Evaluating Hunger Manipulation During Feeding Intervention

Inclusion Criteria: * Be between the ages of 18 months and 6 years of age; * Present with dependence on enteral feeding for at least 80% of their daily caloric needs; - Have some prior experience consuming food orally; * Demonstrate safe and functional swallowing; * Present without neuromuscular conditions who are non-ambulatory (such as cerebral palsy); * Have a body mass index in the 15th percentile, or greater; * Present with no evidence of moderate or severe malnutrition (weight for age or BMI of age z-score \< -1) or recent weight loss; * Engage in no severe problem behavior outside of mealtimes; * Have a stable sleep schedule that will not interfere with therapeutic meals throughout the day; * Caregivers must be English-speaking; * Caregivers must be present for and participate in all treatment sessions. Exclusion Criteria: * Individuals with significant active medical conditions requiring oversight from a physician; * Subjects who display severe problematic behaviors outside of the mealtime, necessitating intervention to specifically address those behaviors; - * Subjects with medical, structural, or functional limitations preventing safe oral intake of pureed foods; * Subjects with documented evidence of moderate to severe malnutrition or recent weight loss; * Individuals with avoidance/restrictive food intake disorders who are not dependent on enteral feedings for at least 80% of their daily caloric needs.