title: Co-occurring behavioral difficulties in children with severe feeding problems: A descriptive study.
abstract: BACKGROUND
  Recent literature highlights the association between behavioral difficulties and the presence of feeding problems in children with an Autism Spectrum Disorder (ASD) relative to children with ASD without feeding problems. However, it is not clear to what extent behavior problems (outside of the meal setting) occur in children with feeding problems without comorbid ASD.
  
  
  OBJECTIVE
  The purpose is to describe co-occurring behavioral difficulties of a sample of children with severe food refusal/selectivity and examine potential predictors of behavioral difficulties outside of the meal context.
  
  
  METHODS
  The medical charts of fifty-four patients were reviewed and data were collected on the frequency of caregiver coaching and/or behavioral intervention outside of the meal context. Age, presence of developmental delay/autism, and type of feeding problem were examined as potential predictors of behavioral support.
  
  
  RESULTS
  Approximately half of the sample received coaching or individualized intervention. The percentage of caregivers who received individualize coaching were similar across groups. Younger age at admission was a predictor of individual caregiver coaching. Presence of delay/ASD, age, and type of feeding problems were not significant predictors for individualized treatment programing.
  
  
  CONCLUSIONS
  These data provide evidence of difficult caregiver-child interactions that occurs outside of the meal context for some children with severe feeding difficulties and suggest that this association may not be exclusive to children with ASD.
authors: Department of Behavioral Psychology, Kennedy Krieger Institute and Johns Hopkins School of Medicine, 707 North Broadway, Baltimore, MD 21205, United States. Electronic address: GonzalezM@kennedykrieger.org.
authors: Melissa L
authors: ML
authors: González
authors: Department of Health and Human Services, University of Maryland Baltimore County, United States.
authors: Karin
authors: K
authors: Stern
mesh_terms: D000367:Age Factors; D000374:Aggression / Q000523:psychology; D000067877:Autism Spectrum Disorder / Q000453:epidemiology* / Q000523:psychology; D001521:Behavior Therapy / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000523:psychology; D019959:Feeding and Eating Disorders of Childhood / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents; D010349:Patient Compliance / Q000706:statistics & numerical data; D000066553:Problem Behavior / Q000523:psychology; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D016312:Treatment Refusal / Q000706:statistics & numerical data
keywords: Caregiver-child interaction; Feeding disorders; Food refusal; Problem behavior