Behavioral Feeding Techniques

Major focus area

Feeding Therapy -> Swallowing

Short description

Behavioral feeding techniques are used by the SLP for the treatment of insufficient food and liquid intake. Behavioral feeding techniques can include but are not limited to food chaining, reinforcements, skill acquisition techniques (Swigert, 1998; Lazarus, et al., 1986; Lazarus & Logemann, 1987; Logemann, et al., 1989; Lazarus, et al., 1993).

Long description

Behavioral feeding techniques are used by the SLP for the treatment of insufficient food and liquid intake. Behavioral feeding techniques can include but are not limited to food chaining, reinforcements, skill acquisition techniques.

1. Food chaining is a method for teach sequential skills for eating and drinking. Backward chaining involves reinforcing links in the chain, beginning at the back end of the chain and working toward the beginning. This done so that in the initial stages of training, the final step is preformed and a conditioned reinforcer is delivered. The SLP then requires more and more steps to be performed. Forward chaining involves teaching the first step with conditioned reinforcement following that first link. The SLP guides the patient through the remaining not-yet-learned steps in the task.

2. Reinforcements can be positive or negative. Positive reinforcement involves adding something to the patient’s environment that was not present before. Patient takes a bite of food a consequence added so that the patient is more likely to open his mouth for more food. Negative reinforcement gets a patient out of a negative situation. It involves taking away something that is negative for the patient that leads to the avoidance or an escape from a situation or stimulus. Patient takes a bite and then is allowed to leave the table after taking a bite which is a negative reinforcement. Because the patient was reinforced she is more likely to eat the predetermined amount of food again the next time.

3. Skill acquisition techniques are designed to help patients learn specific behaviors needed to be successful eaters which they have not learned due to lack of experience (patient who has been NPO). They include prompting, modeling, and shaping a behavior.

(Swigert, 1998; Lazarus, et al., 1986; Lazarus & Logemann, 1987; Logemann, et al., 1989; Lazarus, et al., 1993).

Reference links

  • An Overview Of Assessment And Management Of Dysphagia Within The Pediatric Population 0
    opensiuc.lib.siu.edu     Author: Erica C. Yording - It is estimated that adults swallow up to 2,400 times per day, while children are estimated to swallow between 600 and 1,000 times a day (Arvedson & Brodsky, 2002). During the span of a lifetime, swallowing difficulties may arise as a result of numerous etiologies. Dysphagia may result from neurological, genetic, or structural etiologies (e.g., apraxia, cerebral palsy, Down syndrome, cleft palate, autism spectrum disorder) (Sheppard, 2008). Thus, when these challenges occur, limitations, pain, and frustration may be some of the common feelings that affected individuals and their family experience.
  • Recovery of Postoperative Swallowing In Patients Undergoing Partial Laryngectomy 0
    onlinelibrary.wiley.com     Author: Dr. Alfred W. Rademaker PhD, Dr. Jerl A. Logemann PhD, Dr. Barbara Roa Pauloski PhD, Dr. Julia B. Bowman MA, Dr. Cathy L. Lazarus MA, Et Al - This study assessed the achievement of postoperative swallowing in patients undergoing partial laryngectomy surgery. Oropharyngeal swallow efficiency was used to predict time to achievement of outcome. Fifty-five patients were followed for up to 1 year in two hemilaryngectomy and four supraglottic laryngectomy groups. Within 10 days of healing, a videofluoroscopic evaluation enabled the measurement of swallowing efficiency. Times to achievement of oral intake, removal of feeding tube, preoperative diet, and normal swallow were analyzed using actuarial curves. Patients with hemilaryngectomies achieved swallowing rehabilitation sooner than patients with nonextended supraglottic laryngectomies (p < .05) who, in turn, achieved swallowing function sooner than did patients undergoing supraglottic laryngectomies with tongue base resection (p < .05). Median time to attainment of preoperative diet in these three groups was 28 days, 91 days, and > 335 days, respectively. Higher early postoperative oropharyngeal swallow efficiency was related to earlier achievement of oral food intake and of preoperative diet (p < .05). Results show that the time course for swallowing rehabilitation covers an extended postoperative period. In some surgical groups, functional swallowing and eating may be achieved within 3 months of surgery while for other types, significant impairment remains up to 9 months postoperatively. Early radiographic assessments of swallowing function are useful in predicting the time to swallow recovery. Recovery of swallowing ability may be delayed in patients who have not achieved oral intake before radiotherapy is started.