Severe feeding problems secondary to anatomical disorders: effectiveness of behavioural treatment in three school-aged children created by Jan de Moor, Robert Didden and Jules Tolboom

In the present study, behavioural treatment is described of three school-aged children with severe feeding problems caused by (surgically corrected) anatomical disorders of the digestive system. Two children showed food refusal and were tube-fed whereas the third child showed extreme food selectivity. During treatment, shaping, (non)verbal instruction, intermittent contingent attention, and a token economy were effective in eliminating feeding problems in the children. During a mean of 50 sessions of treatment conducted during a period of seven months, each child learned to consume food items orally within a normal speed range. They also learned to accept food items varying in both taste and texture. Each child's caloric needs were met as a result of total amount of food consumed. The following are discussed: (1) the results of treatment; (2) consequences of participant age for treatment choice; (3) the necessity of recording during treatment sessions; (4) the shortcomings of existing systems of classification of feeding problems.