‘iey eat with others.

The kinesthetic feedback or the feeling of the food may also control the
behavior. This is often related to the texture of the food. For example. some children eat only
crunchy foods. while others avoid all foods with that kind of texture. A wide variety of selective
patterns of eating evolve.

If the function of the behavior can be determined, the behavior may be changed by eliminating its
con. sequences (extinction). desensitizing the behavior. or providing other occasions where the
function can be fulfilled or satisfied when the child exhibits the appropriate behavior. We described
an example of extinction above where attention was withheld and reserved for behaviors we hoped
to see more frequently in the future. Desensitization involves decreasing the effects of a stimulus.
For example, if a child consistently avoids foods of certain textures or tastes. the texture of his
preferred food can gradu~ ally be altered. An eating disorder may present an occasion for a powerful
reinforcer that can be used to shape new behaviors. For example. a preferred food can be withheld
and presented only when a new food is tasted or ingested. This would involve requiring the child to
take only a very small bite before being rewarded. but gradually increasing the variety and quantity
of the new food before the preferred food is made available.

Any one or a combination of the above programs can be useful to specific children. We emphasize.
however. that professional assistance is often necessary when eating concerns arise.

'

Sleep Disorders

Some degree of bedtime disruptive behavior is common in children. Compliance problems

associated with bedtime and the disruptive behaviors that accompany going to bed can often be
dealt with the same way they are treated during the rest of the day. For example. during the day. a
child may be prompted to finish a task when she exhibits disruptive behavior. That would be a good
technique to try at bedtime also. More

pronounced issues related to night waking. freque daytime sleeping. or dangerous nighttime
behavioi represent a serious predicament for families of som children with autism.

One successful method of addressing sleep prob lems has been presented by Piazza and her
colleague; (Piazza & Fisher, 1991a & 1991b; Piazza, Fisher. a Moser. 1991). Briefly, before any
intervention was introduced, an initial bedtime was established based on observations of what time
the child was reliably asleep each evening. The average time asleep was calculated and 30 minutes
were added to that time. When treatment was introduced, the child was not allowed to sleep before
the assessed bedtime and was awak. ened at a predetermined appropriate hour in the morning. The
bedtime hour was faded based on the child‘s behavior each evening. For example. if the child was
asleep within 15 minutes of being put to bed. the next evening's bedtime was set 30 minutes earlier.
if the child did not fail sleep within 15 minutes of the bedtime. the time she was sent to bed the next
night was made 30 minutes later. if the child was still not asleep within the 15-minute period, she
was kept up and awake for an hour. This was repeated as nec» essary until the child initiated sleep
within 15 minutes of being placed in bed. The bedtime hour can be adjusted to the earliest possible
time. This procedure has been effective with children exhibiting nightawak. enings and inappropriate
daytime sleep.