Decreasing Food Stealing of Child with Prader-Willi Syndrome Through Function-Based Differential Reinforcement

Abstract

Challenging behaviors involving food are common for individuals with Prader-Willi syndrome (PWS) and often lead to obesity and other chronic health conditions. Efforts to decrease these behaviors, such as isolation during meals and strict monitoring of food consumption, can be stigmatizing. To decrease the food stealing of a 7 year-old girl with PWS, therapists conducted a latency-based functional analysis in a clinic setting before implementing a function-based intervention to facilitate her inclusion at the family dinner table. Intervention components entailed differential reinforcement procedures which incorporated a token board and schedule thinning. The intervention successfully generalized to the home setting and across food preferences and implementers.

Description and evaluation of a function‐informed and mechanisms‐based framework for treating challenging behavior

“…For instance, individuals whose challenging behavior is sufficiently disruptive and/or dangerous to merit the time and resources required for meaningful intensive treatment represent a small percentage of the general population (e.g., Walker et al, 2005). Related, well-controlled datasets from individual cases can take months to accumulate (e.g., Lambert et al, 2019) and individuals for whom effective treatments have been employed represent a largely heterogenous sample of characteristics, contexts, circumstances, and functions (Beavers et al, 2013), rendering difficult valid attempts at large-scale randomized efficacy trials employing group design.…”

The Stealing Inventory: A preliminary investigation.

“…Study 2 extends Lambert et al (2019) and Simmons et al (2019) in several ways. First, this is the only study including FAs of nonfood stealing and the second study (after Simmons et al) involving FAs of covert food stealing.…”

“…Trial-based FA methods (Bloom et al, 2011; Lambert et al, 2019; McCord et al, 2001; Simmons et al, 2019) involving single response opportunities may address these concerns. For example, both Simmons et al (2019) and Lambert et al (2019) used trial-based FAs and latency-based measures of food stealing, and the former arranged true alone conditions for covert responding. Given the unique considerations for stealing as a target behavior, and the fact that no previous FAs of covert nonfood stealing have been published, optimal FA procedures are uncertain.…”

“…Also, repeated within-session theft opportunities may present other concerns (e.g., cost, undesirable food consumption, etc.). Trial-based FA methods (Bloom et al, 2011; Lambert et al, 2019; McCord et al, 2001; Simmons et al, 2019) involving single response opportunities may address these concerns. For example, both Simmons et al (2019) and Lambert et al (2019) used trial-based FAs and latency-based measures of food stealing, and the former arranged true alone conditions for covert responding.…”

Reliability and validity of using structured visual‐inspection criteria to interpret latency‐based functional analysis outcomes

“…Specifically, this approach measures the time it takes from the onset of a condition to the first occurrence of the problem behavior and determines which test condition produced shorter latencies to problem behavior as compared to the control condition. Latency-based FAs have been used to assess a variety of challenging behavior including problem behavior (e.g., Briggs et al, 2019;Hamilton et al, 2020;Thomason-Sassi et al, 2011), food stealing (e.g., Lambert et al, 2019), transitionrelated problem behavior (e.g., Harper & Luiselli, 2019), repetitive behavior (e.g., Chok & Harper, 2016;Neil & Jones, 2016), and elopement (e.g., Davis et al, 2013;Lambert, Finley, & Caruthers, 2017;Neidert et al, 2013;Traub & Vollmer, 2019). Further, latency-based FAs have been used across a variety of settings including clinics (e.g., Briggs et al, 2019;Thomason-Sassi et al, 2011), schools (e.g., Hansen et al, 2019Lambert, Lopano, et al, 2017), hospital inpatient units (e.g., Lambert, Staubitz, et al, 2017), residential settings (e.g., Harper & Luiselli, 2019), and home environments (e.g., Chok & Harper, 2016;Neil & Jones, 2016).…”