Brief Report: Decreased Bone Health in Children with Autism Spectrum Disorder and Avoidant Restrictive Food Intake Disorder.

PURPOSE: Children with autism spectrum disorder (ASD) and food selectivity are at increased risk for nutritional deficiencies which could affect bone health. METHODS: We report on four male patients with ASD and avoidant restrictive food intake disorder (ARFID) with significant bone conditions including rickets, vertebral compression fractures, osteopenia, and slipped capital femoral epiphyses. RESULTS: Each patient was at risk for at least one nutritional deficiency. Two out of four patients had deficiencies in Vitamins A, B12, E, and zinc. Calcium and Vitamin D deficiency were noted in all four. Two out of four patients with Vitamin D deficiency developed rickets. CONCLUSION: Provisional evidence suggests that children with ASD and ARFID are at elevated risk for serious adverse bone health outcomes.

A Retrospective Consecutive Controlled Case Series of Underspoon: A Modified-Bolus Placement to Address Behavior That Interfere With Swallowing.

Children diagnosed with pediatric feeding disorder (PFD) or avoidant/restrictive food intake disorder (ARFID) may present with comorbid oral-motor delays that often contribute to their failure to consume an adequate volume and/or variety of foods. Once the food enters the mouth, these children may exhibit additional problematic behavior such as expulsion and packing that further averts oral intake. Previous research has evaluated the impact of modified-bolus placement methods, including flipped spoon and NUK® brush, in comparison to upright spoon on expulsion and packing. Whether responses are due to performance or skill deficits, researchers hypothesize that modified-bolus placement may assist with reducing the response effort associated with swallowing. This retrospective consecutive controlled case series assessed the clinical application of an additional modified-bolus placement method, underspoon, to increase food consumption and decrease problematic behavior that interfere with mouth clean for children with PFD or ARFID.

Treatment of Feeding Concerns in Children With Autism Spectrum Disorder: A Systematic Review of Behavioral Interventions With Caregiver Training.

Successful feeding intervention ultimately requires generalization and adoption of treatment into the home. Treatment models, however, differ regarding how and when caregivers are integrated into care delivery process. Some treatments involve a primary model of parent training with caregivers serving as co-therapist at the onset of intervention, while others involve a complimentary model where a therapist delivers the intervention and caregiver training occurs once the child's behavior is stable. This review systematically evaluates the evidence-base regarding behavioral feeding intervention for children with autism spectrum disorder (ASD), with a specific focus on interventions involving parent training. Results provide further evidence regarding the potential benefits of behavioral intervention to improve feeding concerns in ASD, while also highlighting growing attention to documenting and/or evaluating parent training within the treatment literature. Important questions remain regarding factors guiding the use of a primary or complimentary model of parent training.

Correction to: A Demonstration of Caregiver-Implemented Functional Analysis of Inappropriate Mealtime Behavior Via Telehealth.

[This corrects the article DOI: 10.1007/s40617-021-00615-2.].

A Demonstration of Caregiver-Implemented Functional Analysis of Inappropriate Mealtime Behavior via Telehealth.

Treatment for pediatric feeding disorders is imperative, so clinicians should alter the assessment and treatment process, making it is possible for caregivers to deliver via telehealth. Clinicians must first demonstrate that caregivers can conduct initial assessments in this format. We extended the literature on functional analysis of inappropriate mealtime behavior by demonstrating that caregivers can implement functional analysis procedures via telehealth to identify maintaining variables of inappropriate mealtime behavior. Clinicians determined that escape, attention, and tangibles and escape maintained inappropriate mealtime behavior during solids and liquids meals, respectively.

Evaluating the Effects of Instructional Prompts and Strategic Incremental Rehearsal on the Letter Identification Mastery of Two Typically Developing Kindergarteners.

Letter identification impacts the developmental progression of future reading skills. In this study, we evaluated the effects of instructional prompts on letter identification in a single-subject design for 2 kindergarten students who experienced difficulties with letter identification skills. In Phase 1, we evaluated the number of letters participants correctly identified without instructional prompts, and in Phase 2, we evaluated the effects of 2 different instructional prompts and rewards. Phase 3 evaluated the combined effects of strategic incremental rehearsal (SIR) and the most effective instructional prompt identified in Phase 2. Results showed that an effective, yet different instructional prompt was identified for each participant and that SIR plus an instructional prompt was effective for further increasing both participants' correct letter identification. The results of this study demonstrated a useful and effective method for identifying instructional prompts, strategies, or other interventions that improve students' academic responding.