Rapid Eating in an Adolescent with IDD: Parent Coaching Via Telehealth

Individuals with intellectual and developmental disabilities have increased risk for developing challenging behavior. One particularly dangerous topography of challenging behavior is rapid eating. Rapid eating can lead to increased risk for choking and obesity as well as negatively impact social interactions during mealtimes (Anglesea et al., 2008). This study includes a 15-year-old female with autism spectrum disorder and intellectual disability who exhibited rapid eating that resulted in weight gain, choking, and occasional vomiting. An interventionist conducted assessments, created a multi-component behavior intervention plan, trained the parent, and coached the parent via telehealth. The interventionist used an A-B-A-B design to assess the effect of an intervention implemented by the parent with bug-in-ear coaching from a behavior analyst. This intervention was conducted in the family home and the parent served as the interventionist. The behavior intervention plan consisted of an auditory prompt, most-to-least prompting, and differential reinforcement of low rates of behavior. High treatment fidelity resulted in decreased bites per minute taken by the participant and increased independent appropriate eating. The participant also indicated satiation during intervention sessions more often (56%) than during baseline or withdrawal sessions (10%). Social validity was assessed pre-and post-intervention using the Treatment Acceptability Rating Form-Revised (TARF-R) and was rated highly including acceptability and contextual fit. Practitioner and future research recommendations are offered based on the findings.