A translational evaluation of renewal of inappropriate mealtime behavior
Expect inappropriate mealtime behavior to renew when kids eat at home—even if caregivers keep ignoring it—unless you add a brief renewal-mitigation step.
01Research in Context
What this study did
The team worked with children who had feeding disorders. They used extinction to stop mealtime problem behavior in a clinic. Then they sent the kids home with the same plan.
They used an ABAB reversal design. Behavior dropped in the clinic. When families kept doing extinction at home, the problems still came back.
What they found
Renewal happened. The old mealtime behavior returned once the child was back in the home setting. Caregivers followed the extinction plan perfectly, yet the relapse still occurred.
The study shows that changing places can undo good feeding progress even when adults stay consistent.
How this fits with other research
Haney et al. (2021) picked up this exact problem. They added one step: keep extinction going and also reinforce bites of food. That small fix wiped out renewal in every child who had it.
Haney et al. (2022) looked at sixty feeding cases. Renewal showed up in about half of them. Their numbers prove the 2019 relapse was not a one-off.
Muething et al. (2020) scanned 182 context changes across all kinds of ABA. Renewal hit 42 % of the time. The mealtime finding now sits inside a wider pattern.
Kimball et al. (2020) tested renewal in a lab. They paired extinction with differential reinforcement and saw smaller spikes. The clinic-to-home feeding story lines up with their lab data.
Why it matters
You can’t assume a feeding plan that works in clinic will stick at home. Build a renewal-mitigation step into discharge: keep extinction and add reinforcement for bites or compliance. Run that step for the first few home meals while you track data. If you skip it, be ready to see the old behavior surge even when parents do everything right.
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Join Free →Before sending a feeding plan home, schedule two extra sessions where caregiver and child eat in the clinic playroom, then continue extinction plus praise bites in the kitchen for the first three home meals.
02At a glance
03Original abstract
The term renewal describes the recurrence of previously extinguished behavior that occurs when the intervention context changes. Renewal has important clinical relevance as a paradigm for studying treatment relapse because context changes are necessary for generalization and maintenance of most intervention outcomes. The effects of context changes are particularly important during intervention for pediatric feeding disorders because children eat in a variety of contexts, and extinction is an empirically supported and often necessary intervention. Therefore, we used an ABA arrangement to test for renewal during intervention with 3 children diagnosed with a feeding disorder. The A phase was functional reinforcement of inappropriate mealtime behavior in a simulated home setting with the child's caregiver as feeder, B was function-based extinction in a standard clinic setting with a therapist as feeder, and the return to the A phase was function-based extinction in a simulated home setting with caregiver as feeder. Returning to Context A resulted in renewal of inappropriate mealtime behavior across children, despite the caregivers' continued implementation of function-based extinction with high levels of integrity.
Journal of Applied Behavior Analysis, 2019 · doi:10.1002/jaba.647