Spoon distance fading with and without escape extinction as treatment for food refusal.
Escape extinction alone increased food acceptance faster than spoon-distance fading plus EE for one food-refusing child.
01Research in Context
What this study did
One child who refused most foods took part. The team tested two ways to get bites in. First they moved the spoon closer across meals. Then they added escape extinction. Later they dropped fading and used escape extinction alone.
What they found
Fading alone cut problem behavior at first, but acceptance did not hold. Fading plus escape extinction worked better, yet escape extinction by itself moved the child to full bites fastest. Mixed results mean the simple route can win.
How this fits with other research
Scott et al. (2024) pooled 266 kids and still found escape extinction is key. Their big picture matches this single case.
Staddon et al. (2002) and Najdowski et al. (2003) already showed escape extinction drives the change. This study echoes them by showing fading is extra, not essential.
Carr et al. (2003) blended fading with escape extinction and saw gains. The new data say you can drop fading and still beat the combo, a tidy step forward.
Why it matters
You can save time by starting with escape extinction first. Skip the gradual spoon-move-in phase if the learner can tolerate it. Watch the first sessions; if acceptance climbs fast, you may not need extra steps.
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02At a glance
03Original abstract
Little is known about the characteristics of meals that serve as motivating operations (MOs) for escape behavior. In the current investigation, we showed that the distance at which a therapist held a spoon from a child's lips served as an MO for escape behavior. Based on these results, we implemented spoon distance fading, compared fading with and without escape extinction (EE), and compared fading plus EE to EE alone. Initially, inappropriate mealtime behavior decreased during fading, but this effect was not maintained as fading progressed. Inappropriate mealtime behavior was lower initially when we combined fading and EE relative to EE alone, but acceptance increased more rapidly with EE than with fading plus EE. These results suggest that a number of mealtime characteristics might function as MOs for escape behavior and that analyses of MOs may be useful for developing treatments for food refusal.
Journal of applied behavior analysis, 2010 · doi:10.1901/jaba.2010.43-673