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Updated: Aug 20, 2025
04:23
A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
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Protocolized Intervention for Children and Adolescents With Phagophobia
Andrea Begotka1, Alan Silverman, Praveen Goday
1From the Division of Pediatrics, Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, Milwaukee, WI.
Journal of Pediatric Gastroenterology and Nutrition
|November 18, 2022
Summary
This study shows that a behavioral treatment protocol effectively helps children with phagophobia (fear of swallowing) to eat more foods and gain weight. The intervention significantly improved their diet and reduced distress, returning them to normal functioning.
Area of Science:
- Pediatric Psychology
- Behavioral Therapy
- Childhood Feeding Disorders
Background:
- Phagophobia, a fear of swallowing often stemming from aversive oral experiences, can lead to significant feeding difficulties in children.
- This condition frequently results in restricted oral intake, malnutrition, and associated weight loss, impacting overall child development.
- Existing treatments often lack a structured, evidence-based approach for addressing the psychological and behavioral components of phagophobia.
Purpose of the Study:
- To prospectively evaluate the effectiveness of a protocolized shaping intervention for children diagnosed with phagophobia.
- To assess the impact of the intervention on weight, dietary variety, and anxiety levels in affected children.
- To determine if behavioral treatment can restore children with phagophobia to their premorbid functioning and dietary habits.
Main Methods:
- A cohort of 21 children (mean age 8.5 years) diagnosed with phagophobia underwent a comprehensive medical evaluation.
- Participants received a pediatric psychologist-led outpatient shaping protocol involving graduated food exposure and anxiety reduction techniques.
- The treatment involved an average of 6 sessions focused on desensitization and dietary expansion.
Main Results:
- Post-intervention, significant increases in children's weight and the total number of foods consumed were observed.
- Participants demonstrated a greater variety of food intake across different food groups and textures.
- Subjective units of distress related to eating were reported as low by all participants throughout the treatment course.
Conclusions:
- Protocolized behavioral shaping interventions are safe and effective for treating phagophobia in children.
- This therapeutic approach successfully addresses anxiety and expands dietary intake, leading to improved nutritional status.
- The treatment facilitates a return to premorbid functioning and normal eating patterns in children with this feeding disorder.
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