Related Experiment Video
Updated: May 24, 2026

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Comparison of upright and flipped spoon presentations to guide treatment of food refusal
William G Sharp1, Ashley Odom, David L Jaquess
1Marcus Autism Center, Atlanta, Georgia 30329, USA. william.sharp@choa.org
Abstract:
The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.
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