Home-Based Behavioural Intervention across Skill Domains for a Child with Tube Dependency

Figures & data

Figure 1. Mouth clean (consumption) for Maia across puree, self-feeding, and self-drinking sessions.

Note. Sessions are indicated on each x-axis, with the overall timeline of corresponding days on the bottom panel. For purees, the final three baseline sessions were conducted by the BCBA. During intervention for purees and self-drinking, * indicates that acceptance was scored for empty spoon/cup. In panel 2 (self-feeding), texture/volume advancements are noted as follows (1) 2 × 2 cm, (2) 3 × 3 cm, (3) bite-off soft regular (e.g., cheese stick, cooked carrot stick, sandwich quarters, cooked chicken), and (4) raw regular (e.g., strawberry, pear).

Figure 2. Inappropriate mealtime behaviour (IMB) for Maia across puree, self-feeding, and self-drinking sessions.

Note. Sessions are indicated on each x-axis, with the overall timeline of corresponding days on the bottom panel. For purees, the final three baseline sessions were conducted by the BCBA.

Table 1. Outline of overall timeline of treatment.

Phase	Description	Session	Day
Waitlist	Initial assessments Meal observations	n/a	0, 2, 4, 6 mo.
Intensive Phase (Day 1–8)	Baseline: Purees	1–14	1–2
	Baseline: Self-feeding	5–63	1–8
	Baseline: Self-drinking	6–53	1–8
	DRA + Volume fading: Purees (BCBA)	19–46	2–7
	Caregiver training > Implementation: Purees	47–51	7–8
Caregiver Implementation (Day 9–178)	DRA + Volume fading: Purees (continued)	52–218	9–178
	DRA + Volume fading: Self-feeding	64–208	21–178
	DRA + Volume fading: Self-drinking	88–218	49–178
Follow-up	Meal observations	n/a	1, 3, 6, 12 mo.

Figure 3. Food variety across time points. Number of foods by food group is graphed on left y-axis, with total foods graphed on right y-axis.

Figure 4. Maia’s daily oral and tube intake.

Note. BL = Baseline. Note that formula was initially provided via spoon by Maia’s caregivers. From Day 79, formula was provided only in a cup or bottle.

Table 2. Caregiver mean score (range) for each social validity theme.

Theme	Post-intervention	12-month follow-up
Oral eating as milestone	6 (6)	6.8 (6–7)
Overall process (Setting, researchers, communication)	5.8 (5–7)	6.2 (6–7)
Gradual progress	5.5 (5–7)	6 (6–7)
Cultural fit	6 (6)	6 (6)
Benefits (Eating, beyond eating, benefits outweighed any negatives)	6 (6–7)	6.4 (6–7)
Funding & availability	7 (7)	6.7 (6–7)

Table 3. Pediatric Inventory for Parents (PIP) score at pre- and post-intervention.

	Frequency		Difficulty
Domain	Pre	Post	Pre	Post
Communication	14	16	18	13
Medical care	18	15	23	11
Emotional	37	30	50	24
Role function	17	19	25	14
TOTAL	86	80	116	62