Response Blocking to Identify Inappropriate Self-Feeding as a Motivation or a Skill Deficit.

Abstract

Persistent inappropriate self-feeding (e.g., finger-feeding food typically consumed using a utensil after 14-24 months of age) is common for children with neurodevelopmental disorders and other delays and can result in energy and nutrient deficiencies. Although interventions for problematic feeding behavior are common, there is limited information for children without a pediatric feeding disorder who self-feed but exclusively do so inappropriately. We used a proactive approach, with a foundation in the skill-acquisition literature, to address the inappropriate self-feeding of seven children with neurodevelopmental disorders or other delays but without a feeding-related diagnosis. We first evaluated response blocking as an assessment to identify motivation and skill deficits. The assessment identified a skill deficit, a motivation deficit, and a combined deficit for four, two, and one participant, respectively. These results informed treatment for six of the seven participants. Treatment for a motivation deficit included response blocking with and without programmed differential reinforcement. Treatment for a skill deficit included backward chaining with response blocking and programmed differential reinforcement. Treatments were generally successful for all six participants. We discuss the usefulness and implications of response blocking as a brief assessment for inappropriate self-feeding.