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Updated: Aug 29, 2026

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Training parents to implement pediatric feeding protocols
Michael M Mueller1, Cathleen C Piazza, James W Moore
1Marcus and Kennedy Krieger Institutes, Atlanta, Georgia 30329, USA.
Insights
Parent training packages effectively improved treatment integrity for pediatric feeding protocols. These methods demonstrated durable results for up to 3 months, aiding clinical practice application.
Area of Science:
- Behavioral psychology
- Pediatric feeding disorders
- Clinical intervention research
Background:
- Treatment integrity is crucial for the effectiveness of pediatric feeding protocols.
- Parental implementation of these protocols can be challenging.
- Standardized training methods are needed to ensure fidelity.
Purpose of the Study:
- To evaluate multicomponent training packages for parents implementing pediatric feeding protocols.
- To assess the effectiveness of different training components on treatment integrity.
- To determine the durability of treatment integrity post-training.
Main Methods:
- Study 1: 3 parents received training including written protocols, verbal instructions, therapist modeling, and rehearsal.
- Study 2: 6 parents received training with varying combinations of written protocols, verbal instructions, modeling, and rehearsal.
- Follow-up assessments were conducted in clinic and home settings for up to 3 months.
Main Results:
- The training package in Study 1 significantly increased treatment integrity.
- All training packages in Study 2 resulted in very high treatment integrity.
- Follow-up data indicated durable treatment integrity for up to 3 months in 5 participants.
Conclusions:
- Multicomponent parent training packages are effective in enhancing treatment integrity for pediatric feeding protocols.
- These findings support the transfer of research into clinical practice by providing viable training methods.
- High treatment integrity was achieved and maintained, suggesting the potential for improved child outcomes.
Abstract:
Four different multicomponent training packages were evaluated to increase the treatment integrity of parents implementing pediatric feeding protocols. In Study 1 we exposed 3 parents to a training package that consisted of written protocols (baseline), verbal instructions, therapist modeling, and rehearsal training. Results suggested that the package was successful in increasing treatment integrity of the feeding protocols to high levels. Study 2 investigated three different parent-training packages comprised of components used in Study 1. Two parents were exposed to written protocols, verbal instructions, and modeling; 2 parents were exposed to written protocols, verbal instructions, and rehearsal; and 2 parents were exposed to written protocols and verbal instructions. Results of Study 2 showed that each parent-training package produced very high treatment integrity. Follow-up data in the clinic and home for 5 participants suggested that the results were durable for up to 3 months. These results demonstrate a first step in the transfer and application of research findings into routine clinical practice because we evaluated several methods for training parents to implement behavioral feeding protocols, and we demonstrated that these methods resulted in high levels of treatment integrity in a controlled clinical setting.
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