Noncontingent and differential reinforcement in the treatment of pediatric feeding problems.

We conducted functional analyses of the inappropriate mealtime behavior of 5 children diagnosed with feeding problems. Then, we compared the effects of differential and noncontingent reinforcement, and the relative effects of escape extinction with and without differential or noncontingent reinforcement, when escape extinction appeared necessary. Both reinforcement procedures were effective without escape extinction to treat food refusal for 1 child, but only differential reinforcement was effective without escape extinction to treat the child's liquid refusal.

A comparison of functional analysis methods of inappropriate mealtime behavior.

Investigators have evaluated two procedural variations for conducting a functional analysis of inappropriate mealtime behavior exhibited by children with feeding problems. One method involves prompting bites only in the escape condition (e.g.

A comparison of sensory integrative and behavioral therapies as treatment for pediatric feeding disorders.

We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory integration for both children. The results are discussed in terms of the challenges of evaluating sensory-integration-based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important.

Observations in psychotropic medication usage in patients with behavior disorders presenting to a specialty clinic.

In recent decades, national and international surveys have reported increased usage of psychotropic medications in children. A review of the computerized clinic records for 709 children seen in a behavioral specialty clinic from January 2001 to December 2007, inclusive, in a rural US state was completed. The number of children diagnosed with disruptive behavior disorder/behavior management issues increased over the 7-year period, but this was balanced by an increased number of referrals.

Functional analysis and treatment of multiply controlled inappropriate mealtime behavior.

Functional analyses identified children whose inappropriate mealtime behavior was maintained by escape and adult attention. Function-based extinction procedures were tested individually and in combination. Attention extinction alone did not result in decreases in inappropriate mealtime behavior or a significant increase in acceptance.

Spoon distance fading with and without escape extinction as treatment for food refusal.

Little is known about the characteristics of meals that serve as motivating operations (MOs) for escape behavior. In the current investigation, we showed that the distance at which a therapist held a spoon from a child's lips served as an MO for escape behavior. Based on these results, we implemented spoon distance fading, compared fading with and without escape extinction (EE), and compared fading plus EE to EE alone.

Treatment of selective and inadequate food intake in children: a review and practical guide.

Treatment of highly selective or low overall eating by children may prevent the development of more complicated feeding difficulties, which can result in compromised health status and developmental concerns as well as the need for more intensive interventions. Caregiver-friendly intervention strategies that can be implemented with children in their community environments (e.g.

An evaluation of a high-probability instructional sequence to increase acceptance of food and decrease inappropriate behavior in children with pediatric feeding disorders.

We evaluated the effects of escape extinction with and without a high-probability (high-p) instructional sequence on food acceptance and inappropriate behavior for children diagnosed with feeding problems. The high-p sequence consisted of three presentations of a response that was similar topographically (i.e.

On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal.

In the current investigation, we evaluated the relative effects of noncontingent reinforcement (NCR), escape extinction, and a combination of NCR and escape extinction as treatment for the feeding problems exhibited by 4 children. For each participant, consumption increased only when escape extinction was implemented, independent of whether NCR was present or absent. These results were consistent with prior research suggesting that positive reinforcement alone is insufficient for increasing consumption, and that escape extinction often is necessary to increase and maintain food acceptance.