Physical guidance procedures can be effective in the treatment of severe pediatric food refusal. Researchers evaluating the use of physical guidance procedures often include a procedure referred to as a jaw prompt, but other variations of physical guidance may also be effective. An additional form of physical guidance, the finger prompt, might increase food acceptance. We evaluated nonremoval of the spoon and physical guidance (jaw prompt or finger prompt) in a reversal design. Results showed treatment packages including both procedures were effective in increasing food acceptance and decreasing inappropriate mealtime behavior.Trained observers recorded all responses on laptop computers. The primary dependent variables were latency to bite acceptance and IMB. All variables were measured only 263 Two physical guidance procedures
Research has shown that nonremoval of the spoon and physical guidance procedures can be effective in treating active food refusal (e.g., head turning and spoon pushing) and increasing food consumption. These procedures alone may not be effective in treating more passive food refusal (e.g., sitting still without opening mouth). We defined and evaluated the use of a side deposit procedure using a reversal design. Results showed that this procedure, when added to a treatment package including other components (e.g., nonremoval of the spoon and physical guidance), was effective in increasing food consumption and treating passive food refusal.
We conducted descriptive observations of 5 individuals with developmental disabilities and severe problem behavior while they interacted with their caregivers in either simulated environments (an inpatient hospital facility) or in their homes. The focus of the study was on caregiver reprimands and child problem behavior. Thus, we compared the frequency of problem behavior that immediately preceded a caregiver reprimand to that immediately following a caregiver reprimand, and the results showed that the frequency of problem behavior decreased following a reprimand. It is possible that caregiver reprimands are negatively reinforced by the momentary attenuation of problem behavior, and the implications for long- and short-term effects on caregiver behavior are discussed.
Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food refusal to determine if the consequences commonly delivered during functional analyses were observed during parent-conducted meals. The conditional probabilities for the delivery of attention, tangible items, and escape following food refusal and acceptance were compared to the unconditional probabilities of each event. Results showed that attention and escape most frequently followed refusal and differed depending on the topography of refusal. Implications for further evaluations of food refusal using similar methods are discussed.
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