Sunday, April 21, 2013

Pediatric Feeding Issues

Ok, so here goes nothing.  The first blog.  No pressure!  I've said that I want to focus on the latest research when it comes to kids with special needs.  When I find an article that seems interesting and of value to me in my work, I want to be able to share it with you.  Besides, I may be using the findings of my latest research on your kids!  I'm not going to get into all of the technical jargon of the articles on these blogs, but I will post a link to the article for those of you who love looking at the graphs and getting more information like I do.

The first article that I want to share with you all has to do with eating issues.  I have worked with lots of kids who I have had to help expand the variety of foods that they will eat.  A lot of them would only eat certain foods (chicken nuggets, chips, etc.)  Those actually sound pretty good right now, but probably because I'm hungry. Focus, Lisa! 

Anyway, the name of the article is "A Comparison of Sensory Integrative and Behavioral Therapies as Treatment for Pediatric Feeding Disorders." 

It is written by: Laura R Addison, Cathleen C Piazza, Meeta R Patel, Melanie H Bachmeyer, Kristi M Rivas, Suzanne M Milnes, Jackie Oddo,
 
and can be found in: J Appl Behav Anal. 2012 Fall; 45(3): 455–471. doi: 10.1901/jaba.2012.45-455
 
Here is a link to this article:

http://www.ncbi.nlm.nih.gov/pmc/issues/215201/

Basically, the authors did a study to determine if the two kids in the study would eat more food and engage in fewer inappropriate behaviors (turning away, pushing the spoon away, spitting the food out, etc.) if the therapists gave the kids access to preferred toys and attention or if the kids did sensory integration activities right before eating.  In both instances, they determined beforehand that the kids did those icky behaviors to escape from having to eat the food or drink the drink.  So they implemented "escape extinction" which means that the therapist basically didn't let the kids get out of eating by doing those icky things.  Instead, the therapist just held the spoon at the kids lips and continued to try to have them eat the food/drink the drink.  They didn't say anything to the kids about what they were doing at the time. 

Long story/article short, they found that both kids ate more food and had fewer icky behaviors when the did the "escape extinction" thing as well as letting the kids have access to fun stuff and attention throughout the eating sessions. 

Here are some things to consider though:
  • There were only two kids in this study
  • The kids were 1 and 3
  • Both kids had other diagnoses in addition to feeding issues
So here are my questions for you.  That's right, you don't get off easy when you sign up for my blog. I want your opinions and feedback.  How else am I going to learn?  I can't depend on research articles alone!
  1. If you have a kiddo who is a picky eater, do you think it's more of a sensory thing for your kiddo, or a control thing, or both? Something else?
  2. How do you guys feel about having a therapist hold the spoon in front of your child's mouth the whole time while trying to get them to eat?  Maybe I should ask how would you feel if you were the one that was asked to do that?
  3. This kind of goes along with the last question: In some studies, if the kiddo spits the food out, the therapist will scoop it back up (as long as it wasn't on the floor or whatever) and feeds it back to the kiddo.  How do you feel about that? 
I think this article is a good article to start with.  I know it's something that many parents have to deal with, whether or not they have a kid with special needs.  As much as I've enjoyed writing this first blog, I really must go eat.  Somehow, after those last two questions though, chicken nuggets and chips don't sound quite as good.

Happy eating and feeding!