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Comparative Study
. 2012 Spring;45(1):83-96.
doi: 10.1901/jaba.2012.45-83.

Comparison of upright and flipped spoon presentations to guide treatment of food refusal

William G Sharp  1 , Ashley Odom, David L Jaquess
Affiliations
Comparative Study

Comparison of upright and flipped spoon presentations to guide treatment of food refusal

William G Sharp et al. J Appl Behav Anal. 2012 Spring.

Abstract

The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.

Keywords: alternating treatments; antecedent manipulation; bite presentation; escape extinction; expulsions; flipped spoon; oral-motor deficits; pediatric feeding disorders.

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Figures

Figure 1
Figure 1
Percentage of trials with mouth clean (top) and mean number of expulsions per bite (bottom) for Joshua. The first flipped phase presents the averages for each bite volume, summarizing a total of 230 sessions (2 cc: 77 sessions; 4 cc: 84 sessions; 5.4 cc: 69 sessions). PA  =  presentation assessment.
Figure 2
Figure 2
Percentage of trials with mouth clean (top) and mean number of expulsions per bite (bottom) for Jimmy. The first flipped phase presents the averages for each bite volume, summarizing a total of 156 sessions (2 cc: 28 sessions; 4 cc: 8 sessions; 5.4 cc: 120 sessions). The second upright phase presents the average of forty sessions per point, summarizing a total of 200 bite presentations. PA  =  presentation assessment.
Figure 3
Figure 3
Percentage of trials with mouth clean (top) and mean number of expulsions per bite (bottom) for Greg. The first flipped phase presents the averages for each bite volume, summarizing a total of 103 sessions (2 cc: 15 sessions; 5.4 cc: 88 sessions). PA  =  presentation assessment.
See this image and copyright information in PMC

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