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Updated: Jul 5, 2026

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Transition from tube to oral feeding in the school setting
Laura S McKirdy1, Justine J Sheppard, Mary L Osborne
1Lake Drive School, Mountain Lakes, NJ 07046, USA. lmckirdy@mtlakes.org
Purpose:
A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills.
Method:
The program combined educational and therapeutic goals. It was implemented in a regional public school for children with hearing impairments. A team approach was used. Collaboration with the student's families, medical care providers, personal assistants, and classroom staff was maintained.
Results:
Detailed case reviews are provided for 2 of the children who completed the program at age 8;1 (years;months) and 7;8 after 29 and 26 months of treatment, respectively. At the end of the program, tube feeding was discontinued; the children were feeding themselves and taking medications orally. One child was using mature eating skills to eat an unrestricted diet; the other was eating a modified diet consisting of a full nutrient drink and limited smooth and lightly textured solids.
Conclusion:
Successful transition to oral feeding and advancement of developmental eating skills were accomplished in a school setting for long-term tube-fed children with medically complex conditions. The program included collaboration with family and medical personnel as well as integrated therapeutic and educational goals.
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