Empirical Examination of a Multicomponent Treatment for Pediatrie Food Refusal

The behavioral literature has recently given much attention to assessment and treatment of pediatrie feeding problems in general, and food refusal in particular. Functional relations have been examined between treatment procedures and food acceptance using either additive or component analysis procedures, Several studies have demonstrated efficacy of combining continued presentation with positive reinforcement and other procedures for shaping food acceptance and consumption. This study reports on assessment and treatment of food refusal for four boys receiving total tube feedings. The purpose was to assess generality of previous findings, and to examine effects of various components of a package used to treat food refusal. The study replicated the contingency contacting procedure reported by Hoch et al. (1994) for two participants and extended it to include a component analysis for two additional participants. Data suggest that food refusal appeared to be maintained primarily by negative reinforcement contingencies in three participants, while both inadequate positive reinforcement and naturally occurring negative reinforcement appeared to control refusal for a fourth participant. These findings further support the notion of multiple determination of food refusal. Caregiver responses indicated a high degree of satisfaction at discharge and during follow-up.