A comparison of re‐presentation and modified chin prompt to treat different topographies of liquid expulsion
Match the prompt to the way the child spits—forceful needs chin help, dribble needs re-presentation, some need both.
01Research in Context
What this study did
Ibañez et al. (2021) worked with three kids who kept spitting out drinks.
The team watched how each child spit—some pushed the liquid out hard, others let it dribble.
They tried two quick fixes: re-presenting the cup right after spitting, or gently lifting the chin to close the mouth.
An alternating-treatments design told them which tactic worked best for each child each day.
What they found
Both tricks cut spitting for two kids.
One child only stopped spitting when the two tricks were used together.
Forceful spitters did better with the chin prompt; dribblers did better with re-presentation.
How this fits with other research
O’Neill et al. (2022) used the same rapid-fire design to show that stretching the prompt delay beat fixed 2-s or 5-s delays when teaching labels.
Both papers prove you can test tiny tweaks side-by-side instead of guessing.
Wilder et al. (2023) also compared two schedules—fixed vs variable momentary DRO—and found equal drops in automatically reinforced problem behavior.
Like Ibañez, they saw that the form of the behavior (how it looks) can guide which schedule you pick.
Why it matters
Next time a client spits liquids, watch first: is it a forceful push or a quiet run-out? Match the prompt to the topography, and be ready to combine tricks if one isn’t enough. This five-second check can save weeks of trial and error.
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02At a glance
03Original abstract
Treatment of one behavior in the chain of consumption might be associated with the emergence of other problematic behaviors. For example, some children with feeding disorders expel liquid. Moreover, the form in which children expel liquid might vary and influence whether a treatment to reduce liquid expulsion will result in clinically meaningful outcomes. In the current investigation, we first identified topographies of liquid expulsion (e.g., forceful, run out) for each child. We then compared and evaluated the effects of 2 procedures, a modified chin prompt and re-presentation, on the liquid expulsion of 3 children with feeding disorders. For 2 participants, expulsion decreased to clinically meaningful levels with a modified chin prompt or re-presentation. However, for 1 participant, expulsion decreased to clinically meaningful levels only when we combined the modified chin prompt and re-presentation as part of a treatment package. We discuss possible mechanisms underlying the effects of a modified chin prompt and re-presentation, in addition to areas for future research.
Journal of Applied Behavior Analysis, 2021 · doi:10.1002/jaba.872