A food satiation and oral hygiene punishment program to suppress chronic rumination by retarded persons.
A quick Listerine rinse after each episode, paired with a full meal, can stop years of chronic rumination in adults with ID.
01Research in Context
What this study did
Two adults with profound ID lived in a state facility. Both had rumbled food back up for years.
The team first let each person eat until full. Then they added a quick consequence. After every rumination episode, staff gave a 2-minute Listerine rinse.
They tracked rumination across meals using a simple tally sheet. The design was a multiple baseline across the two participants.
What they found
Rumination dropped to almost zero within days. The change held over the study period.
Both adults gained weight and looked healthier. Staff needed only a bottle of mouthwash and a timer.
How this fits with other research
Migan-Gandonou et al. (2020) ran the same idea 40 years later. They swapped Listerine for a quick tooth-brush. A child with autism stopped rumination for four full years. This shows the method works across ages and diagnoses.
Einfeld et al. (1995) found hand-mouthing is kept going by hand feeling, not mouth feeling. That helps explain why just filling the stomach was not enough. The bad taste had to block the mouth sensation that reinforced rumination.
Leung et al. (1998) used wrist weights to cut self-hitting by a large share. Like the 1979 study, they showed a simple physical fix can crush an automatically reinforced behavior without hurting daily living skills.
Why it matters
If you serve clients who ruminate, pair a tiny oral hygiene consequence with a full meal. It is cheap, fast, and the 2020 paper proves the effect can last for years. Start Monday by adding a 2-minute mouthwash rinse after each episode and watch the data fall.
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02At a glance
03Original abstract
Food satiation and oral hygiene punishment were used to treat the non-life-threatening rumination of two institutionalized profoundly retarded persons. Satiation consisted of allowing the clients to eat until a satiation criterion of food refusal was achieved or until two full meal portions were consumed. The oral hygiene procedure consisted of cleansing the clients' teeth and gums with Listerine for 2 minutes following each instance of rumination. In the formal study, three conditions--baseline, satiation, and satiation plus oral hygiene--were used following the lunch meal in a multiple-baseline across-subjects design. One client's rumination decreased from an average of 89.5% during baseline to 48.8% during the satiation condition and to 3% during satiation plus oral hygiene. The second client's rumination decreased from a baseline average of 49.9% to 7.9% during satiation and to 1.4% during satiation plus oral hygiene. Generalization probes taken following the breakfast and dinner meals showed a systematic decline in rumination as the various conditions were implemented following the lung meal. In the 16-week follow-up, rumination was treated following all meals with oral hygiene, and satiation was used at one of the daily meals for 1 week on a rotating basis. Rumination remained at a near-zero level following all meals throughout the follow-up. Thereafter, a maintenance program was conducted by the ward staff. The satiation plus oral hygiene punishment treatment program appears to be an immediate, effective, enduring, and humane method of treating the non-life-threatening rumination of retarded individuals.
Journal of autism and developmental disorders, 1979 · doi:10.1007/BF01531447