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Case Study 3 : Overcoming Food Refusal in a 1-Year-Old

Intensive treatment took 1-year-old from 0% of bites (baseline) to accepting 100% of bites; successfully incorporated 22 new foods into his diet

Christopher, a neurotypical one-year-old, presented with several challenges. He nursed infrequently, relying primarily on formula fortified breast milk for calories.

At six months, Christopher displayed strong food aversion behaviors, including gagging and
refusal to consume purees. His parents resorted to unconventional feeding methods, such as squirting pouches into his throat, as he progressively lost weight.

His treatment goals focused on reducing food aversion, broadening his diet with increased portion sizes and variety, and transitioning him to regular-texture foods, ultimately aiming to
enhance his nutrition and promote healthy growth.

To address this multifaceted challenge, a comprehensive solution was implemented.
Christopher was enrolled in a specialized feeding intensive program that aimed to address his unique needs. All treatment sessions were conducted effectively and remotely through Telehealth, ensuring continuity of care.

The treatment plan encompassed various strategies, including the application of Differential
Reinforcement of Alternative Behaviors (DRA) and Escape Extinction (EE) protocols. Pre-intensive sessions were meticulously designed to gradually build Christopher’s acceptance of dry spoons.

Moreover, recognizing the crucial role of parental involvement, his parents were actively engaged and received training on both feeding disorders and behavior analytic principles.

At the outset of the treatment journey, Christopher’s condition was challenging. He displayed an alarming trend, accepting 0% of the food offered during baseline sessions, signaling the severity of his food refusal behaviors. However, as the intensive treatment program progressed, remarkable improvements emerged.

Christopher showed consistent progress, ultimately accepting 100% of the food presented to him. Moreover, the treatment effectively broadened his dietary horizons by introducing and
incorporating 22 new foods into his previously limited diet, providing him with a more varied and nutritious diet.

The introduction of regular texture foods, while challenging, led to the identification of an underlying issue—a tongue tie. Acknowledging this discovery, Christopher was promptly referred to a speech therapist who specialized in enhancing his oral motor skills and overall feeding experience.