COMPARISON OF UPRIGHT AND FLIPPED SPOON PRESENTATIONS TO GUIDE TREATMENT OF FOOD REFUSAL

The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral‐motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re‐presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re‐presentations for all participants. Findings from follow‐up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.