A systematic review of functional analysis in pediatric feeding disorders

Saini et al. (2019) hunted for every published feeding functional analysis. They found 18 papers that ran 86 separate FAs with kids who had feeding disorders.

The team tallied which consequence kept each child’s food refusal or packing alive.

Escape from bites or sips topped the list. It showed up in 92 out of every 100 analyses.

Other functions appeared, but escape dominated by a mile.

Saini et al. (2024) later showed you can spot that same escape function in just 10 minutes. Their mini-FA matched the full-length results for three autistic children.

Kirkwood et al. (2021) took the next step. After escape was found, they treated four kids whose food refusal was also fueled by attention. Matching treatment to both functions worked for three of them.

Van Arsdale et al. (2024) scanned 15 recent studies and found noncontingent reinforcement is now a go-to strategy once escape is identified, though teams define it differently.

Melanson et al. (2023) place these feeding FAs inside a bigger wave. Across 1,333 FAs from 2012-2022, sessions got shorter, tangibles are tested more, and autistic kids are included far more often.

When a child hits, spits out food, or turns away, start with an escape test. If the behavior drops when you remove the spoon, you have your answer. Use that quick 10-minute screen to save clinic time, then fold in attention or tangible tests only if needed. Build treatments that give kids brief breaks for bites accepted and withhold those breaks for refusal. You will move faster from assessment to dinner-table success.