Increasing Mealtime Independence With an Adaptive Puree Pouch Holder for a Child With Puree-Dependence and Vision Difficulties

The case study provides a clinical example of incorporating adaptive feeding equipment into behavioral treatment programming to increase mealtime independence for a child with puree-dependence and vision difficulties. We used an ABCA design to evaluate a treatment package that included graduated guidance, escape extinction, noncontingent reinforcement with attention and a tangible item, and differential negative reinforcement to increase independent feeding. The results demonstrated increased independent feeding from an adaptive puree pouch holder for a 3-year-old boy diagnosed with global developmental delay, pediatric feeding disorder, and a vision impairment. Independent feeding generalized to the home setting and maintained at a 12-month follow-up.