It has been estimated that up to 90% of children diagnosed with autism can have feeding difficulties, so applying ABA techniques to treating Autism related feeding difficulties was a natural evolution for Applied Behaviour Analysis (ABA).
Autism comprises of numerous different facets, so when treating autism attention needs to be payed to all these facets. One big challenge within treating autism can be feeding disorders. This can include difficulties with eating and or drinking that negatively influence weight and nutrition. It can also include food or fluid refusal, sensitivity, possible behavioural problems occurring during mealtimes.
The goal of ABA therapists is to find out what is causing the problem behaviours during a mealtime. A functional assessment is necessary before applied behaviour analysts recommend or develop any programs. It includes determining the client’s needs and consent, environmental limits, and other contextual variables. Aversions to feeding may be due to medical or behavioural factors, or even a combination of the two. These aversions may be based on taste, texture, colour, or numerous other factors. Feeding protocols vary greatly, but all are systematic and require a strong reinforcer.
Feeding programs usually consist of identifying one target food to start with. Systematic steps will then be taken to desensitize the child to the food type, for example the child will be requiring to only touch the food and will then be reinforced. Once the child is comfortable to touch the food the child will have to pick up the food. Thereafter, the child will have to touch the food to their mouth, put the food item in their mouth, chew for a certain amount of bites, then eat the food and lastly the number of bites will be systematically increased until the child is comfortable eating the specified food.
Before starting a feeding program, it is important to rule out any medical problems such as gastro esophageal reflux, constipation, diarrhoea, food intolerances and/or allergies. Oral motor delays, dysphasia and delayed gastric emptying or motility problems can also have an influence on feeding.
Feeding therapies usually look like following:
1. It is not a magical solution, it takes time. Start with one food at a time and systematically increase as success is shown. Focus on specific caregiver training as well as generalisation for example, from the centre to the home.
2. It is always honest. Do not hide the food or dress it up as something else.
3. It can be messy. Food might be thrown around or the child’s fine motor skills might not be there yet.
4. It can also get a little loud. It is new rules being introduced and might take some time getting used to.
5. And lastly it can even be fun. It begins with a dense schedule of reinforcement, affording one to one attention. The experience of pride in achievements also adds to this high. And novel food might just become preferred foods.