Use of component analyses to identify active variables in treatment packages for children with feeding disorders.

The team worked with kids who refused most foods. They wanted to know which parts of a feeding package really matter.

They used a multielement design. This means they quickly switched parts on and off. They watched what happened to food acceptance and problem behavior.

Escape extinction came out on top every time. If the child could not leave the table, bites went up.

Other pieces helped some kids, but only when escape extinction was already in place. Without it, nothing worked.

Siu et al. (2011) ran a direct replication. They got the same result: escape extinction is required; escape reinforcement alone fails.

Najdowski et al. (2003) later showed that adding praise or toys can cut crying, but extinction still drives the eating gains.

Tereshko et al. (2021) looked at 21 studies that skipped extinction. They found mild gains with antecedent tricks alone. This seems to clash, but those studies targeted picky eating, not total refusal. The kids in Hogg et al. (1995) were more severe.

Scott et al. (2024) pooled 266 cases. Their mega-review now sits on top of the 1995 finding. It says combine escape plus non-escape tactics for the biggest effect, updating the old single-case advice.

You now have thirty years of backup: start every feeding plan with escape extinction. Run a quick component check to see if extra pieces like differential reinforcement or high-pro sequences help that child. Skip the extras if they add no value. This saves you time and cuts stress for the family.