Extensions of Assessment and Treatment of Food Selectivity
Extensions of Assessment and Treatment of Food Selectivity
Extensions of Assessment and Treatment of Food Selectivity
Food presentation
• Preferred/nonpreferred foods randomized and presented twice
• Place on plate with spoon/fork
• No differential reaction if the child eats the food or not
• Food removed contingent on any bid
• Instruct through language or contingencies, depending on child’s skills
Video 1
Video 2
Functional Analysis
Dad’s Attention
Escape
Snacks
Avoidance TV
Toys
Control Mom’s Attention
Functional Analysis
Purpose
o Safely demonstrate control over mealtime problem behavior
o Develop a baseline of tolerable problem behavior in the presence of food-
related establishing operations
o Identify a motivating context in which to subsequently increase
consumption during treatment
Performance-based Functional Analysis
PB in SR
Robert
1
In SR
PB in EO
In EO
0
0 4 8 2 6 0 4 8 2 6 0 4 8 2 6 0 4 8 2 6 0 4 8 2 6 0 4 8 2 6 0 4 8 2 6 0
:0 :1 :2 :4 :5 :1 :2 :3 :5 :0 :2 :3 :4 :0 :1 :3 :4 :5 :1 :2 :4 :5 :0 :2 :3 :5 :0 :1 :3 :4 :0 :1 :2 :4 :5 :1
00 00 00 00 00 01 01 01 01 02 02 02 02 03 03 03 03 03 04 04 04 04 05 05 05 05 06 06 06 06 07 07 07 07 07 08
Minutes
Video 3
Video 4
By the end of the assessment….
Corresponding consequence
delivered
Luke
Age: 6
Language Level: Age appropriate
Diagnosis: Autism; ADHD
Referred for: Food selectivity, mealtime problem behavior
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Video 5
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Swallow x 4 Functional Analysis Baseline Shaping with partial extinction
Swallow x 3
Swallow x 2
Swallow
Chew 5 s
Chew 3 s
Tongue 3 s
Tongue Full
Full SR
SR
Lips Full SR
Partial
Partial SR
SR
Smell Partial SR
Nose No
No SR+
SR+
No SR+
Hold Burrito
Burrito
Burrito
Noodle
Touch Noodle
Noodle
Lasagna
Touch (plate) Lasagna
Lasagna
Pasta
1 ft away Pasta
Pasta
2 ft away
5 ft away Luke
5 ft (covered)
IMB
SPB
Pack
Gag
Vomit
Cry
5 10 15 20 25 30 35 40 45
Trials
4 5 6 7 8
Visits
4/28 5/5 Date 5/12 5/17 5/19
Treatment components
• Choice-board
• Shaping
• Varying levels of
• Differential
differential reinforcement
reinforcement with
• Choice of food
synthesized reinforcers
• Choice of what to do with
• Choice to participate
food
• Hang-out corner
Shaping without escape extinction
What to do
with it
Nonpreferred
Food
Choice
What to do Preferred
with it Food
Nonpreferred Preferred
Food Toys
Choice
• Strip down materials and procedural components until
the child understands the contingency
What sized array can they select from?
Choice
• Strip down materials and procedural components until
the child understands the contingency
What sized array can they select from?
Pictures vs actual food items
Consider taking the time to teach choice-making
Choice
Participation
What to do Preferred
with it Food
Nonpreferred Preferred
Food Toys
Hang out Space
Treatment table
Reinforcement
space
Choice
o The Enhanced Choice Model (Rajaraman et al. 2021)
Potentially more appropriate for a controlled settled and kids
with strong communication skills
o Open-door policy
Potentially more appropriate for children with less language
Be attuned to behavior suggesting withdrawal of assent
o Full-assent based procedures
Potentially more appropriate for children with strong
communication skills and less controlled settings
Video 7 and 8
Choice
“to use that understanding to design service systems that accommodate the
vulnerabilities of trauma survivors and allow services to be delivered in a
way that will facilitate consumer participation”
“The concept of consumer participation implies not only that the person is an
active, willing participant in the therapeutic or research process, but that
their participation is critical to success.”
“Trauma-assumed care”
“…..it is both possible and probable that there are clients who
arrive at the doorstep of ABA services with a history of trauma that
will remain unknown to the service provider.”
Guiding conscience
Key Components of TIC
“to use that understanding to design service systems that accommodate the
vulnerabilities of trauma survivors and allow services to be delivered in a way
that will facilitate consumer participation”
The concept of consumer participation implies not only that the person is an
active, willing participant in the therapeutic or research process, but that
their participation is critical to success.
Assessment
Cheese
Apple
Shaping
Baseline Baseline
Sweet Potato
Cheese
Apple
Shaping
Baseline Baseline
Sweet Potato
Cheese
Apple
Shaping
Baseline Baseline
Sweet Potato
Cheese
Apple
Baseline Shaping
Sweet Potato
Cheese
Apple
Additional TIC Components
o Collaborated when he had difficulties at a given step
Ensure Safety
and Trust
Emphasize Skill
Building
Additional TIC Components
o Collaborated when he had difficulties at a given step
Emphasize Skill
Building
Thank you!
Presented by:
Holly C. Gover, PhD, BCBA-D
holly.gover@vumc.com
Initial Screening
1. Meal-building
2. Generalization to mealtimes
3. Generalization to caregivers and the home
4. Assess need to repeat treatment with new foods