Assessing physiological arousal and emotional valence during behavioral intervention for pediatric feeding difficulties: A pilot study

This study's purpose is to introduce a new measurement system that objectively assesses the social validity of behavioral feeding intervention from the child's perspective via the concurrent measurement of two dimensions of emotion. To date, the primary measures of social validity for behavioral feeding intervention are caregiver treatment acceptability and satisfaction surveys. This is the first study to objectively measure two dimensions of emotion, physiological arousal and emotional valence, while children received behavioral intervention for feeding difficulties. Data collectors used a new open-source data collection software, cometrics, developed to synchronize and record physiological and observational data. Physiological data was collected using a wearable biosensor and observers recorded an index of child happiness, unhappiness, or neither using definitions by Phipps et al. (2022) for six children with a pediatric feeding disorder. Two out of six children needed programmed habituation to the device before data collection. All children assented to wearing the device during data collection. Recorded indices mapped to separable physiological states using electrodermal activity and its constituent components, skin conductance responses and skin conductance level, in addition to skin temperature. Findings demonstrated the feasibility of measuring two dimensions of child emotions during behavioral feeding intervention and revealed that children's physiological responses were distinctly different during intervals scored as happy, unhappy, or neither. This new data collection system has implications for future research on the child's emotional experience of behavioral feeding treatment and increases the possibilities for improving clinical practice.