Descriptive Analyses of emesis and an experimental evaluation of the effects of NCR on emesis

Principal Investigator: Carrie Borrero

Pediatric feeding disorders can result in severe consequences such as growth failure. Feeding disorders are also associated with a wide range of different types of refusal. Food refusal can include vomiting; however, interventions to target vomiting are underreported in the current feeding literature. To begin to investigate this area, the current study will summarize completed questionnaires provided to caregivers at Kennedy Krieger Institute’s feeding evaluation clinic to gather information on the prevalence of emesis in children with feeding disorders as well as current strategies being implemented in response to their child’s emesis. Subsequently descriptive analyses will be conducted. Descriptive analyses have been used to observe food refusal directly under naturally occurring conditions; therefore, within the plan of the current study is to conduct descriptive analyses of: a) emesis b) gagging and c) coughing during caregiver-fed meals and therapist-fed to gather more information on the most common caregiver responses following emesis for patients who have already discharged from an intensive program for the assessment and treatment of food refusal. Gagging and coughing will be included given that these responses are often associated with the occurrence of emesis.

Next, the use of noncontingent reinforcement (e.g., free access to a DVD) to reduce emesis is a common clinical intervention on the feeding unit, and we plan to review data from patients exposed to a reversal design to evaluate the effects of noncontingent reinforcement on frequency and grams of emesis. All sessions will have been conducted during the day and at mealtime sessions scheduled on the Pediatric Feeding Disorders Unit at Kennedy Krieger Institute in Baltimore, Maryland. The entire study will complete a retrospectives review and review existing clinical records (data and videotapes) which will be de-identified for all research analyses.