Kirkwood Caitlin A, Piazza Cathleen C, Peterson Kathryn M
Munroe-Meyer Institute, University of Nebraska Medical Center.
J Appl Behav Anal. 2021 Jun;54(3):928-945. doi: 10.1002/jaba.825. Epub 2021 Mar 19.
Previous literature supports the use of functional analyses to prescribe treatments for children with feeding disorders (Bachmeyer et al., 2009). Nevertheless, clinicians often train caregivers to use healthy contingencies, independent of whether those contingencies are function based. However, it is unclear whether including nonfunction-based contingencies differentially affects inappropriate mealtime behavior. In the current investigation, the caregivers of 3 children with feeding disorders provided escape from bites and drinks and attention following inappropriate mealtime behavior. Results of a functional analysis showed escape from bites or drinks, but not attention, reinforced inappropriate mealtime behavior. We then tested the effects of escape extinction when the feeder either provided or withheld attention following inappropriate mealtime behavior. Inappropriate mealtime behavior decreased and acceptance increased when the feeder implemented escape extinction independent of whether they provided or withheld attention. We discuss the implications of including nonfunction-based components in the treatment of pediatric feeding disorders.
以往的文献支持使用功能分析来为患有喂养障碍的儿童制定治疗方案(巴赫迈尔等人,2009年)。然而,临床医生通常会培训照顾者使用健康的意外情况,而不管这些意外情况是否基于功能。然而,尚不清楚纳入非基于功能的意外情况是否会对不适当的用餐行为产生不同的影响。在当前的调查中,3名患有喂养障碍儿童的照顾者在不适当的用餐行为后提供了免受咬伤和饮料以及关注。功能分析的结果表明,免受咬伤或饮料的影响,而不是关注,强化了不适当的用餐行为。然后,我们测试了在不适当的用餐行为后喂食者提供或不提供关注时逃避消退的效果。当喂食者实施逃避消退时,无论他们是否提供或不提供关注,不适当的用餐行为都会减少,接受度会增加。我们讨论了在儿科喂养障碍治疗中纳入非基于功能的成分的意义。