Abstract:
Children with tube dependency (TD) rely on external tubes to obtain the necessary nutrients to grow, develop and ultimately, survive. Despite such positive benefits of tube feeding, various studies have reported the long-term risks of tube dependency. Of the various intervention approaches, many studies have demonstrated the efficacy of behavioural interventions for helping children with TD to transition to oral feeding. However, there remain to be more studies to have conducted the intervention in the child's naturalistic setting (e.g., home) and promote caregivers as the primary behaviour change agent.
In the current study, two children with TD received two weeks of intensive behavioural intervention in their home settings. Upon initial improvement in their oral acceptance of foods, parents were supported to implement the tailored behavioural intervention to maintain the treatment gains and help their child further advance their feeding skills. One participant was attending school at the time of the study. Thus, equal emphasis was placed on training school staff to facilitate generalisation. Overall, improvements in target skills were evident from both children, consuming increasing portions of varied foods and target drinks. In turn, both children achieved marked tube feed reduction throughout the study, and one ceased tube feeding following study termination. The study highlights the efficacy of a home-based behavioural intervention for children with TD. Further discussions are made regarding the potential factors influencing the intervention's success, limitations, and implications for future research.
