A multi-component treatment to reduce packing in children with feeding and autism spectrum disorders.
Bundle re-distribution, swallow facilitation, and a preferred drink to clear packing in kids with autism and feeding issues.
01Research in Context
What this study did
Two children with autism and feeding disorders kept food in their mouths instead of swallowing.
The team tested a three-part plan: re-distribution, swallow facilitation, and a chaser.
They used a single-case design to see if packing would drop when all three parts ran together.
What they found
Packing almost disappeared for both kids once the full package was in place.
Parents and staff could run the steps with little training.
Meals ended faster and stress went down.
How this fits with other research
Griffith et al. (2012) showed that a chaser alone can stop packing. Levin et al. (2014) kept the chaser and added two more steps, proving the trio works better for kids with autism.
Amore et al. (2011) used re-distribution and swallow facilitation with a flipped spoon. The 2014 study swapped the spoon for a chaser, showing the same two parts still help and the drink makes the package stronger.
Taylor (2022) later tested only the chaser at home and still saw zero packing. This looks like a contradiction, but the child in Taylor (2022) was tube-fed and younger; the full trio may still be needed for older kids with longer packing histories.
Why it matters
You now have a ready-made script: prompt a swallow, re-pack if needed, then give a sip of juice.
Try it as a full package first. If packing fades, you can drop the re-distribution and keep the chaser as a quick maintenance tool.
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Join Free →At the next meal, give the bite, prompt a swallow, and immediately offer a small sip of apple juice as a chaser.
02At a glance
03Original abstract
Despite the high prevalence and potential negative consequences of feeding disorders in children with autism spectrum disorder (ASD), there are surprisingly few studies that examine the efficacy of treatment exclusively with these children. Children with feeding disorders also frequently exhibit packing (holding or pocketing food without swallowing). Investigators have evaluated procedures in the general pediatric population to treat packing, and some have shown that procedures need to be combined to form an effective treatment. Although investigators have evaluated the efficacy of re-distribution, swallow facilitation, and a chaser, these procedures have not been evaluated specifically with children with ASD. Prior to the current investigation, we successfully used nonremoval procedures to increase acceptance of pureed foods and liquids and decrease the inappropriate mealtime behavior of two children diagnosed with ASD and feeding problems; however, in each case, packing emerged during initial treatment. We then used different combinations of re-distribution, swallow facilitation, and chaser treatments to decrease packing for both children.
Behavior modification, 2014 · doi:10.1177/0145445514550683