Syringe fading as treatment for feeding refusal.

One child with feeding disorder clamped his teeth to block cup or spoon contact. The team started all liquids and solids through a plastic syringe held at the lips. They moved the syringe tip a little farther from the mouth each meal. The cup and spoon stayed in view the whole time. Nonremoval rules still applied; the meal ended only after the bite or sip was taken.

The child began to open for the syringe within the first few sessions. Acceptance climbed as the syringe moved closer to the cup. After several steps, the child took liquid from the cup and solids from the spoon without clenching. Gains held after the syringe was removed completely.

Hattier et al. (2011) first showed spoon-to-cup fading works for liquid refusal. The 2014 study extends that idea by starting even earlier—at the syringe—when teeth block the spoon entirely. LeFrancois et al. (1993) proved utensil fading beats texture refusal without force; the new paper keeps the same gentle step-wise logic but targets a different escape move. Kozlowski et al. (2024) later repeated syringe-to-cup fading with two children with autism and got the same positive jump, showing the tactic travels across diagnoses. Firth et al. (2001) found plain nonremoval of the spoon also works; syringe fading simply offers a side door when the front door is bolted shut.

If you run nonremoval of the cup or spoon and the child jams his teeth, you no longer have to choose between force-feeding or giving up. Slide in with a syringe, then fade toward the utensil in tiny, visible steps. The whole process keeps the meal calm, keeps the contingency clear, and still reaches the same end point: normal eating with a cup and spoon.