In the current investigation, we evaluated a method for increasing self-feeding with 3 children with a history of food refusal. The children never (2 children) or rarely (1 child) self-fed bites of food when the choice was between self-feeding and escape from eating. When the choice was between self-feeding 1 bite of food or being fed an identical bite of food, self-feeding was low (2 children) or variable (1 child). Levels of self-feeding increased for 2 children when the choice was between self-feeding 1 bite of food or being fed multiple bites of the same food. For the 3rd child, self-feeding increased when the choice was between self-feeding 1 bite of food or being fed multiple bites of a less preferred food. The results showed that altering the contingencies associated with being fed increased the probability of self-feeding, but the specific manipulations that produced self-feeding were unique to each child.

We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory integration for both children. The results are discussed in terms of the challenges of evaluating sensory-integration-based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important.

The purpose of the current investigation was to identify an appropriate texture for initial treatment of 1 child's feeding problem. Variability in mouth clean (a product measure of swallowing) during a texture assessment suggested that individual pureed foods differentially affected feeding behavior. A single-food assessment identified individual problematic foods. We used the results of these assessments to inform treatment, resulting in high levels of mouth clean across foods.