Meals Without Tears: Treating Food Selectivity and Mealtime Problem Behavior Using Caregiver Input
Selective eating can negatively impact a child’s physical development, and when combined with mealtime problem behavior, it is disruptive to a family’s life. The purpose of our set of studies is to evaluate an assessment and skill-based treatment of food selectivity without evoking problem behavior. In Study 1, we used caregiver input to populate a single stimulus preference analysis. We identified foods the child regularly eats, foods the caregiver would like the child to eat, mealtime problem behavior, and other variables possibly influencing food selectivity, such as alternative foods or activities presented during mealtimes. Based on the results of the analyses, we were able to make treatment recommendations for most participants. In Study 2, we conducted a functional analysis and found that mealtime problem behavior was maintained by escape from non-preferred foods and access to preferred foods and electronics. We used those reinforcers to teach the participants appropriate requests for alternatives, tolerance for delays to or denials of those requests, and compliance with food-related shaping steps. By the end of treatment, participants ate small meals consisting of a variety of previously non-preferred foods. Treatment was extended to relevant caregivers and environments. Throughout the process, inappropriate mealtime behavior occurred at low rates and severe problem behavior did not occur, suggesting that these procedures are indeed useful for assessing and treating food selectivity safely and effectively.