Synthesis of Applied Behavior Analytic Interventions for Packing in Pediatric Feeding Disorders.
A 2018 map shows chasers, flipped spoons, texture drops, and simultaneous presentation all beat packing, yet the field still lacks head-to-head trials.
01Research in Context
What this study did
Zhou et al. (2018) pulled every ABA study that tried to stop packing in kids with feeding disorders.
They read the papers, listed the tricks, and looked for holes in the evidence.
No new kids were fed; this was a map of what already exists.
What they found
The team found chasers, flipped spoons, texture changes, and simultaneous presentation all claimed wins.
Yet no one had stitched the studies together to see which tactic is strongest or where the gaps hide.
How this fits with other research
Single-case papers the review captured—like Griffith et al. (2012), Taylor (2022), and Whipple et al. (2020)—all report positive results with their own tiny samples.
The 2018 map shows the field keeps re-inventing small fixes instead of testing them head-to-head.
Saini et al. (2019) adds the why: escape from bites fuels most mealtime refusal, so packing fixes may flop if we skip a functional analysis first.
Why it matters
You now have a shopping list of evidence-based moves for packing, but you also know the evidence is thin.
Run a quick functional analysis, pick one reviewed tactic, collect your own data, and add your case to the next review.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Pick one tactic from the map—start with a 30 ml chaser after each bite—and graph packing across five meals.
02At a glance
03Original abstract
Packing, which consists of holding food in the mouth for an extended time during meals, is a form of disordered feeding associated with pediatric feeding disorders. The behavior can disrupt the pace and completion of a meal and lead to increased risk of choking, inadequate food and liquid intake, and elevated caregiver stress associated with mealtimes. Applied behavior analysis research has developed and evaluated behavioral interventions to improve feeding by reducing packing. This systematic review extends prior research by synthesizing characteristics of the packing intervention literature, evaluating the certainty of the evidence provided by studies, identifying potential directions for future research, and discussing the results in the context of evidence-based practice.
Behavior modification, 2018 · doi:10.1177/0145445517724541