Behavioral treatment of food refusal and selectivity in developmentally disabled children

Treatment of Selective and Inadequate Food Intake in Children: A Review and Practical Guide

“…Thus, it may be possible to increase the quantity or variety of foods that children consume without having to use EE if highly preferred foods or drinks can be identified for the children. It is important to note, however, that in the study conducted by Riordan et al (1980), food refusal and inappropriate mealtime behaviors were ignored throughout treatment. Therefore, it may be important to ignore problem behavior in order to obtain treatment effects with some children (i.e., those whose problem behavior is maintained by attention).…”

“…Thus, antecedent-based procedures were used to decrease the value of escape. These procedures included simultaneous presentation of preferred and non-Study Goals Procedures Results Riordan et al (1980) Increase variety and quantity of foods consumed DRA + demand fading Contingent access to preferred foods (without EE) resulted in an increase in bite acceptance of non-preferred foods, and demand fading resulted in an increase in the total volume of oral intake Riordan et al (1984) Increase variety of foods consumed DRA Contingent access to preferred foods and ignoring disruptive mealtime behavior (without EE) resulted in increased acceptance of non-preferred foods for the participants who exhibited food selectivity Cooper et al (1999) Increase variety and quantity of foods consumed DRA with/without EE (NRS)…”

“…In the studies on DRA included in this review, preferred foods or drinks were always used as positive reinforcers, either alone or in combination with social praise (Brown, Spencer, & Swift, 2002;Cooper et al, 1999;Levin & Carr, 2001;Riordan, Iwata, Wohl, & Finney, 1980;Riordan, Iwata, Finney, Wohl, & Stanley, 1984). Thus, the effectiveness of stimuli other than preferred foods or drink remains unclear.…”

“…In Riordan et al (1980), for example, 2 children were required to accept one bite of a non-preferred food to gain access to a preferred food item and social praise at the beginning of treatment. Subsequently, the experimenters increased the number of bites required to obtain the preferred food item.…”

“…Nonetheless, these items may be critical for obtaining treatment effects, and the quantity may be reduced over time by thinning the reinforcement schedule or increasing the number of bites required for reinforcement (Riordan et al, 1980). Gradual schedule thinning also is important for maintaining treatment effects.…”