Physical diseases (e.g., food allergi=
es)
<=
span
style=3D'font-size:75%'>•Oral-motor delays
<=
/div>
<=
span
style=3D'font-size:75%'>•Dysphagia
¢Always get a medical examination prio=
r to
attempting beha=
vioral
interventions for feeding problems!
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Etiol=
ogy of
Feeding Problems
<=
span
style=3D'font-size:71%'>lI=
t’s
all in the consequences
<=
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style=3D'font-size:75%'>•Getting good stuff (desired consequen=
ces
increase behavior)
•Avoiding bad stuff (removal of undesi=
red
consequences also increases
behavior)
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Environmental Causes
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¢Example: Child getting a desired consequence for food selective behavior
An undesired
food is presented
Jacob spits
the food out
=
Jacob gets a
desired food
consequence
for expulsion…What will happen
to the future frequency of expelling
food in similar situations?
Environmental Causes
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¢Example: Child avoiding/escaping an undesired <=
span
style=3D'position:absolute;top:32.25%;left:21.91%;width:71.91%;height:5.25=
%'>consequence for food selective behavior
An undesired
food is presented
Jacob pushes
the food away
=
The undesired
food is removed
consequence
of Jacob pushing it away…What will
happen to the future frequency of pushing
food away in similar situations?
Environmental Causes
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¢Example: Child getting a desired consequence AND avoiding an undesired consequence for engaging in food selective behavior
A undesired
food is presented
Jacob vomits
=
The undesired
food is removed
AND Jacob gets
a desired food
Jacob
is given a desired food as a consequence
of Jacob vomiting…What will happen
to the future frequency of vomiting in
similar situations?
Environmental Causes
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¢Example: caregiver getting a desired conse=
quence
AND avoiding an undesired conseq=
uence
for removing child’s undesired food =
and
offering preferred food
Jacob cries when
caregiver presents
undesired food
caregiverremoves
undesired
food and offers
a preferred food
=
Jacob eats AND
caregiver escapes
listening to crying
removing undesired foo=
ds
and offering preferred =
foods
in similar situations?
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