Use of Component Analyses to Identify Active Variables in Treatment Packages for Children With Feeding Disorders

Abstract

We evaluated the separate components in treatment packages for food refusal of 4 young children. First, treatment packages were implemented until food acceptance improved. Next, a component analysis was conducted within a multielement or reversal design to identify the active components that facilitated food acceptance. The results indicated that escape extinction was always identified as an active variable when assessed; however, other variables, including positive reinforcement and noncontingent play, were also identified as active variables for 2 of the children. The results suggest that the component analysis was useful for identifying variables that affected food acceptance.

A Comparison of Descriptive and Functional Analyses of Inappropriate Mealtime Behavior

“…It has been shown frequently that escape is the most common reinforcer for food refusal and that the most effective treatments typically include some component to prevent the child from avoiding the food presented (Bachmeyer, 2009;Cooper et al, 1995;Piazza, Patel, Gulotta, Sevin & Layer, 2003;Williams, Field, & Seiverling, 2010). In addition, even when other reinforcers such as attention and tangibles have been identified, the necessary component to an effective intervention has been shown to be escape extinction, suggesting that any positive reinforcers identified may augment the effects of treatment but may not be solely sufficient to increase food acceptance (Patel, Piazza, Martinez, Volkert, & Santana, 2002;Reed et al, 2004).…”

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

“…A multi-component treatment package consisting of positive reinforcement and escape extinction is the most commonly used intervention for this problem (e.g., Ahearn, Kerwin, Eicher, Shantz, & Swearingin, 1996;Babbitt et al, 1994;Cooper et al, 1995;Kerwin, Ahearn, Eicher, & Burd, 1995;Piazza, Patel, Gulotta, Sevin, & Layer, 2003). The positive reinforcement component typically involves providing the child with access to preferred stimuli (e.g., food, toys, praise, tokens) for desired eating behavior (i.e., accepting or swallowing bites).…”

The Effects of Choice Between Nonpreferred Foods on the Food Consumption of Individuals with Food Selectivity

“…Specifically, NRS is a behavioral technique that involves either a therapist or guardian presenting a bite of food on a spoon close to the child's lips and keeping the spoon to the lips until the child accepts the bite (Cooper et al, 1995;Ahearn, 2002). With this procedure, if the child engages in any problem behavior such as crying, aggression, or pushing the spoon away, then the demand to eat the bite is not removed and the spoon remains in place until the bite is taken.…”

“…Although some studies have demonstrated an increase in food consumption without the use of escape extinction, many other studies have found escape extinction to be a critical component in treating feeding disorders (Cooper et al, 1995) or have found reinforcement interventions when implemented without escape extinction to be ineffective in treating problematic mealtime behavior (Patel et al, 2002;Dawson et al, 2003). Patel et al attempted to examine the differences between differential reinforcement for acceptance and differential reinforcement for mouth cleans on the food consumption of three participants with feeding disorders.…”

“…In one such study evaluating behavioral treatments on the food consumption of individuals with feeding disorders, Cooper et al (1995) implemented different multicomponent treatment packages for four children with various diagnoses and identified which components were critical in the ongoing maintenance of food acceptance by conducting a post-treatment component analysis. The packages consisted of a combination of several of the following components: a warm-up period; choice between foods; contingent attention, toys, and/or preferred edibles; noncontingent toys and attention; and/or escape extinction.…”