Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food refusal to determine if the consequences commonly delivered during functional analyses were observed during parent-conducted meals. The conditional probabilities for the delivery of attention, tangible items, and escape following food refusal and acceptance were compared to the unconditional probabilities of each event. Results showed that attention and escape most frequently followed refusal and differed depending on the topography of refusal. Implications for further evaluations of food refusal using similar methods are discussed.

Escape extinction has been shown to be highly effective in the treatment of food refusal; however, unpleasant side effects such as extinction bursts may accompany extinction procedures. Bursting has been reported to occur in 24% to 39% of all cases for which extinction was used as a component during treatment of problem behavior. Although commonly used in treatments, the occurrence of extinction bursts in the treatment of pediatric food refusal has not been studied. This study measured the frequency of bursting in 10 children for whom escape extinction was used to treat food refusal. Results showed that extinction bursts were observed in 30% of the children included in the study, although they were relatively brief and resolved quickly.Considerations for using escape extinction in interventions will be discussed. K E Y W O R D Sescape extinction, extinction burst, food refusal, pediatric food refusal

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Mealtime observations were conducted and occurrences of appropriate and inappropriate mealtime behavior and various forms of parental attention (e.g., coaxing, reprimands) were recorded for 25 children admitted to an intensive feeding program and their parents. Using the data from the observations, lag sequential analyses were conducted to identify changes in the probability of child appropriate and inappropriate mealtime behavior before and after various forms of parental attention. A combination of univariate and repeated measures ANOVAs using frequency of child behavior were also conducted to corroborate conclusions drawn from the visual analysis of individual participant data. Results showed that parental attention was frequently followed by temporary decreases in inappropriate mealtime behavior and increases in bite acceptance. Moreover, various forms of parental attention resulted in statistically significant changes in child behavior, which supports the clinical utility of these data.