The Impact of Emerging Liquid Preference in the Treatment of Liquid Refusal

Treatment of liquid refusal in pediatric feeding disorders is essential for decreasing tube dependence, alleviating some medical conditions (e.g., constipation), and increasing caloric and nutritional intake (e.g., formulas). Although investigators have conducted edible preference assessments for solids, there are no studies to our knowledge in which investigators have evaluated liquid preference prior to and during treatment of liquid refusal. In the current study, we evaluated liquid preferences repeatedly over time during behavioral treatment for liquid refusal. Although none of the children demonstrated a preference for liquids during a paired-choice preference assessment, 2 of the 3 children showed a preference when we implemented an avoidance component. However, for all 3 children, latency to acceptance and inappropriate mealtime behavior decreased for liquids during behavioral treatment with undifferentiated responding between liquid types. Future research may evaluate the utility and correlation of liquid preference assessments preceding treatment for liquid refusal.