Differential Reinforcement of Acceptance without Escape Extinction in a Boy with Developmental Delays and Food Selectivi
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Differential Reinforcement of Acceptance without Escape Extinction in a Boy with Developmental Delays and Food Selectivity Mariana de los Santos 1 & Bryant C. Silbaugh 2 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Although differential reinforcement is procedurally simple, and a common component in intervention packages for feeding disorders, few published studies evaluated its effects in isolation. Even fewer studies have isolated the effects of differential reinforcement on feeding in free-operant arrangements. In the current clinical case study, we report the expansion of a practitioner’s scope of competence to include the treatment of food selectivity by evaluating the effects of differential reinforcement of acceptance with high preferred food in a boy with developmental delays and food selectivity. Acceptance of nonpreferred foods increased first in a restricted operant arrangement, and then a free operant arrangement, both without escape extinction. Improvements in acceptance generalized to additional foods and a parent. These results extend prior research by demonstrating differential reinforcement of acceptance using high preferred foods without escape extinction may improve feeding in restricted- and free-operant arrangements for some children with developmental delays. Keywords Differential reinforcement . Food selectivity . Free operant . Pediatric feeding
disorders . Scope of competence Pediatric feeding disorders are learned biobehavioral conditions which can include medical, feeding skill, nutritional, and psychosocial factors (Goday et al. 2019) and range in severity from food refusal (i.e., severe) to food selectivity (i.e., moderate; e.g., Silbaugh et al. 2016a, b). Like the boy in the current study, children with mild cases of food selectivity consume a limited variety of healthy foods based on aversions or
* Bryant C. Silbaugh [email protected]
1
BLOOM Children’s Center, San Pedro Garza García, Nuevo León 66230, México
2
Department of Interdisciplinary Learning and Teaching in the College of Education and Human Development, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
Journal of Developmental and Physical Disabilities
preferences associated with physical dimensions of foods such as texture, consistency, or color, without biomedical factors that would require medical intervention (Silbaugh et al. 2016a, b). Food selectivity also commonly includes inappropriate mealtime behavior (e.g., Piazza et al. 2003) which can be further classified topographically as mealtime challenging behavior (e.g., batting at the spoon or crying) or disordered feeding (e.g., gagging, expulsion, packing) (Silbaugh et al. 2016a, b). Pediatric feeding disorders are estimated to be highly prevalent in children with developmental disorders (i.e., up to 89%; Ledford and Gast 2006; Palmer and Horn 1978; Williams et al. 2000) but estimates vary widely based on methods, definitions, and instruments (Sharp et al. 2013). Children with pediatri
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