Further Manipulations in Response Effort or Magnitude of an Aversive Consequence to Increase Self-Feeding in Children with Feeding Disorders

Volkert and colleagues worked with three children who refused to feed themselves. The team wanted to see if they could make self-feeding easier by changing two things. They either made the therapist-fed bite harder to get, or they made that bite smaller or less tasty.

Each child got a custom plan. One child had to open extra times before the adult would feed them. Another got a tiny, cold bite if they did not pick up the spoon. The third child faced both changes at once. The team tracked how often the kids fed themselves across meals.

All three children started feeding themselves more once the rules changed. When the adult-fed bite took more work, the kids chose to scoop their own food. When the adult-fed bite was puny or cold, they also reached for the spoon.

Problem behavior stayed low and meals ended faster. Parents learned the tweaks in one session and kept them going at home.

Scott et al. (2024) pooled 266 kids and found that mixing escape and non-escape extinction gives the biggest gains. Volkert’s cases fit right into that recipe, showing one easy way to sharpen escape extinction without extra toys or tokens.

Amore et al. (2011) first showed that letting a child leave the table right after a bite can spark self-feeding. Volkert keeps the escape idea but flips it: the child escapes the yucky adult bite by feeding themselves. Same principle, new twist.

Engler et al. (2023) watched 60 kids and saw that extinction meltdowns happen in fewer than one-third of meals. Volkert’s three cases line up—no big bursts even when they raised the effort or lowered the payoff.

You can add these tweaks tomorrow. No new equipment, no extra staff. Just make the bite you offer smaller, colder, or harder to get while keeping the self-fed bite normal. Start with one change, watch the data, and adjust. Parents like it because it feels fair—no force, just clearer choices.