title: Comparison of upright and flipped spoon presentations to guide treatment of food refusal.
abstract: The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.
authors.affiliation: Marcus Autism Center, Atlanta, Georgia 30329, USA. william.sharp@choa.org
authors.forename: William G
authors.initials: WG
authors.lastname: Sharp
authors.forename: Ashley
authors.initials: A
authors.lastname: Odom
authors.forename: David L
authors.initials: DL
authors.lastname: Jaquess
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005108:Extinction, Psychological; D005247:Feeding Behavior / Q000523:psychology*; D019959:Feeding and Eating Disorders of Childhood / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012054:Reinforcement, Psychology