A newsletter by the ASD Network
Picky Eaters

A picky eater is a broad term covering many food issues. This is a common topic when it comes to both students on the autism spectrum and those with developmental disabilities. Their food intake is often limited on texture, taste, and familiarity. Often, these children choose crunchy items such as crackers and cereals (Knox, et. al, 2012). Many students on the spectrum have both poor nutrition and behaviors around eating. Common feeding difficulties are trouble with mechanics, sensory processing issues, gastrointestinal distress, swallowing, restricted food preference, and nutritional concerns.

When treating picky eaters, it is important to consider the ethical issues. Ethical and legal issues regarding the implementation of feeding interventions in schools may vary across training, location, and experience and consulting with a team of experienced professionals (i.e. SLP, OT, dietician, medical doctor, psychologist, BCBA, etc.) The team approach is a critical component of the treatment plan. Professionals should look at scope of practice, using multidisciplinary teams, components of IDEA, and the related services (in the school). Most treatments of eating problems have been implemented in hospitals and clinical settings, but there is research that "some students with milder forms of extreme problem behavior can receive intervention at schools and as a component of their education program" (Knox, et, al 2012).

Assessment when planning an intervention for any behavior should look at the function. Is it escape, attention, access to a tangible, or sensory? Once the cause of the behavior has been identified, intervention strategies can be developed that address  that function.
Research has shown that applied behavior analysis procedures such as antecedent interventions and escape extinction have been effective in treating feeding issues with students with autism. Escape extinction is the most restrictive and is often used when difficult behaviors -- such as expelling or "packing food," resisting food presentation and disrupting meals - occur. Escape extinction is not easily implemented, is perceived poorly, and can increase in problem behavior. Antecedent procedures are implemented before acceptance of a bite or drink or immediately after acceptance of bite or drink, to promote eating.

A webinar on this topic will review types of eating issues, ethical issues related to treating feeding issues in schools, assessment procedures, and a review of evidence based practice to help with specific issues. Click here for additional information and registration.

-Knox, M, Rue, H. C., Wildenger, L., Lamb, K., & Luiselli, J. K., (2012). Intervention for
food selectivity in a specialized school setting: Teacher implemented prompting, reinforcement, and demand fading for an adolescent student with autism. Education and Treatment of Children, 35 , 407-417.
-Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric feeding
disorders: A quantitate synthesis of treatment outcomes. Clinical Child
Psychology Review, 13 , 348-365.
-Sira, B. K. & Fryling, M. J. (2012). Using peer modeling and differential reinforcement in  the treatment of food and selectivity. Education and Treatment of Children 35, 91-100.
-Volkert, V. M. & Vaz, P. C. M. (2010). Recent studies on feeding problems in children
with autism. Journal of Applied Behavior Analysis, 43 , 155-159.

Coming up in December:

1 & 2 Intensive Teaching of Verbal Behavior for Early Learners
2nd How to Design a Comprehensive Plan for Students with Autism
5 & 6  Advanced Verbal Behavior Protocols 
9th Transition:  Preparing for the Real World 
9th  Supporting Social and Communication Functioning in Early Childhood
Errorless Learning
Kate Loving, M.Ed., BCBA

What is it? A type of learning that decreases or eliminates the opportunity for incorrect choice selection, therefore maximizing the possibility of a correct response. 

Simply put, errorless learning allows learning to occur with few or no negative stimuli. (Green, 1996; Smith, 2001; Smith, Iwata, Goh, & Shore, 1995).

Why is it important?  If students with ASD or other disabilities are allowed to error, they will likely just practice that error over and over again.
Errorless learning:
  • Minimizes the number of errors
  • Increases overall time available for instruction
  • Reduces the likelihood that errors will be repeated in future trials
  • Reduces frustration and the occurrence of inappropriate emotional behaviors by increasing opportunities for reinforcement
How to implement?
  1. Identify show the student the desired behavior.
  2. Identify prompts that will ensure success.
  3. Have the student begin to perform the response.
  4. Provide prompts to make sure the student performs the desired behavior correctly.
  5. If behavior/response is incorrect, increase prompt to make the child successful.
  6. Repeat the trial several times until the student appears to be able to demonstrate the desired behavior correctly and independently.
  7. Following a specified number of non-prompted behavior, conduct a trial to assess the student's correct or incorrect learned behavior
  8. Finish the lesson on a successful trial with appropriate reinforcement.
  9. Fade or decrease prompting as soon as indicated by data collection.
Example:  Ms. Johnson utilized errorless learning when teaching David, a 12 year old boy with Autism Spectrum Disorder (ASD), to discriminate between pictures of men's and women's bathroom signs. She first instructed David to touch the men's bathroom picture, and then provided a full prompt by taking David's hand and touching the correct picture.  She gave David a token on his token board (reinforcement) or completing the task.  

After three trials, Ms. Johnson faded the prompt by gently lifting David's hand toward the correct picture. When David successfully performed the task with a lower level of prompt, he received another token.  Gradually, Ms. Johnson faded all prompts and after several trials, David could successfully perform the task with no prompts. Reinforcement was eventually faded as this was now considered a mastered task.

Errorless Learning/Teaching. ASAT (Association for Science in Autism Treatment): http://www.asatonline.org/intervention/procedures/errorless.htm
Smith, R. G., Iwata, B. A., Goh, H., & Shore, B. A. (1995). Analysis of establishing operations for self-injury maintained by escape. Journal of Applied Behavior Analysis, 28, 515-535.
Terrace, H. S. (1963). Discrimination learning with and without "error." Journal of the Experimental Analysis of Behavior 6, 1-27.

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