Further Manipulations in Response Effort or Magnitude of an Aversive Consequence to Increase Self-Feeding in Children with Feeding Disorders

An evaluation of negative reinforcement to increase self-feeding and self-drinking for children with feeding disorders

Self-feeding with utensils represents an important step in a child's progression toward age-typical eating and emerges in the absence of intervention for most children. In contrast, children with feeding disorders may lack the skill or motivation to self-feed, which impedes progress toward age-typical eating. In the current study, experimenters used a multielement design to evaluate negative reinforcement in the form of meal termination to transition six participants with a feeding disorder from caregiver-fed to self-fed bites and drinks. Caregivers conducted meals in which they fed the participant or prompted them to self-feed. During self-fed meal-termination sessions, participants had the opportunity to end the meal contingent on self-feeding the presented bite(s) or drink(s). Self-feeding increased during meal-termination sessions for all participants. The experimenters discuss these results relative to their potential to inform interventions for children with feeding disorders that progress the child toward age-typical eating.

Using Delay Fading Procedures to Increase Self-Control

Children and adolescents, relative to adults, disproportionately favor smaller, immediate outcomes over larger, delayed outcomes. From a behavioral perspective, this sensitivity toward immediate rewards constitutes impulsive choice, which characterizes numerous behavioral health problems commonly observed during childhood (particularly among individuals with neurobehavioral disabilities). Accordingly, a variety of behavioral technologies have been developed and are widely implemented in applied settings (e.g., self-monitoring programs, interdependent group contingencies, individualized token reinforcement programs) to reduce impulsive responding and promote self-control. Although there is a plethora of research literature detailing these interventions, several promising delay fading procedures may also have clinical utility in applied treatment contexts. The purpose of the present review is to highlight contemporary behavior-analytic research involving delay fading procedures that may increase self-control among children and adolescents and facilitate additional research in the area of self-control.

Evaluation of Practice Trials to Increase Self-Drinking in a Child with a Feeding Disorder

Self-drinking is an important skill for children to acquire as they transition from infancy to early childhood; however, the literature is limited (e.g., Collins, Gast, Wolery, Holcombe, & Leatherby, 1991; Peterson, Volkert, & Zeleny, 2015). We manipulated the consequences associated with self-drinking relative to those associated with being fed along the dimension of response effort. Results demonstrated that self-drinking increased when the child could either choose to self-feed one drink or be fed one drink and 5 practice trials with an empty cup.