Analyzing the Ethics of Intervention for Food Refusal

¶ … Ethics of Intervention for Food Refusal

'Feeding' means ingesting food during initiation stages between an adult and a child, mostly mothers; while 'eating' means an individual ingesting food on his own. Feeding problems and issues are very common in toddlers and infants and parents often report vomiting, spitting around mealtime, and lack of gain of weight of children.. The parents also report their toddlers being very fussy about their food, which includes eating a minority of foods while rejecting most others and also eating very little at every meal. The studies show that more than half of the parents of toddlers and infants report feeding problems with special needs children being at a lot of risk, necessitating corrective, intervention plans (Kerwin, 2004).

Intervention

The Escape Extinction (EE) is put into action when the feeding problem of a child is understood to be tackled by negative reinforcement, which is a process in which the escape and avoidance of eating is not permitted any longer. Non-removal of spoon (NRS) is an example of Escape Extinction which involves putting the spoon in front of the child's mouth till he bites it. Physical guidance is another example, which includes applying a little pressure on the mandibular of the child's chin or joint to guide open his mouth (Bachmeyer, 2009).

1. My initial reaction regarding the escape strategies was quite shocking because using a negative force with children, in my opinion, would only cause the child to become more rigid in nature. However after going through the procedure and the results of the escape strategies, I found out that it was quite successful. A study pointed out that manipulating the intervention in regard to rate, quality, magnitude and response effort would affect the acceptance of food. Some researchers changed the quality of the results of liquid acceptance in three conditions in which the liquid was a preferred food of the child (i.e. positive reinforcement), non-preferred food was avoided (i.e. negative reinforcement) or presentation of a non-preferred food and preferred food. The results of the study showed that the treatment options were viable and should be further investigated in order to bring out a better treatment for children with food refusal behaviour (Bachmeyer, 2009).

2. Escape Extinction is a common intervention but it has also been linked with several side effects that include evocative responses from the child, aggression and emotional responses like crying. Treatment fidelity might be compromised when implementing EE so it might not be appropriate to follow EE in the natural environment of a child like at school or at home or even by change agents who are inexperienced that can include paraprofessionals, teachers or even parents. Several studies have shown effective results of feeding without the use of Escape Extinction. These studies state that a friendly caregiver in a community environment has reduced the avoidance of food (Bachmeyer, 2009).