How does non-nutritive sucking support infant feeding?

Fifty nine premature infants participated in a randomized controlled study to determine the effectiveness of non-nutritive sucking (NNS). It was predicted that NNS would not accelerate the development of full oral feeding or early language skills as sometimes perceived in practice. However, it was predicted that using NNS as a strategy to support parents to identify and respond to early communication and oral readiness signs would increase confidence in infant management and enable quicker discharge home. Infants were aged 26–35 weeks gestation. Infants with no significant difficulties were randomly assigned to one of three groups; Group 1, NNS pre-tube feeding (n = 19); Group 2, NNS on onset of tube feeding (n = 20) and Group 3, Control (n = 20). Follow-up occurred at 6 months. There were no significant differences with number of days to full oral feeding between the groups receiving NNS and the Control group, χ²(2, n = 59) = 4.33, p = .115. A significant difference in number of days in hospital between the Control group and the other two groups was found χ² (2, n = 59) = 7.678, p = .022. Significant changes were noted with the development of more normal sucking patterns in Groups 1–3. At 6 months there were no significant differences in receptive or expressive language skills between all groups. NNS had no significant impact on the transition to full oral feeding or later language development. There was a significant difference in the number of days in hospital between the Control group and the other two groups which involved parents in identification of early communication signs. Possible reasons for this change and future directions are discussed.     

A comparison of a modified sequential oral sensory approach to an applied behavior‐analytic approach in the treatment of food selectivity in children with autism spectrum disorder

Treatments of pediatric feeding disorders based on applied behavior analysis (ABA) have the most empirical support in the research literature (Volkert & Piazza, 2012); however, professionals often recommend, and caregivers often use, treatments that have limited empirical support. In the current investigation, we compared a modified sequential oral sensory approach (M‐SOS; Benson, Parke, Gannon, & Muñoz, 2013) to an ABA approach for the treatment of the food selectivity of 6 children with autism. We randomly assigned 3 children to ABA and 3 children to M‐SOS and compared the effects of treatment in a multiple baseline design across novel, healthy target foods. We used a multielement design to assess treatment generalization. Consumption of target foods increased for children who received ABA, but not for children who received M‐SOS. We subsequently implemented ABA with the children for whom M‐SOS was not effective and observed a potential treatment generalization effect during ABA when M‐SOS preceded ABA.     

Evaluation of two physical guidance procedures in the treatment of pediatric feeding disorder

Children with pediatric feeding disorder may refuse to consume an adequate variety and/or volume of food to maintain expected growth. They can consume food but may actively or passively refuse, resulting in escape or avoidance of eating. Behavioral interventions like positive reinforcement with escape extinction can increase consumption. However, sometimes these interventions are insufficient, especially in treating passive refusal. In these cases, physical guidance may be used to prompt an open mouth to deposit food. Research indicates open-mouth prompts are effective and rated as acceptable. This study replicated an existing physical guidance procedure, the finger prompt, and compared its efficacy and acceptability with that of a spoon prompt. This study extended research by defining and measuring passive refusal as a dependent variable and assessing social validity among different stakeholders and times. Both prompts were effective in treating food refusal, and caregivers rated the finger prompt as more preferred.     

Using a chaser to decrease packing in children with feeding disorders

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During the chaser procedure, the therapist presented the chaser immediately for 2 children or 15 s after each bite presentation for 1 child. The chaser was effective in decreasing packing for all 3 children. The results are discussed in terms of the clinical importance of the findings and directions for future research.     

Immediate postsession feeding reduces operant responding in rats

Three experiments investigated the effects of immediate and delayed postsession feeding on progressive-ratio and variable-interval schedule performance in rats. During Experiments 1 and 2, immediate postsession feeding decreased the breakpoint, or largest completed ratio, under progressive-ratio schedules. Experiment 3 was conducted to extend the results of the first two experiments to responding maintained by variable-interval schedules with different session lengths (15 and 60 min). Response rates decreased in all 4 subjects when postsession feeding immediately followed a 15-min session and in 3 of 4 subjects when postsession feeding immediately followed a 60-min session. The implications of this research are twofold: (1) The functional context in which within-session reinforcers are embedded extends outside the experimental chamber, and (2) supplemental postsession feedings should be sufficiently delayed from the end of a session to avoid weakening operant behavior in the experimental sessions.     

Using negative reinforcement to increase self-feeding in a child with food selectivity

We examined the effects of a negative reinforcement-based treatment on the self-feeding of 1 child with food selectivity by type and texture. Self-feeding increased when the child could choose to either self-feed 1 bite of a target food or be fed 1 bite of the target food and 5 bites of another food. Possible mechanisms that underlie the effectiveness of the intervention and implications for future research are discussed.     

Transfer from “edible” categorization training to feeding behavior in pigeons (Columba livia)1

Abstract: We investigated a transfer from an operant experimental situation to a feeding situation in pigeons using real objects as stimuli. Four pigeons were trained in an operant box to categorize familiar edible items as positives and inedible items as negatives with a go/no‐go procedure. Next, two pairs of unfamiliar edible items were added as stimuli. One of the paired stimuli was arbitrarily assigned as positive and the other as negative. We tested the subjects in their home cages to see whether they would feed on the items they were trained to categorize as positives. In three of the six cases in which categorization training was successful, they continued to peck the positive items. This result suggests that the pigeons transfer what they learned in the operant training situation to the feeding situation.