Use of Extinction and Reinforcement to Increase Food Consumption and Reduce Expulsion

Abstract

Extinction and reinforcement contingencies were used to treat 2 children with feeding disorders. Positive reinforcement and avoidance extinction effectively increased food acceptance but also increased food expulsion. Reduced expulsion and increased swallowing were achieved by repeated presentation of expelled food, a second extinction component

Functional Analysis of Inappropriate Mealtime Behaviors

“…For example, under what conditions is escape extinction effective in treatment, and do differential or noncontingent reinforcement procedures contribute to treatment effects? Several procedures have been conceptualized as escape extinction (Ahearn et al, 1996;Coe et al, 1997;Cooper et al, 1999), but it is not clear which procedures constitute escape extinction for individual children.…”

Functional Assessment and Behavioural Intervention for Eating Difficulties in Children with Autism: A study Conducted in the Natural Environment Using Parents and ABA Tutors as Therapists

“…However, if food selectivity results in the child failing to eat a sufficient variety of foods, the child will not maintain nutritional status required to grow; in these cases food selectivity may present a more serious health risk . Research on feeding problems has focused on increasing acceptance and reducing inappropriate behaviour during meal times, demonstrating that behavioural interventions are effective in increasing food consumption in children who demonstrate Functional Assessment and 7 selectivity or eat too little (e.g., Ahearn, Kerwin, Eicher, Shantz, & Swearingin, 1996;Coe et al, 1997;Patel, Piazza, Martinez, Volkert, & Santana, 2002;Riordan, Iwata, Finney, Wohl, & Stanley, 1984;Werle, Murphy, & Budd, 1993).…”

“…Coe et al, 1997;Riordan et al, 1984). Various elements of the delivery and type of positive reinforcement used to increase eating have been employed, including simultaneous or delayed reinforcement and primary or secondary reinforcement.…”

Behavioral Management of Feeding Disorders of Childhood

“…inpatient or day treatment) under the direct supervision of a psychologist. Perhaps the most commonly used form of negative reinforcement is the use of physical guidance (also called contingency contacting or chin or jaw prompting) to induce a child to accept or swallow a bite of food [41,42,43,44]. In practice, a child is offered a bite of food, if he or she refuses the food the feeder physically guides the food to the child's lips or into the child's mouth and holds the jaw until the bite is accepted and swallowed.…”

“…Also, avoidance conditioning has been effectively applied as a punishment technique to reduce a problem behavior (e.g. expelling and psychogenic vomiting) by pairing a more extreme aversive consequence such as mouthwash (to brush a child's teeth or to be dabbed on the child's lips) or re-presentation (the refeeding of expelled foods) [44]. However, careful consideration of the use of these techniques should be made with a feeding specialist prior to use as there is a relatively high risk of increasing aversion if the techniques are used improperly.…”