Treating Total Liquid Refusal With Backward Chaining and Fading

Abstract

In this study, we report on a 12-year-old boy with autism, mental retardation, and a history of severe gastrointestinal problems who presented with total liquid and food refusal. Backward chaining was used to shape drinking from a cup, and a fading procedure was used to increase the quantity of water he was required to drink.

Analysis of Factors That Affect Responding in a Two‐response Chain in Children With Developmental Disabilities

“…Many skills taught to individuals with developmental disabilities consist of behavior chains, such as washing clothes, drinking from a cup, and following picture-activity schedules (e.g., Hagopian, Farrell, & Amari, 1996;MacDuff, Krantz, & McClannahan, 1993;McDonnell & McFarland, 1988). Prompts and reinforcement are used to teach each response in the chain in a manner that ensures that the sequence of behaviors operates as a functional unit.…”

Liquid fading to establish milk consumption by a child with autism

“…The process of fading was uncomplicated, yielding a positive outcome following a relatively brief course of intervention. Another meaningful Like other studies evaluating fading procedures in the treatment of food refusal (Hagopian et al, 1996;Patel et al, 2001), we incorporated a probe assessment methodology that measured periodically consumption of the previously avoided stimulus. In the present case, each probe revealed that following exposure to fading Angie consumed a moderate amount of milk, which increased as intervention progressed, culminating in her acceptance of the full 8 ounce cup of milk once she had completed the 87.5% fading step.…”

“…In a study that included shaping and fading methods, Hagopian, Farrell, and Amari (1996) taught a 12-year-old boy with autism and total liquid refusal to drink water from a cup. The shaping component of intervention consisted of having the boy swallow after an empty syringe was placed in his mouth and subsequently, following presentation of the syringe dipped in water.…”

“…In the following study, we describe a liquid fading intervention that was used successfully to establish milk consumption by a young child with autism. Similar to Hagopian et al (1996) and Patel et al (2001), we incorporated probe assessments to monitor the pace of fading within a step-wise progression. Unlike the study by Patel et al (2001), we did not include escape extinction with the intervention protocol, relying instead on paced instructional prompting as a supplemental procedure.…”

Assessment and Treatment of Feeding Problems among Children with Autism Spectrum Disorders

“…Hagopian et al (1996) used backward chaining, reinforcement, and stimulus fading to treat total liquid refusal in a 12 year-old boy with ASD who was currently receiving nutrients through a central line. They task analyzed drinking from a cup into the following response chain: (a) bringing cup of water to mouth, (b) accepting water into mouth, and (c) swallowing.…”