Treatment for Younger Siblings of Participants in a Home-Based Intensive Paediatric Feeding Programme in Australia

Abstract Early childhood feeding problems can be challenging. Children who limit their food consumption may significantly impact multiple critical areas of development. Effective treatment should be accessed as early as possible but has been limited to a handful of US hospital programmes. Feeding problems affect both children with and without disability, and families may struggle with multiple children having feeding difficulties. We provided short-term (less than 2 weeks), in-home, intensive, behaviour-analytic feeding intervention to two children with typical development who were younger siblings of children already in the programme. We used a withdrawal/reversal design to assess the effects of nonremoval of the spoon, re-presentation, contingent and noncontingent access to tangibles, differential attention, and response cost. This multi-component intervention was effective in increasing the consumption of a wide variety of foods at regular texture and self-feeding for both participants. Variety was increased to over 60 foods from all food groups. Admission goals were met (100%). We trained caregivers to high procedural integrity and generalised the protocol. We provided actual plate picture examples of family meals consumed where the brothers and parents ate the same meal. Caregiver satisfaction and social acceptability were high. Gains were maintained at 3-year follow-up where parents reported problems were fully resolved.