A parent training programme for chronic food refusal: a case study

Abstract

Summary The present paper describes the successful implementation of a training programme for the parents of a child with moderate learning difficulties presenting with chronic food refusal and provides an example of how professionals can work with families to manage clinical problems in the home. The parents were taught to use the Premack principle to motivate their child in the consumption of previously refused foods. A multiple baseline design across three foods demonstrated the efficacy of the programme and the dietary changes were maintained at the 3‐month follow‐up.

Treatment of Selective and Inadequate Food Intake in Children: A Review and Practical Guide

“…In the studies on DRA included in this review, preferred foods or drinks were always used as positive reinforcers, either alone or in combination with social praise (Brown, Spencer, & Swift, 2002;Cooper et al, 1999;Levin & Carr, 2001;Riordan, Iwata, Wohl, & Finney, 1980;Riordan, Iwata, Finney, Wohl, & Stanley, 1984). Thus, the effectiveness of stimuli other than preferred foods or drink remains unclear.…”

“…This selectivity with preferred foods makes preparing meals cumbersome and in some cases impossible. Brown et al (2002) examined the use of providing preferred foods in a preferred format or flavor contingent on acceptance of the same foods presented in a non-preferred format or flavor (e.g., crinkle-cut chips instead of straight-cut chips, a bread roll instead of sliced bread, different flavored yogurt). The participant was a child with moderate learning difficulties who exhibited selectivity by food type.…”

“…However, it should be noted that some children may demonstrate refusal behaviors to gain access to foods that are relatively more preferred . In these cases and/or when preferred foods can be identified, practitioners should consider providing preferred foods contingent on consumption of less preferred foods (e.g., Brown et al, 2002;Riordan et al, 1990) or simultaneously presenting (or blending) more preferred with less preferred foods (e.g., Piazza et al, 2002;Luiselli et al, 2005).…”

Utilizing a home‐based parent training approach in the treatment of food selectivity

“…Preliminary findings are positive with behavior changes occurring in the desired direction for the most part and results being maintained when evaluated over extended periods of time (e.g., Brown et al, 2002;Mueller et al, 2003;Najdowski et al, 2003;O'Reilly & Lancioni, 2001, Werle et al, 1998 even when reinforcement magnitude and schedules are thinned (e.g., Najdowski et al, 2003). In addition, when collected, procedural integrity (e.g., Anderson & McMillan, 2001;Galensky et al, 2001;Mueller et al, 2003) and parent collected interobserver agreement (IOA) data (e.g., Werle et al, 1993Werle et al, , 1998Najdowski et al, 2003) have demonstrated promising results.…”

“…In the handful of studies that have been conducted, parents have been trained to implement these treatment procedures in a variety of settings such as in a clinic (e.g., Brown, Spencer, & Swift, 2002;Cooper et al, 1995;Mueller et al, 2003), at the homes of participants (e.g., Anderson & McMillan, 2001;Cooper et al;Galensky, Miltenberger, Stricker, & Garlinghouse, 2001;Mueller et al;Najdowski et al, 2003;O'Reilly & Lancioni, 2001;Werle et al, 1993Werle et al, , 1998, and in a restaurant (Najdowski et al). Preliminary findings are positive with behavior changes occurring in the desired direction for the most part and results being maintained when evaluated over extended periods of time (e.g., Brown et al, 2002;Mueller et al, 2003;Najdowski et al, 2003;O'Reilly & Lancioni, 2001, Werle et al, 1998 even when reinforcement magnitude and schedules are thinned (e.g., Najdowski et al, 2003).…”