ABA Fundamentals

Teaching the Skill of Chewing From a Behavior Analytic Approach: A Systematic Review.

Alaimo et al. (2023) · Behavior modification 2023
★ The Verdict

ABA chewing packages work, but we are still guessing which pieces are must-haves.

✓ Read this if BCBAs building feeding plans for kids who pocket or swallow food whole.
✗ Skip if Clinicians only treating food selectivity, not chewing skill.

01Research in Context

01

What this study did

Harkins et al. (2023) hunted for every single-case study that used ABA to teach chewing.

They found a small pile of papers and pulled out the parts each package used.

The goal was to see which pieces matter most when a child cannot chew.

02

What they found

All the packages worked, but no two were the same.

Some used escape extinction, some used prompts, some used both.

We still do not know which parts we can drop and still win.

03

How this fits with other research

Scott et al. (2024) looked at 266 kids and say escape plus non-escape extinction beats either one alone.

Christina’s review shows many studies used escape extinction, but none tested that exact split.

Chawner et al. (2019) reviewed food acceptance and also saw multicomponent wins, giving chewing a mirror image.

The old 1979 tongue-thrust paper used simple differential reinforcement and still raised chewing, hinting big packages may be overkill.

04

Why it matters

If you write a chewing plan today you have to throw in the kitchen sink because we do not know the minimum set.

Start with the Scott recipe—escape plus non-escape extinction—then track each extra part.

Your data may finally tell us what we can leave out and still teach a safe chew.

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→ Action — try this Monday

Add a brief finger prompt after escape extinction if bites still turn to mush.

02At a glance

Intervention
feeding intervention
Design
systematic review
Finding
not reported

03Original abstract

Relatively few empirical studies of pediatric chewing interventions have been published in the psychology literature. The purpose of this paper was to systematically review chewing interventions within the applied behavior analysis literature. We identified a small, but growing, behavior analytic literature demonstrating the effectiveness of various multicomponent treatment packages to teach and improve chewing skills. Future researchers should consider a range of participant characteristics, including results of oral motor assessments, explore a more extensive definition of chewing to target the complex nature of chewing as well as component skills, and examine the necessary and sufficient components of chewing interventions along with the potential benefits of multidisciplinary interventions.

Behavior modification, 2023 · doi:10.1177/01454455221140483