Social Validity of Paediatric Feeding Treatment across Goals, Processes, and Outcomes

Abstract

Social validity of treatment for paediatric feeding disorders can be defined as the extent to which caregivers find treatment goals and procedures acceptable, and the level of satisfaction with the outcomes of treatment. However, there are few studies which examine social validity data, or that evaluate social validity against key treatment variables. The aim of this report was to compare caregiver ratings of treatment acceptability and satisfaction against treatment variables. Social validity measures were obtained from the caregivers of all children consecutively admitted to a home-based behaviour-analytic treatment programme for paediatric feeding disorders (N = 32) in Australia. All children (M = 6 years, range 2–13 y) had severe feeding problems and most had mealtime skill deficits and autism and developmental delays or intellectual disabilities. Social validity measures included treatment acceptability and satisfaction surveys. In a retrospective analysis, social validity scores were compared against variables including participant characteristics and goals, treatment procedures, and treatment outcome. The retrospective analysis identified no significant correlations. In this sample, caregiver social validity ratings were very high, and data-based treatment outcomes for all children showed high levels of clinical significance including consumption, food variety, and feeding skill development. This report is the first to examine social validity in a data-based manner. With the exception of duration of treatment, no further relations were identified. Whilst the findings may be impacted by little variability/ceiling effects, this further communicates that the empirically-supported treatment for a paediatric feeding disorders is highly effective, and highly valued by caregivers of children. It is recommended that further data-based research continue to examine further measures and determinants of social validity.

Keywords:

• Avoidant/restrictive food intake disorder (ARFID)
• home treatment
• inappropriate mealtime behaviour
• paediatric feeding disorders
• social validity
• treatment acceptability

Ethical approval

This was performed in accordance with ethical standards laid out in the 1964 Declaration of Helsinki and its later amendments and the American Psychological Association (APA) ethical standards in the treatment of humans.

Informed consent

Caregivers provided written informed consent.

Disclosure statement

The author reports no conflicts of interest or funding sources. These case histories were conducted in the context of treatment evaluations for clinical cases where progress monitoring and data indicated that additional procedures were needed and is a retrospective report of existing non-identifiable data. Participant names were changed to protect confidentiality. The first author was the treatment provider.

For topics other than social validity, twenty of these cases have been previously reported in an outcomes publication (T. Taylor et al., 2021), and five in single-case experimental design publications (T. Taylor, 2018, 2020a, 2020b; T. Taylor & Haberlin, 2020; T. Taylor et al., 2019).

Notes

1 Due to response covariation, inability to expel or swallow if bite is not accepted, passive refusal/”waiting out,” restricted range on demand presentation time and session duration due to escape extinction protocol components, multiple extinction bursts due to treatment changes or variety increases, and because the reversal was primarily based on percentage consumption.