A recent review conducted by Bryant Silbaugh, assistant professor of special education in The University of Texas at San Antonio (UTSA) Department of Interdisciplinary Learning and Teaching, revealed that behavioral interventions based on applied behavior analysis can improve feeding for children with autism.
Silbaugh, along with UTSA undergraduate, master's and doctoral students, works with children and their parents at the Silbaugh Behavior Research Group (SBRG) Feeding Lab, a part of the Autism Research Center at the UTSA Downtown Campus.
‘Kids with autism spectrum disorder (ASD) commonly reject certain vegetables, fruits and meats by spitting, gagging or throwing tantrums, and show a strong preference for foods high in carbohydrates and sugar.’
In the laboratory and during home or clinic visits in the community, Silbaugh and his team conduct behavioral assessments with children and their parents to identify feeding disorders in children with developmental disorders. The research team studies what the children eat and reject in addition to the types of foods that are included in the family's diet.
"We take an individualized approach to characterize the child's feeding problem, identify nutritious foods the family would like them to eat and address feeding and related social skills to help make mealtimes enjoyable again," said Silbaugh. "During assessment and intervention, parents are active participants so they are informed about what is going on and how to address the feeding disorder."
More research is needed to understand how these interventions work, for whom and how to disseminate best practices to educators and clinicians.
In another study recently submitted for publication in leading scientific journal, Silbaugh and his colleagues evaluated an intervention for packing in a young girl with autism and food selectivity. Packing consists of holding food in the cheeks for extended periods of time, and it disrupts the pace, onset and completion of the meal.
Their results suggested that packing can be replaced with chewing and swallowing by withholding attention for the child's difficult behavior, providing clear instructions to chew and swallow, delivering bites of preferred food when swallowing occurs and asking the child to take a small drink of water if any food remains after chewing. Silbaugh said more research is needed to determine whether the intervention would have the same benefits for other children who exhibit packing.
"In the lab, we are developing evidence-based practices to help health providers and parents address feeding challenges and to incorporate healthier foods in a child's diet," said Silbaugh.
The research Silbaugh conducts is attracting the attention of others. A behavioral analyst in Mexico, for example, who directs a clinic which provides behavioral intervention services for children with autism, has started to translate assessments used by the Silbaugh lab into Spanish. These assessments will be used make behavioral intervention available to children with autism in Mexico and help the behavior analyst promote dissemination in Mexico by collaborating to publish her clinical data.
Silbaugh is a Board Certified Behavior Analyst (BCBA) with nearly a decade of experience providing applied behavior analysis interventions for children with autism in homes, schools and other community settings. His research interests include pediatric feeding disorders, behavioral mechanisms of variability, the assessment and treatment of challenging behavior and evidence-based practices.