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Utensil Fading to Increase Appropriate Utensil Acceptance.

Alison M Kozlowski^1,2, Racheal Clark^1,2, Brittney Workman¹

¹Kennedy Krieger Institute, 707 North Broadway, 2nd Floor, Baltimore, MD 21205 USA.

Behavior Analysis in Practice

|October 11, 2024

Summary

Escape extinction therapy effectively increases food acceptance in children with feeding issues. New methods like finger-to-spoon fading show promise for children with autism spectrum disorder, expanding treatment options.

Keywords:

Avoidant/restrictive food intake disorder Drink refusal Fading Feeding disorder Food refusal Utensil

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Area of Science:

Pediatric feeding disorders
Applied Behavior Analysis (ABA)
Autism Spectrum Disorder (ASD) interventions

Background:

Escape extinction is a validated treatment for improving food and drink acceptance in children with feeding difficulties.
Nonremoval of utensils alone may be insufficient when children exhibit lip closure or teeth clenching.
Physical guidance techniques can help but may necessitate alternative utensils.

Purpose of the Study:

To replicate spoon-to-cup fading for an oral feeder with autism spectrum disorder (ASD).
To demonstrate the efficacy of finger-to-spoon fading.
To provide a clinical example of syringe-to-cup fading for oral feeders with ASD.

Main Methods:

Replication of spoon-to-cup fading in a child with ASD and oral feeding.
Implementation and assessment of finger-to-spoon fading.
Clinical case illustration of syringe-to-cup fading.

Main Results:

Successful replication of spoon-to-cup fading in a child with ASD.
Demonstrated effectiveness of finger-to-spoon fading.
Provided a viable clinical example of syringe-to-cup fading for oral feeders with ASD.

Conclusions:

Escape extinction, with adapted physical guidance techniques, is effective for children with ASD and feeding difficulties.
Finger-to-spoon fading offers a novel approach for challenging feeding behaviors.
These methods expand the therapeutic toolkit for pediatric feeding interventions.