Use of a high‐probability instructional sequence to increase compliance to feeding demands in the absence of escape extinction

Abstract

We evaluated the effects of a high-probability (high-p) instructional sequence on the feeding-related compliance (food acceptance) of a young boy diagnosed with a feeding disorder. The high-p sequence consisted of three presentations of an empty spoon; the low-probability (low-p) instruction was the presentation of a spoon with food. Results showed that acceptance of food increased in the presence and not the absence of the high-p sequence. Data are discussed in terms of the role of high-p instructional sequences in the treatment of feeding problems.

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

“…Patel et al (2007) evaluated the effects of a high-p instructional sequence on food acceptance with a child who had been diagnosed with developmental delays, and who inconsistently consumed a limited variety of foods. The high-p sequence consisted of three presentations of an empty spoon; the low-p instruction was the presentation of a spoon with food.…”

“…It should be noted, however, that research has shown this strategy to be effective in the absence of EE with only 1 participant and with access to a preferred activity as the noncontingent reinforcer. A high-p instructional sequence may be an alternative strategy if the child demonstrates high levels of compliance with a request that is similar to food consumption (e.g., acceptance of an empty spoon; Patel et al, 2007). Evidence for the effectiveness of this strategy in the absence of EE, however, is also limited to 1 participant.…”

Evaluating the High-Probability Instructional Sequence to Increase the Acceptance of Foods with an Adolescent with Autism

“…Patel et al (2007) further evaluated the high-p sequence, in the absence of EE, with a 4-yearold boy who engaged in food selectivity and found the high-p sequence to be effective at increasing the acceptance of foods. Interestingly, the studies by Patel et al (2006Patel et al ( , 2007 used high-p tasks that were topographically similar to the lowprobability (low-p) tasks (rather than high-p tasks that were topographically dissimilar to the low-p tasks, e.g., "touch your shoulder"). Specifically, Patel et al (2006) used bites from an empty Nuk® brush, spoons with liquid, and spoons with a preferred liquid as the high-p tasks, and Patel et al (2007) used bites from an empty spoon as the high-p task.…”

“…Interestingly, the studies by Patel et al (2006Patel et al ( , 2007 used high-p tasks that were topographically similar to the lowprobability (low-p) tasks (rather than high-p tasks that were topographically dissimilar to the low-p tasks, e.g., "touch your shoulder"). Specifically, Patel et al (2006) used bites from an empty Nuk® brush, spoons with liquid, and spoons with a preferred liquid as the high-p tasks, and Patel et al (2007) used bites from an empty spoon as the high-p task. Along these lines, Meier et al (2012) evaluated the effects of the high-p sequence in the absence of EE on acceptance of lowp foods with a 3-year-old girl with autism spectrum disorder.…”

Proactive strategies for children with food refusal.

“…For the third child in the investigation, although the high-p sequence did not produce an increase in food acceptance, inappropriate behaviors did decrease when the high-p sequence was used. Patel et al (2007) further investigated the effects of a high-probability instructional sequence without the use of escape extinction on food acceptance.…”