All Title Author
Keywords Abstract

The Teaspoon Method; A Simple Training Program for Feeding Disorders in High Functioning Autistic Children

DOI: 10.4236/ojped.2017.72009, PP. 59-71

Keywords: Autism, Feeding Disorders, Children, Parents

Full-Text   Cite this paper   Add to My Lib


Objective: About 90% of autistic children are known to have a selective feeding disorder. In particular, methods are lacking for stimulating self feeding and treating selective eating amongst school-aged and adolescent autistic children. We developed a simple training programme for paediatricians in a general hospital to improve the eating pattern of autistic children and decrease selectivity. Methods: The study is an experimental patient series. The instructions for the training were given in 15-minute sessions by a paediatrician with the use of social positive and negative reinforcements. The negative reinforcement was an avoidance situation. The training was performed with parental participation in the home environment of the child. Results and conclusion: In the before and after measurement, the quantitative intake of fruit, potatoes and vegetables increased significantly (p < 0.05). Food selectivity decreased, expressed by an increase in variation of consumed fruit, meat, potatoes and sandwich filling (p < 0.01). The costs of the training are low, and the children stay in their home environment.


[1]  Bandini, L.G, Anderson, S.E., Curtin, C., et al. (2010) Food Selectivity in Children with Autism Spectrum Disorders and Typically Developing Children. The Journal of Pediatrics, 157, 259-264.
[2]  Kodak, T. and Piazza, C.C. (2008) Assessment and Behavioral Treatment of Feeding and Sleeping Disorders in Children with Autism Spectrum Disorders. Child and Adolescent Psychiatric Clinics of North America, 17, 887-905, x-xi.
[3]  Schreck, K.A., Williams, K. and Smith, A.F. (2004) A Comparison of Eating Behaviors between Children with and without Autism. Journal of Autism and Developmental Disorders, 34, 433-438.
[4]  Piazza, C.C., Patel, M.R., Santana, C.M., et al. (2002) An Evaluation of Simultaneous and Sequential Presentation of Preferred and Nonpreferred Food to Treat Food Selectivity. Journal of Applied Behavior Analysis, 35, 259-270.
[5]  Valleau, J.C. and Sullivan, E.L. (2014) The Impact of Leptin on Perinatal Development and Psychopathology. Journal of Chemical Neuroanatomy, 61-62, 221-232.
[6]  Rodrigues, D.H., Rocha, N.P., Sousa, L.F., et al. (2014) Changes in Adipokine Levels in Autism Spectrum Disorders. Neuropsychobiology, 69, 6-10.
[7]  Tang, B., Piazza, C.C., Dolezal, D. and Stein, M.T. (2011) Severe Feeding Disorder and Malnutrition in 2 Children with Autism. Journal of Developmental and Behavioral Pediatrics, 32, 264-267.
[8]  Volkert, V.M. and Vaz, P.C. (2010) Recent Studies on Feeding Problems in Children with Autism. Journal of Applied Behavior Analysis, 43, 155-159.
[9]  Herndon, A.C., DiGuiseppi, C., Johnson, S.L., et al. (2009) Does Nutritional Intake Differ between Children with Autism Spectrum Disorders and Children with Typical Development? Journal of Autism and Developmental Disorders, 39, 212-222.
[10]  Manikam, R. and Perman, J.A. (2000) Pediatric Feeding Disorders. Journal of Clinical Gastroenterology, 30, 34-46.
[11]  Herguner, S., Kelesoglu, F.M., Tanidir, C. and Copur, M. (2012) Ferritin and Iron Levels in Children with Autistic Disorder. European Journal of Pediatrics, 171, 143-146.
[12]  Zimmer, M.H., Hart, L.C., Manning-Courtney, P., et al. (2012) Food Variety as a Predictor of Nutritional Status among Children with Autism. Journal of Autism and Developmental Disorders, 42, 549-556.
[13]  Anderson, S.E., Must, A., Curtin, C. and Bandini, L.G. (2012) Meals in Our Household: Reliability and Initial Validation of a Questionnaire to Assess Child Mealtime Behaviors and Family Mealtime Environments. Journal of the Academy of Nutrition and Dietetics, 112, 276-284.
[14]  Hendy, H.M., Williams, K.E., Riegel, K. and Paul, C. (2010) Parent Mealtime Actions That Mediate Associations between Children’s Fussy-Eating and Their Weight and Diet. Appetite, 54, 191-195.
[15]  Seiverling, L., Hendy, H.M. and Williams, K. (2011) The Screening Tool of Feeding Problems Applied to Children (STEP-CHILD): Psychometric Characteristics and Associations with Child and Parent Variables. Research in Developmental Disabilities, 32, 1122-1129.
[16]  Piazza, C.C., Fisher, W.W., Brown, K.A., et al. (2003) Functional Analysis of Inappropriate Mealtime Behaviors. Journal of Applied Behavior Analysis, 36, 187-204.
[17]  Najdowski, A.C., Wallace, M.D., Penrod, B., et al. (2008) Caregiver-Conducted Experimental Functional Analyses of Inappropriate Mealtime Behavior. Journal of Applied Behavior Analysis, 41, 459-465.
[18]  Vaz, P.C., Volkert, V.M. and Piazza, C.C. (2011) Using Negative Reinforcement to Increase Self-Feeding in a Child with Food Selectivity. Journal of Applied Behavior Analysis, 44, 915-920.
[19]  Dutch Nutrition Centre (2014) Age Appropriate Portions for Children.
[20]  Kearney, A.J. (2008) Understanding Applied Behavior Analysis, an Introduction to ABA for Parents, Teachers, and Other Professionals. Jessica Kingsley Publishers, London.
[21]  Bachmeyer, M.H., Piazza, C.C., Fredrick, L.D., et al. (2009) Functional Analysis and Treatment of Multiply Controlled Inappropriate Mealtime Behavior. Journal of Applied Behavior Analysis, 42, 641-658.
[22]  Seiverling, L., Williams, K., Sturmey, P. and Hart, S. (2012) Effects of Behavioral Skills Training on Parental Treatment of Children’s Food Selectivity. Journal of Applied Behavior Analysis, 45, 197-203.
[23]  Lewis, C.D., Traboulsi, E.I., Rothner, A.D. and Jeng, B.H. (2010) Xerophthalmia and Intracranial Hypertension in an Autistic Child with Vitamin A Deficiency. Journal of Pediatric Ophthalmology & Strabismus, 48, E1-E3.
[24]  McAbee, G.N., Prieto, D.M., Kirby, J., Santilli, A.M. and Setty, R. (2009) Permanent Visual Loss Due to Dietary Vitamin A Deficiency in an Autistic Adolescent. Journal of Child Neurology, 24, 1288-1289.
[25]  Tanoue, K., Matsui, K. and Takamasu, T. (2012) Fried-Potato Diet Causes Vitamin A Deficiency in an Autistic Child. Journal of Parenteral and Enteral Nutrition, 36, 753-755.
[26]  Camargo Jr., C.A., Ganmaa, D., Frazier, A.L., et al. (2012) Randomized Trial of Vitamin D Supplementation and Risk of Acute Respiratory Infection in Mongolia. Pediatrics, 130, e561-567.
[27]  Wu, A.C., Tantisira, K., Li, L., et al. (2012) Effect of Vitamin D and Inhaled Corticosteroid Treatment on Lung Function in Children. American Journal of Respiratory and Critical Care Medicine, 186, 508-513.
[28]  Pogge, E. (2010) Vitamin D and Alzheimer’s Disease: Is There a Link? The Consultant Pharmacist, 25, 440-450.
[29]  Villamor, E., Marin, C., Mora-Plazas, M. and Baylin, A. (2011) Vitamin D Deficiency and Age at Menarche: A Prospective Study. The American Journal of Clinical Nutrition, 94, 1020-1025.
[30]  Biancheri, R., Cerone, R., Schiaffino, M.C., et al. (2001) Cobalamin (Cbl) C/D Deficiency: Clinical, Neurophysiological and Neuroradiologic Findings in 14 Cases. Neuropediatrics, 32, 14-22.
[31]  Codazzi, D., Sala, F., Parini, R. and Langer, M. (2005) Coma and Respiratory Failure in a Child with Severe Vitamin B(12) Deficiency. Pediatric Critical Care Medicine, 6, 483-485.
[32]  Stabler, S.P. (2013) Clinical Practice. Vitamin B12 Deficiency. The New England Journal of Medicine, 368, 149-160.
[33]  Peirano, P.D., Algarin, C.R., Chamorro, R.A., et al. (2010) Sleep Alterations and Iron Deficiency Anemia in Infancy. Sleep Medicine, 11, 637-642.
[34]  Peirano, P., Algarin, C., Chamorro, R., et al. (2012) Iron Deficiency Anemia in Infancy Exerts Long-Term Effects on the Tibialis Anterior Motor Activity during Sleep in Childhood. Sleep Medicine, 13, 1006-1012.
[35]  Imdad, A., Mayo-Wilson, E, Herzer, K. and Bhutta, Z.A. (2017) Vitamin A Supplementation for Preventing Morbidity and Mortality in Children from 6 Months to 5 Years of Age. Cochrane Database of Systematic Reviews, No. 3, CD008524.


comments powered by Disqus

Contact Us


微信:OALib Journal