Taylor Tessa, Kozlowski Alison M, Girolami Peter A
Paediatric Feeding International, Sydney, NSW, Australia.
Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA.
NeuroRehabilitation. 2017;41(2):395-402. doi: 10.3233/NRE-162071.
Feeding disorders are multifaceted with behavioral components often contributing to the development and continuation of food refusal. In these cases, behavioral interventions are effective in treating feeding problems, even when medical or oral motor components are also involved. Although behavioral interventions for feeding problems are frequently employed with children with autism, they are less commonly discussed for children with cerebral palsy.
The purpose of this study was to compare the effectiveness of using applied behavior analytic interventions to address feeding difficulties and tube dependence in children with autism and children with cerebral palsy.
Children ages 1 to 12 years who were enrolled in an intensive feeding program between 2003 and 2013, where they received individualized behavioral treatment, participated.
Behavioral treatment components were similar across groups, predominately consisting of escape extinction (e.g., nonremoval of the spoon) and differential reinforcement. For both groups, behavioral treatment was similarly effective in increasing gram consumption and in decreasing refusal and negative vocalizations. A high percentage of individualized goals were met by both groups as well as high caregiver satisfaction reported.
Behavioral interventions for food refusal are effective for children with cerebral palsy with behavioral refusal, just as they are for children with autism.
喂养障碍是多方面的，行为因素常常促使食物拒斥的产生和持续。在这些情况下，即使存在医学或口腔运动因素，行为干预对于治疗喂养问题也是有效的。虽然针对喂养问题的行为干预经常用于自闭症儿童，但对于脑瘫儿童的讨论较少。
本研究的目的是比较应用行为分析干预措施对自闭症儿童和脑瘫儿童喂养困难及管饲依赖的治疗效果。
纳入2003年至2013年间参加强化喂养项目并接受个体化行为治疗的1至12岁儿童。
各组的行为治疗组成部分相似，主要包括逃避消退（如不拿走勺子）和差别强化。对于两组而言，行为治疗在增加进食量、减少拒斥和负面发声方面同样有效。两组都有很高比例的个体化目标得以实现，且照顾者满意度也很高。
针对食物拒斥的行为干预对有行为性拒斥的脑瘫儿童有效，对自闭症儿童同样有效。
