Utilizing a Lip Closure Prompt to Increase Food Acceptance in the Treatment of Feeding Disorders

Feeding disorders can be quite complex, with medical concerns, anatomical abnormalities, skill deficits, and behavioral or environmental components contributing to the development and maintenance of significant feeding concerns. Because of this, an interdisciplinary approach to assessment and treatment is oftentimes warranted. Within the current study, a 4-year-old boy with autism spectrum disorder and oral phase dysphagia, who also met criteria for pediatric feeding disorder, presented with severe food selectivity and baby bottle dependence. Behavioral concerns as well as oral motor deficits were identified as contributing to his lack of food acceptance. While there are various behavioral treatments to increase food acceptance and decrease problem behaviors during mealtimes in children with feeding disorders (e.g., nonremoval of the spoon, alternative methods of food deposit), these treatments may not be effective for children with co-morbid oral motor deficits, or the use of such behavioral treatments may perpetuate oral motor deficits. Therefore, herein we evaluate the effectiveness of a lip closure prompt, in combination with a behavioral treatment package, at increasing food acceptance in a child with a feeding disorder who did not demonstrate lip closure on a spoon. Following this combined treatment approach, the child began accepting bites from a spoon and the lip closure prompt was faded out. The effectiveness of this combined treatment approach, as well as implications for future research and treatment in pediatric feeding disorders, is discussed.