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Expanding the unit of analysis and intervention for children with developmental disabilities and food refusal behaviour Binnendyk, Lauren

Abstract

The purpose of this study was to empirically investigate an approach to behavioural feeding intervention that integrates child eating behaviour, parent-child interaction, and the activity setting of meal routines into an ecological unit of analysis. The aim of this unit of analysis is to generate necessary and sufficient knowledge for the design of effective and acceptable feeding interventions that parents can sustain across a variety of natural family meal routines in the home for a long period of time. Specifically, the present study examined the efficacy of an ecological behavioural feeding approach for: (a) improving child eating behaviour; (b) empowering parents to build a valued and successful mealtime routine; and (c) transforming coercive parent-child interactions into constructive interactions in meal routines. Three families of children with developmental disabilities and severe food refusal behaviour participated. One home-based meal routine for each family was selected for assessment and intervention. A single subject, nonconcurrent, multiple baseline design across families was employed. Direct observation data were gathered across baseline, intervention, and follow up phases. Following implementation of the ecological behavioural feeding approach, single subject research results showed improvements in child problem behaviour, consumption of new foods, and participation in valued meal routines. These improvements maintained three months post-intervention. Sequential analysis results across the three families showed improvements in parent-child interaction during meal routines. Statistically significant, four-step coercive processes were evidenced during baseline but not during intervention. The onset of intervention evidenced the emergence of statistically significant, four-step constructive processes. Social validity data indicated that the families viewed the approach as acceptable. Positive outcomes, however, were moderated by little to no improvement in overall family functioning. Results are discussed in terms of contributions to the literature, limitations and cautions, and implications for practitioners and researchers who are involved in behavioral feeding interventions.

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Attribution-NonCommercial-NoDerivatives 4.0 International

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