For this strategy, it’s important to identify a preferred food for your child. At meal time, break the non-preferred food into small, bite-sized pieces. Tell your child that he or she must eat one piece of the non-preferred food before getting a piece of the preferred food. Over time, you can gradually increase the number of bites of the non-preferred food while keeping the one bite of the preferred food. Eventually the child will be able to eat an entire meal without having to have a preferred bite until the end.

Another strategy developed by Meier, Fryling, and Wallace (2012) uses a high-probability sequence. This is appropriate for kids who consume some foods but not others. Break the non-preferred and preferred foods into small bites. At the table, give your child three bites of the preferred food, one bite at a time, 15 seconds apart. So that’s preferred food, 15s, preferred food, 15s, preferred food, 15s. After the third 15s set, place the non-preferred food in front of the child. If he or she eats it, then wait 15s and present the preferred food again starting the sequence over. Over time, you can gradually reduce number of preferred food bites one at a time until the child is just eating the non-preferred food. If, after the first non-preferred food presentation, the child refuses (pushes it away, says no, etc.) remove the non-preferred food, wait 15s and then start over.

If the above food presentation does not work over multiple sessions, then another procedure might be more appropriate. This one, created by Piazza, Patel, Gulotta, Sevin, and Layer (2003) is a procedure for total food refusal or for those that the above treatment was ineffective. In this protocol you identify a preferred toy or other activity. You present the food with the instruction, “Take a bite.” If your child accepts the food within 5s, give lots of praise and access to the preferred activity or item for 15s. Remove the toy and wait 15s more, then present another bite of food. If the child spits out the bite, he or she cannot have the toy or activity for this bite. Simply pick up the food and represent the bite by holding the food up to the child’s lips. Be sure not to provide any attention for spitting out the food (i.e., don’t say something like, “That’s not what we do with food” or “don’t do that,” etc.). Simply hold the food to the child’s lips for the duration of the session or he or she eats it, whichever happens first. If the child does not eat the food at all during the initial 5s, put the food up to his or her lips and tell him or her to “Take a bite” once every thirty seconds. This should continue until the session ends or the child takes a bite, whichever comes first.

While this is not an all inclusive list of procedures to try when a child refuses food, this is a good place to start. If none of these procedures seem to help the situation, be sure to ask your behavior assistant and Behavior Analyst for help. Hopefully these procedures will make the table a place for family get-togethers rather than a battle over eating!

References

Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. M., & Layer, S. A. (2003). On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal. The Journal of Applied Behavior Analysis, 36, 309–324.

Reed, G. K., Piazza, C. C., Patel, M. R., Layer, S. A., Bachmeyer, M. H., Bethke, S. D., & Gutshall, K. A. (2004). On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal. The Journal of Applied Behavior Analysis, 37, 27–42.

Meier, A. E., Fryling, M. J., & Wallace, M. D. (2012). Using high-probability foods to increase the acceptance of low-probability foods. The Journal of Applied Behavior Analysis, 45, 149–153.

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As a parent or guardian of a child with autism, the decision choosing the treatment option that will best benefit your child can be a challenging one.  You may rely on the advice of friends or family or turn to the Internet to seek information about your options.  During the course of your search for the best treatment option, you may discover a form of therapy known as Sensory integration therapy (SIT).  We would like to share with you what the latest research has to say about SIT, so that you can make a more informed decision about your child’s treatment.

Lang et al. (2012) conducted a systematic review of peer-reviewed, scientifically valid research articles on the topic of SIT.  Lang et al. (2012) described SIT in the following way:

Implementation of SIT typically involves some combination of the child wearing a weighted

vest, being rubbed or brushed with various instruments, riding a scooter board, swinging,

sitting on a bouncy ball, being squeezed between exercise pads or pillows, and other similar

activities” (p. 1005).

Researchers (Lang et al., 2012) found that out of 53 published articles on various aspects of SIT, only 25 could be included in the review, with the remaining articles excluded due to questionable bases for research, flawed execution of the experiments, or poor data collection. These researchers really did their homework!  Of those remaining 25 studies, only 3 suggested that SIT was an effective form of therapy, 8 found non-conclusive results, and 14 found no benefit (Lang et al., 2012).  Ultimately, the research (Lang et al., 2012) concluded that SIT is not currently supported by the evidence and that practitioners who intend to serve children with autism should not rely upon SIT as a form of treatment.  Furthermore, Lang et al. (2012) go on to suggest that, due to its scientific uncertainty, SIT should only be used in highly controlled research settings. If you have any questions about SIT or other options you have discovered in your search for effective autism therapies, feel free to contact your behavior analyst for more information on those topics or other research-based methods that may be effective in your child’s behavior program.

Reference:

Lang, R., O’Reilly, M., Healy, O., Rispoli, M., Lydon, H., Streusand, W., Davis, T., Kang, S.,

Sigafoos, J., Lancioni, G., Didden, R., & Giesbers, S. (2012). Sensory integration therapy for

autism spectrum disorders: A systematic review.  Research in Autism Spectrum Disorders, 6,

     1004-1018.

The post Sensory Integration Therapy: What Parents Need To Know appeared first on Reaching Milestones.

This was Jacob in 2009, when he became the first client in our Richmond Hill clinic.  Since that day, Jacob has made tremendous progress. BCS immediately began providing intensive therapy in Jacob’s home. His mother played a vital role in his progress, as she sought to learn as much as she could about ABA. She learned the procedures and implemented them even when a behavior analyst was not present. Working together, Jacob’s mother, the supervising behavior analyst and behavior assistant created goals for Jacob and worked to teach him the necessary skills to achieve those goals. Within the first 6 months of receiving ABA services, Jacob was able to tolerate bathing without exhibiting problem behaviors, made trips to the ocean, increased his verbal repertoire significantly and no longer required Occupational Therapy or psychotropic medication to control self-injurious behaviors and aggression.  Within 18 months Jacob no longer required Speech Therapy and demonstrated age-appropriate developmental milestones, including language and social skills.

Today, Jacob no longer requires intensive ABA therapy. He does not demonstrate any of the problem behaviors that he demonstrated just 3 short years ago. He has been placed in a mainstream classroom, without any educational supports. He not only participates on a local youth baseball team, but he excels both athletically and socially. Not to mention, he is super cute! Congratulations to Jacob and the entire Montelbano family! You have truly Reached a Milestone with BCS. Visit any of our offices including our ABA Therapy for Autism Jacksonville Fl.

The post Jacob’s Story – Effective Autism Treatment appeared first on Reaching Milestones.