Marta didn’t eat very many foods, which is how I came to know her. She liked goldfish, but they had to be plain yellow goldfish otherwise she wouldn’t touch them. Marta would eat some fruits, but no vegetables. She used to eat pasta and French fries, but now she wouldn’t touch them. Marta’s refusal also made taking medication very challenging. One behavior was really common when it came to non-preferred food items. Marta would vomit, often times before the food even entered her mouth.
Marta began working with a Behavior Analyst in the Healthy Beginnings program to assess her refusal at mealtime. Parents were included in an effort to teach them the strategies to employ at home. A consultation with a speech and language pathologist didn’t identify any abnormalities. Therefore, we were able to conclude that motivation was key to this feeding problem, but finding the right motivation wasn’t easy.
It became apparent that Marta’s vomiting was an effective escape tactic, despite our efforts to increase her acceptance of new foods. At times, it appeared almost effortless for Marta to vomit upon taking a bite of a novel food. After half a dozen appointments, we found something that she liked: the big yellow playroom at the Verbal Beginnings Center and she really wanted to show it to her mom. Thus, the promise was made that if she took all of her bites, she could bring her mom to the playroom. Marta seemed unsure at first, but she tried a bite of unfamiliar food. She then threw up the food but wanted to try again. Success! We capitalized on this achievement and offered Marta five minutes of time in the yellow playroom before she had to take the next bite. In doing so, Marta found even more things that she liked in the playroom and when it was time for her to take her next bite, she was ready. Marta took her next bite and didn’t vomit. With this, we were able to build momentum for introducing new foods. And while some foods still resulted in vomiting, Marta continued to be motivated. She had a reason to try foods that she previously had been afraid of.
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Written by Ben Sarcia, MA, BCBA, LBA
