Feeding Forward: From Fussy to Foodie

You’re not alone. You may hear that children will grow out of it, eat if hungry, are fine if they’re not underweight, or are not ready for feeding intervention. But research suggests this is not the case and, in fact, the problems can worsen over time.
Feeding difficulties are complex and people need the right help – and this support is available. It can work quickly and have rippling positive effects into other areas for the person and their loved ones.

“Collectively, caregivers rated behaviour-analytic treatments high in social validity and treatments were highly effective. Caregivers reported increased broader quality of life and lasting positive impacts, decreased stress, and lack of negative effects.”
“Accurate dissemination is needed to increase earlier access to effective feeding treatment for families and specialised training for professionals to promote data-based and individualised decision-making in this vital area.”

11 skills in just 2 weeks! Took tedious hard work, but he eventually was a little chopstick expert, even with small vitamins. Another one of my favourite/tippie-top treatment arrangements, plus important novel cultural caregiver perspectives shared including on social validity.

On multimodal social validity assessment (including direct objective recipient measures) with heaps of practical implications, and one of my most preferred/tippie top/fun treatment arrangements and data collection keys to add (h = happy) ever. Variety record 224 🥇

Reviews novel important details on the processes and outcomes involved in empirically-supported treatment for paediatric feeding disorders/ARFID/tube weaning
Jam packed with resources!
Top-Read Papers! “Interested in catching up on some of the most engaging papers from EJOBA in 2023?…

What’s most touching is seeing so many ‘firsts’ – not only during the tube weaning program, but in updates from the families after. With all the complexity and hard work that goes into it, it’s so rewarding to finally see a child…

“Our review focused on looking at the evidence across different treatment options for transitioning children from tube feeding to eating (commonly known as tube weaning).” “Behavioural treatments reported significant gains in oral consumption and improvement in mealtime behaviours but there were less reports of children being tube weaned. Behavioural studies often involved children with very complex and severe feeding difficulties, and many had DD.” “A high level of treatment intensity is needed, at least over a few weeks. This involves multiple meals per day, over consecutive days.”

New edition of the Australian Autism Handbook is finally available in print! Beyond grateful to have had the opportunity to take part in “Eating” in: “The Big Issues: Sleeping, Toilet Training, and Eating” with Dr. Sarah Leadley Taylor. Thanks a million and congrats to Benison O’Reilly and Seana Smith!
“A fully updated edition of the widely praised and most trusted Australian guide on how to raise a child with autism spectrum disorder.” “Advice from leading world experts delivers the information you can TRUST.”

Surprisingly, despite its importance and attention given in discussion currently in our field, supporting data and research are very much lacking. Data are needed in paediatric feeding to help accurately disseminate this highly important, effective, acceptable, and valued treatment, increasing access to treatment for families in need to improve their quality of life, and increasing opportunities for training/education for professionals. This is the first report to our knowledge to analyse social validity data comprehensively across variables such as participant characteristics, goals, treatment processes, treatment components, and outcomes. Ratings were high across the board (4.8 & 4.9 out of 5). Check out the results/graphs/tables! Future research could get caregiver input to design assessments, and use methods to analyse open-ended data (as in Anderson et al., 2021), in addition to the extensions to this work in Taylor & Taylor 2022b.

I was trained separately on group statistics and visual inspection of single-case experimental design, but not trained on objective supplements for visual inspection. After much searching I found this novel approach (machine learning/artificial intelligence) by Dr. Marc Lanovaz that is being used in many other fields such as medicine. This method could improve accuracy of decision making, training efficiency, and communicability/quantification of results.

“In this month’s issue, Sheila Klick, MEd, BCBA and Dr. Mary Jane Weiss, highlight the importance of carefully searching for and selecting, evidence-based treatment options when children are experiencing feeding issues. While reviewing research by Taylor & Taylor (2021), the authors describe how current recommendations may not align with current research, and how parents can beware of adverse reactions to these treatment options.” The distance between empirically-supported treatment and actual practice for paediatric feeding problems

Author perspectives: “This is the most excited I have ever been about an article. I love the colourful pictures of real food the kids actually ate to show real life and easily relatable proof of the results…In the graphs, you can still see each kid’s individual results instead of being lumped into the group and how big the change was for each kid. This was three years of my own hands-on personal direct close hard work with each kid and family in their homes, rather than a large hospital with lots of teams and supervising staff. It is an entirely different special experience, especially seeing the huge impact on the families’ lives (seeing the kids eat with their siblings and family, at restaurants, at school)…”