Accuracy of Caregiver Report for Evaluating Treatment Effects for Pediatric Feeding Disorder: A Replication
Parents can reliably spot real feeding-treatment gains at home, matching expert observers almost every time.
01Research in Context
What this study did
Pichardo and team asked the families to track their child’s feeding at home.
Parents used simple sheets to count bites accepted and problem behavior.
Trained observers watched the same meals and scored the same things.
Then they compared the two sets of numbers across 16 treatment phases.
What they found
Parents and pros agreed on 14 to 16 of the 16 phase changes.
That is 87 to 100 percent match.
Caregiver data caught every real treatment effect that the experts saw.
How this fits with other research
Falligant et al. (2020) also ran a single-case replication, but they looked at computer aids instead of caregivers.
Both papers show that simple checks can still be trustworthy.
Exline et al. (2024) go one step further.
They showed parents can run full FCT plus schedule thinning over Zoom and keep high fidelity.
Pichardo’s work gives the green light for that parent data to count as real measurement.
Dugan et al. (1995) proved feeding treatments can work; Pichardo now shows parents can track if those treatments are working at home.
Why it matters
You can send a short data sheet home and trust the numbers you get back.
This saves hours of in-clinic meals and lets you adjust treatment faster.
Next time a parent asks, “Is it working yet?” you can say, “Show me your sheet,” and act on it.
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02At a glance
03Original abstract
ABSTRACT Interventions based on the principles of applied behavior analysis are highly effective at treating pediatric feeding disorder by increasing appropriate mealtime behaviors and decreasing inappropriate mealtime behaviors. Treatment effectiveness is usually evaluated with data collected by trained observers. Unfortunately, trained observers may not always be available or present to monitor child behavior. To address this barrier, caregivers may be able to track their child's feeding treatment progress. A recent preliminary study suggested that some caregivers' data may correspond well with trained observers and that caregivers can detect large changes in challenging behavior. In the current investigation, we replicated and extended Becraft et al. with 8 caregivers of children receiving treatment for pediatric feeding disorder. Overall, caregiver data were significantly correlated with observer data for inappropriate and appropriate behavior for seven out of eight caregivers. We also evaluated agreement between caregiver and observer data on the presence or absence of an effect (i.e., a difference between phases). Out of 16 possible phase contrasts, caregiver data agreed with observer data on whether there was a treatment effect 14 and 16 times via visual analysis for inappropriate and appropriate behavior, respectively. These preliminary data suggest that caregiver data may be used to track feeding treatment progress to determine whether there is a treatment effect with little to no formal data collection training.
Behavioral Interventions, 2026 · doi:10.1002/bin.70067