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A comparison of function- and nonfunction-based extinction treatments for inappropriate mealtime behavior.

Caitlin A Kirkwood1, Cathleen C Piazza1, Kathryn M Peterson1

  • 1Munroe-Meyer Institute, University of Nebraska Medical Center.

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|March 19, 2021
PubMed
Summary

Caregiver attention did not affect mealtime behavior in children with feeding disorders. Escape extinction, however, reduced inappropriate behaviors and increased food acceptance, regardless of attention.

Keywords:
attentionescape extinctionfunction-based treatmentnegative reinforcementpediatric feeding disorders

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Area of Science:

  • Pediatric feeding disorders
  • Behavioral analysis
  • Clinical psychology

Background:

  • Functional analyses are recommended for treating pediatric feeding disorders.
  • Clinicians often use non-function-based contingencies in caregiver training.
  • The impact of non-function-based contingencies on mealtime behavior is not well understood.

Purpose of the Study:

  • To investigate the reinforcing properties of escape and attention in children with feeding disorders.
  • To evaluate the effectiveness of escape extinction, with and without attention, on inappropriate mealtime behaviors.

Main Methods:

  • A functional analysis was conducted with three children diagnosed with feeding disorders.
  • Caregivers provided escape from food/drinks and attention following inappropriate mealtime behaviors.
  • Escape extinction was implemented, varying the provision of attention.

Main Results:

  • Functional analysis indicated that escape, not attention, reinforced inappropriate mealtime behavior.
  • Escape extinction significantly decreased inappropriate mealtime behavior across all participants.
  • Food acceptance increased when escape extinction was implemented, irrespective of attention.

Conclusions:

  • Escape from meal demands, not caregiver attention, is a key maintaining factor for problem behaviors in pediatric feeding disorders.
  • Escape extinction is an effective intervention for reducing inappropriate mealtime behaviors and increasing food acceptance.
  • Non-function-based components, like attention, may not be necessary when implementing effective extinction procedures for pediatric feeding disorders.