Gover Holly C, Hanley Gregory P, Ruppel Kelsey W, Landa Robin K, Marcus Juliana
Vanderbilt Kennedy Center, Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Western New England University, Springfield, MA, USA.
Int J Dev Disabil. 2023 Feb 1;69(1):53-65. doi: 10.1080/20473869.2022.2123196. eCollection 2023.
Food selectivity affects up to 72% and 45% of individuals with and without disabilities, respectively, and there is a need for interventions that rely on positive, unrestrictive strategies. We evaluated an assessment and treatment package for food selectivity for young children with developmental disabilities that prioritized caregiver collaboration, client autonomy, and did not rely on restrictive procedures (e.g. escape extinction). The process involved: (a) collaborating with caregivers on the selection of foods and design of the children's functional analyses; (b) indirectly and directly measuring food preferences prior to treatment; (c) evaluating the sensitivity of mealtime problem behavior to environmental variables through an interview-informed synthesized contingency analysis (IISCA); and (c) incorporating the assessment results into a progressive treatment process consisting of choice-making opportunities and differential reinforcement of successive approximations to consumption. Children also had the ability to opt in and out of treatment sessions. The treatment was effective in increasing consumption of nonpreferred foods and successfully extended to caregivers. Practical implications and directions for future research are discussed.
食物选择性分别影响多达72%的残疾人和45%的非残疾人，因此需要依赖积极、非限制性策略的干预措施。我们评估了一套针对发育障碍幼儿食物选择性的评估和治疗方案，该方案优先考虑照顾者协作、服务对象自主性，且不依赖限制性程序（如逃避消退）。该过程包括：(a) 与照顾者合作选择食物并设计儿童功能分析；(b) 在治疗前间接和直接测量食物偏好；(c) 通过基于访谈的综合权变分析（IISCA）评估进餐问题行为对环境变量的敏感性；以及 (c) 将评估结果纳入由选择机会和对逐渐接近进食的连续近似行为进行差别强化组成的渐进治疗过程。儿童也有选择参与或退出治疗课程的能力。该治疗在增加对非偏好食物的摄入量方面有效，并成功扩展到照顾者。讨论了实际意义和未来研究方向。
