Teaching behavior analysts in an early intensive behavioral intervention setting to conduct a structured mealtime protocol

Abstract

Children with autism spectrum disorder often display feeding problems, such as consumption of a limited variety of foods. It is also common for these children to be enrolled in early intensive behavioral intervention (EIBI) services for comprehensive treatment. Combined, these factors make it possible that behavior analysts will have a role in a child's clinical care related to feeding. However, given that the etiology of pediatric feeding disorders is complex and multifactorial, clinicians should ensure they have sufficient training and a setting that is appropriate for assessment and treatment. Therefore, we evaluated the effects of behavioral skills training in an EIBI setting to conduct a structured mealtime protocol. Training resulted in increases in procedural integrity, and we replicated these effects for all participants.

An evaluation of training components necessary to teach staff members to conduct an intensive pediatric feeding intervention

“…Another difference between Ibañez et al (2023) and the current study is the type of feeding protocol trained.…”

“…The three remaining participants required in vivo feedback and modeling to increase correct steps to clinically significant levels (i.e., three consecutive sessions of steps implemented correctly at or above 85%). Ibañez et al (2023) utilized BST to train caregivers to implement a structured meal protocol. These researchers combined training components into a single BST package, including WI, modeling, and rehearsal plus feedback.…”

“…That is, despite the existence of a number of studies on training parents or other caregivers to implement feeding protocols, only a single study has examined various training modalities to train staff members to implement an intensive feeding protocol in a pediatric feeding clinic. Although Ibañez et al (2023) showed that BST was effective to train behavior analytic staff to implement a feeding protocol, training methods which require fewer resources have not yet been evaluated in isolation and may be equally effective. That is, BST is a multi-step procedure; exposure to instructions alone, without modeling and role-play, may be sufficient for at least some staff members to acquire the skills needed to implement a feeding protocol.…”

“…However, very little research exists on training staff to implement pediatric feeding procedures. In fact, only one study (Ibañez et al., 2023) on this topic has been published to date. That is, despite the existence of a number of studies on training parents or other caregivers to implement feeding protocols, only a single study has examined various training modalities to train staff members to implement an intensive feeding protocol in a pediatric feeding clinic.…”

“…Ibañez et al (2023) evaluated the effects of behavioral skills training (BST) on participant (1) bite presentation, (2) provision of differential consequences based on client bite acceptance, and (3) provision of differential consequences based on client post-acceptance behavior. BST consisted of: (a) written instructions (WI), (b) modeling, and (c) rehearsal plus feedback.…”