Recently as an intern for RiSE Scholarship Foundation, Inc., I was able to sit down with TJ Bergman, who is a Behavior Data Analyst (BDA) at the Marcus Autism Center’s Feeding Disorders Program at the Marcus Autism Center in Atlanta, Georgia.
His position involves interacting with patients who have sensory challenges, developmental delays and other aversions to food, which can interfere with maintaining a healthy diet. Often children with learning differences experience some of these challenges and we at RiSE wanted to share his tips for treating this challenges, as well as what the Marcus Institute can provide if you are in the Atlanta area.
Thank you for taking the time to speak with RiSE, Can you explain what you do on a daily basis?
In my position as a BDA, I have a variety of duties. As a therapist, I implement behavioral protocols to address chronic food refusal in children with a multitude of developmental and medical issues. We monitor mealtime behaviors during sessions with a behavioral coding system that records the frequency and duration of those behaviors. Outside of sessions, the data recorded is analyzed, graphed, and presented at rounds where our inter-disciplinary team (oral-motor, nutrition, behavior & nursing) makes treatment decisions based on what we see.
Do you have any tips or recommendations for parents that may be in the same position as those you work with?
I urge parents that are raising a child with medical and/or developmental issues, and also have a history of chronic food refusal, to seek professional treatment. It is an issue that, at first glance, may not appear very serious. On the contrary, it is a condition which, if left untreated, can develop into a lifelong problem that can lead to a plethora of other severe medical problems. A proper diet is critical to living a healthy life. As with any medical concern, start the conversation with the pediatrician, and then intervention can start in their community with a therapist (occupational, speech or behavioral) who has special expertise with feeding problems.
What are some specific feeding techniques that you have found work best?
Although I cannot dive into the specifics of how we conduct our treatments, our program uses protocols that are targeted towards increasing appropriate mealtime behaviors and reducing inappropriate mealtime behaviors—all within the context of each child’s feeding skills and potential. For example, we focus on reinforcing appropriate behaviors such as accepting and swallowing the bite quickly, and ignoring inappropriate behaviors like crying and turning the head away from the food, and we may modify texture or food presentation based on a child’s oral motor skills.
Why would you recommend behavioral therapy over other approaches?
Chronic food refusal is often complicated by a learned behavior stemming from some impact from the environment. That impact could be a physiological issue or a phobia, among other things. The discipline of Behavior therapy that we use is Applied Behavior Analysis (ABA). ABA assesses the relationship between these targeted behaviors and the environment, and uses reinforcement to modify the behaviors. In my experience, it has shown to be most helpful for our patients. Additionally, many studies have shown that ABA is one of the most effective forms of treatment for children with autism and other developmental disorders. It is important to note, however, that feeding problems often involve challenges in multiple domains, and working with all of the professional needed is key to success.
What services can the Marcus Institute offer to those on the Autism Spectrum?
The Marcus Autism Center is a not-for-profit dedicated to diagnosing and treating children with autism and other related disorders. Marcus offers a range of clinical services. In addition to the Pediatric Feeding Disorders program that I work in, the Center has a Severe Behavior program, a School Consultation program, a Language and Learning Clinic, a Pediatric Neurodevelopment Center (psychology, psychiatry, developmental pediatrics), and an Early Intervention Educational program. Additionally, Marcus offers a wide variety of In-Home and Community Services. There is also a good deal of overlap between the clinical services and various research programs in which families may choose to obtain other assessments or interventions, or simply to contribute to the clinical science related to autism spectrum disorders.
If a person is unable to come to Marcus, what types of therapists would you recommend to help with ABA?
If proximity to Marcus is an issue, there are several other Autism Centers for children across the country. I would suggest doing some research and finding a center that is convenient for the family. Otherwise, the family could seek aid from a personal therapist, or consult the special education programs at the local public and private schools in the area.
Is there a website you could recommend to others with tips for their children?
Honestly, Marcus’s website is a lush source of information for parents raising children with developmental disorders. It provides an incredible amount of information and advice for parents, as well as providing links to many other websites for further information. I highly suggest parents visit www.marcus.org
Article by Liz Blue
Liz Blue is a graduate of University of Georgia with a B.S. in Psychology. While attending UGA, Liz worked for two years in the cognitive neuroscience lab, with a specialization in the processes of neural correlates. She is currently a cognitive trainer at Learning RX and is a contributor for RiSE Scholarship Foundation, Inc.