A systematic literature review of antecedent and reinforcement‐based behavioral feeding interventions without the implementation of escape extinction
You can often increase food acceptance using only antecedent and reinforcement tactics—no escape extinction required.
01Research in Context
What this study did
Tereshko et al. (2021) hunted for papers that fixed food refusal without escape extinction. They screened every feeding study they could find. Only 21 made the cut.
All 21 used antecedent tricks or pure reinforcement. No forced bites. No "you can't leave the table" rules.
What they found
Every study showed kids ate more food when adults set up the meal differently or paid off bites with toys, praise, or snacks. No extinction needed.
Quality was mixed. Some studies had only one child. Others lacked strong designs. Still, the pattern held: acceptance rose without escape extinction.
How this fits with other research
Scott et al. (2024) pooled 266 cases and found the biggest gains came from mixing escape extinction with non-escape tactics. That seems to clash with Tereshko's no-extinction stance. The gap is method, not truth. Scott counted every tactic together. Tereshko asked, "Can we win without the tough part?" Both answers can be right.
Older single-case papers like Staddon et al. (2002) and Najdowski et al. (2003) showed escape extinction was the active ingredient. Tereshko does not overturn those data. It simply shows you can sometimes win gentler, smaller, or earlier in treatment.
Carter (2010) showed positive reinforcement alone can crush escape-maintained problem behavior without extinction. That lab result backs Tereshko's feeding focus and hints the same rule crosses contexts.
Why it matters
If a family refuses escape extinction, you now have a menu of options: high-probability sequences, stimulus fading, differential reinforcement, tiny tastes with big rewards. Start there and measure. If progress stalls, you can still add extinction later. Tereshko gives you the first chapter of a gentler treatment book.
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02At a glance
03Original abstract
AbstractRestrictive and avoidant patterns of eating behavior can be seen in children with and without a diagnosed disability, and these patterns may then lead to avoidant/restrictive food intake disorder. The three main categories of feeding problems often observed in children are food refusal, refusal to self‐feed, and food selectivity. This literature review includes 21 articles that implemented feeding interventions, without the use of escape extinction or other intrusive interventions, to increase food acceptance. Each article was analyzed across several dimensions (participants, setting, assessments conducted, experimental design, intervention implemented, and outcome and generalization). From this analysis, information regarding the use of antecedent and reinforcement‐based practices for feeding intervention is discussed, as well as limitations in the current literature and suggestions for future research.
Behavioral Interventions, 2021 · doi:10.1002/bin.1769