Paediatric Feeding International, Australia.
Paperbark Solutions, University of New England, Australia.
J Adolesc. 2019 Dec;77:11-20. doi: 10.1016/j.adolescence.2019.09.007. Epub 2019 Oct 5.
Avoidant/restrictive food intake disorder (ARFID) can occur in children with typical development and persist past childhood. This significantly impacts most areas of children's lives, but may become more evident in teenage years, especially socially. There is an empirically supported treatment for ARFID with 40 years of research backing, this being behaviour-analytic feeding interventions. However, application to individuals over age 12 is lacking, and needs to be investigated for effectiveness. This is important as the addition of ARFID (formerly called feeding disorders) to the DSM-V has seen an increase in new treatments for ARFID by attempting to apply eating disorder treatments to this population including children. More research is needed to identify if already established behavioural intervention procedures are effective for ARFID in individuals with selectivity, without disabilities, older ages, and in settings outside of intensive specialised feeding hospital admissions in the United States.
A 13-year-old female with ARFID and years of failed treatment attempts participated in her home in Australia. We conducted multiple stimulus without replacement preference assessments and used a changing criterion design with multiple baseline probes. Treatment consisted of demand fading, choice, differential attention, and contingent access. We did not use cognitive or family based treatment.
Consumption increased to 100%. Variety reached 61 foods across all food groups. She met 100% of goals and ate at a restaurant. Caregivers reported high satisfaction and social acceptability. Gains were maintained at 9 months.
This brief, behaviour-analytic in-home treatment was effective in increasing food group variety consumption.
回避/限制型食物摄入障碍（ARFID）可发生于发育正常的儿童，且可延续至儿童期之后。这会显著影响儿童生活的大多数方面，但在青少年时期可能更为明显，尤其是在社交方面。有一项经过实证支持的 ARFID 治疗方法，即行为分析性喂养干预，该方法已有 40 年的研究支持。然而，该方法在 12 岁以上个体中的应用尚缺乏研究，需要对其有效性进行调查。这一点很重要，因为将 ARFID（以前称为喂养障碍）纳入 DSM-V 后，试图将饮食障碍的治疗方法应用于这一人群，包括儿童，导致针对 ARFID 的新治疗方法有所增加。需要进一步研究以确定已经建立的行为干预程序是否对选择性、无残疾、年龄较大的个体以及美国以外的强化专科住院治疗环境之外的 ARFID 有效。
一名患有 ARFID 的 13 岁女性，经过多年治疗尝试均失败，在澳大利亚的家中参与了治疗。我们进行了多次无替换刺激偏好评估，并使用变化标准设计和多个基线探针。治疗包括需求淡化、选择、差异注意和 contingent access。我们没有使用认知或家庭为基础的治疗。
摄入量增加到 100%。各种食物达到 61 种，涵盖所有食物组。她达到了 100%的目标并在餐厅用餐。照料者报告了较高的满意度和社会可接受性。9 个月时仍保持着疗效。
这种简短的、基于行为分析的家庭治疗方法在增加食物种类和摄入量方面是有效的。
