Effect of Brief Clinic-Based Training on the Ability of Caregivers to Implement Escape Extinction

Escape extinction has been demonstrated to be an effective treatment for children exhibiting food refusal. To date, most studies have been conducted in inpatient treatment settings by trained clinicians. Few studies have evaluated the extent to which caregivers are able to implement efficacious interventions in their home for their food-selective child. This study evaluated a systematic strategy for training caregivers to implement escape extinction. A modified changing-criterion design was used to evaluate a clinic-based training procedure consisting of escape extinction and differential reinforcement. After participants met prespecified criteria with regard to the number of bites accepted and latency until acceptance, caregivers were taught to implement the procedure in the clinic. After criteria were met with caregivers feeding their children, caregivers were taught to implement the procedure during meals conducted at their home. Follow-up data conducted for three participants indicated that generalization across time and food types had occurred.