Chapter 8
This chapter reviews some of the basic issues that relate to feeding problems, such as medical conditions and social factors. In addition, fundamental behavioral strategies for providing support to young children with feeding difficulties are described. More advanced strategies are also described, but these techniques require extensive training beyond the scope of this chapter and intense supervision and oversight from an appropriately trained professional. Feeding issues can lead to serious health problems, and the techniques described in this chapter are intended to provide an overview of how parents and educators can promote healthy feeding behaviors, so medical professionals should always be referred to in the case of feeding issues.
- Describe how family eating patterns can have a beneficial and/or detrimental effect on the eating behaviors of children.
- Discuss some potential causes of feeding problems in young children.
- Describe in detail two possible procedures that might be used to address a feeding problem.
- Cleft lip
Involves a separation of the upper lip. - Cleft palate
Involves a separation of the roof the mouth. - Hypotonia
Lack of muscle tone. - Tongue thrust
Involves pushing the tongue forward. - Cerebral palsy
This deals with the impairment of motor movements that are the result of neurological dysfunction. There are four types, which include dyskinetic, spastic, ataxic, and mixed. - Prader–Willi syndrome
This is associated with difficulties controlling appetite. In very young children, there is usually hypotonia that results in feeding difficulties. - Autism spectrum disorder
This is characterized by impairments in communication, socialization, and restrictive or repetitive patterns of behavior. - Down syndrome
This results from chromosomal abnormalities and can be associated with hypotonia, dental problems and obesity.
www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm
www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/
Addison, L. R., Piazza, C. C., Patel, M. R., Bachmeyer, M. H., Rivas, K. M., et al. (2012). A comparison of sensory integrative and behavioral therapies as treatment for pediatric feeding disorders. Journal of Applied Behavior Analysis, 45, 455–471. DOI: 10.1901/jaba.2012.45-455.
Berlin, K. S., Hobart-Davies, W., Silverman, A. H., Woods, D. W., Fischer, E. A., & Rudolph, C. D. (2010). Assessing children’s mealtime problems with the Mealtime Behavior Questionnaire. Children’s Health Care, 39, 142–156.
Bernard-Bonnin, A.-C. (2006). Feeding problems of infants and toddlers. Canadian Family Physician, 52(10), 1247–1251.
This chapter focused on the issues related to feeding disorders. Several anatomical and physiological conditions that influence feeding were discussed. Some of these include hypotonia, tongue thrust, and facial abnormalities. Several disabilities that are associated with feeding problems were described, including cerebral palsy, Prader–Willi syndrome, autism spectrum disorder, Down syndrome, and attention deficit hyperactivity disorder. The environmental issues that can influence feeding problems include lack of opportunities to practice, characteristics of food such as texture, color, consistency, etc., limitations on variety of food, pica, and family eating practices. Assessment is an important part of developing an appropriate intervention for a feeding problem, and assessment results can lead directly to specific interventions. The interventions for feeding problems may be presented as comprehensive packages to impact daily routines or as more specific interventions that focus on reinforcement, escape extinction, pairing or blending foods, and behavior momentum techniques.