Katherine Riegel

Practice does make perfect. A longitudinal look at repeated taste exposure.

Previous research has found that 10-15 exposures to a novel food found can increase liking and consumption. This research has been, however, largely limited cross-sectional studies in which participants are offered only one or a few novel foods. The goal of the current study uses a small clinical sample to demonstrate the number of exposures required for consumption of novel foods decreases as a greater number of foods are added to the diet. Evidence that fewer exposures are needed over time may make interventions based upon repeated exposure more acceptable to parents and clinicians.

Combining repeated taste exposure and escape prevention: An intervention for the treatment of extreme food selectivity

Repeated taste exposure has been used to introduce novel foods in several settings, but none of these efforts have targeted clinical populations. This study describes an intervention that combines repeated taste exposure and escape prevention in the treatment of extreme food selectivity in two children with autism. Future applications of repeated taste exposure are discussed.

Parent mealtime actions that mediate associations between children's fussy-eating and their weight and diet

The present study evaluated parent mealtime actions that mediate associations between childrens fussy-eating and their weight and diet. Participants included 236 feeding-clinic children in three diagnostic groups: 50 with autism, 84 with other special needs, and 102 without special needs. Childrens weight was measured as body mass index percentile (BMI%), with only 26.4% of the present sample found to be underweight (BMI% less than 10). Parents reported childrens diet variety as the number of 139 common foods accepted, childrens FUSSINESS with the Child Eating Behavior Questionnaire, and their own use of four actions from the Parent Mealtime Action Scale: POSITIVE PERSUASION, INSISTENCE ON EATING, SNACK MODELING, SPECIAL MEALS. Multiple regression found that only SPECIAL MEALS explained variance in childrens BMI% and diet variety. For children without special needs, mediation analysis revealed that variance in childrens BMI% explained by FUSSINESS was accounted for entirely by the parents preparation of SPECIAL MEALS. For all diagnostic groups, mediation analyses revealed that variance in childrens diet variety explained by FUSSINESS was accounted for by the parents use of SPECIAL MEALS. We conclude that although the parents use of SPECIAL MEALS may improve BMI% in fussy-eating clinic children, it may also perpetuate their limited diet variety.

Feeding Disorder of Infancy or Early Childhood: How Often Is It Seen in Feeding Programs?

To date, there is little consensus in the literature on defining childhood feeding disorders. The definition of feeding disorder of infancy and early childhood included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM–IV–TR]) assumed the disorder is due to a nonorganic etiology. The goal of this study was to examine the prevalence of feeding disorder of infancy and early childhood as defined by the DSM–IV–TR in a sample of 234 children referred to a feeding program. The results showed only 19 of these children met the DSM–IV–TR definition. The implications of this finding are discussed.

Brief, Intensive Behavioral Treatment of Food Refusal Secondary to Emetophobia

Emetophobia, a fear of vomiting, has been reported in both adults and children but is not well documented. This study describes the treatment of an 8-year-old girl who developed emetophobia and food refusal after an acute illness. The intervention consisted of an exposure-based treatment conducted over 7 days at a feeding program. The girl was discharged consuming all of her nutrition by mouth, and her gastrostomy tube feedings were eliminated.

Implications of Avoidant/Restrictive Food Intake Disorder (ARFID) on Children with Feeding Problems

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) diagnosis, avoidant/restrictive food intake disorder (ARFID), has replaced the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of feeding disorder of infancy and early childhood. The prevalence of 3 diagnostic criteria—significant weight loss or insufficient growth, dependence on enteral feeding or oral nutritional supplements, and nutritional deficiency—was examined in a sample of 422 children referred for feeding problems. Insufficient growth was found in 19.7% of the sample. Dependence on supplements included both children who were tube fed (16.8% of the sample) and who received oral supplements (37.7% of the sample). The nutritional deficiency, defined in this study as eating 10 or fewer foods monthly, was found in 21.5% of children. For the total sample, 63% met one or more of the 3 diagnostic criteria for ARFID examined. One exclusion for the diagnosis is that the eating disturbance not be attributed to a concurrent medical condition, which, in this sample, were present in 149 children. If all of these children were excluded, 133 children or 32% of the sample would meet the criteria for the diagnosis of ARFID. Implications of the diagnostic criteria for ARFID and the 3 exclusions were discussed for children with feeding problems.