Assessment of Parental Acceptability and Preference for Behavioral Interventions for Feeding Problems.
Parents like differential reinforcement and dislike escape extinction for feeding issues, so start with DR to secure buy-in.
01Research in Context
What this study did
The team sent a short survey to parents of children with autism or developmental delay.
Parents read brief descriptions of two feeding treatments: differential reinforcement and escape extinction.
They then rated how acceptable and preferable each approach felt to them.
What they found
Parents picked differential reinforcement as the most acceptable and preferred option.
They rated escape extinction as the least acceptable, even when feeding problems were severe.
Severity level did not change the preference order.
How this fits with other research
Cividini-Motta et al. (2024) reviewed dozens of skill-building studies and found the same DR tactics parents like also speed up learning.
Duker et al. (1996) showed that combining DR with escape extinction quickly cuts destructive meal-time behavior.
That pairing looks like a contradiction—parents dislike escape extinction, yet it works.
The gap is methodological: the 1996 study measured behavior change, while Vazquez et al. (2019) measured parent comfort.
Both can be true; you can start with parent-approved DR, then add brief extinction only if needed.
Why it matters
If parents hate the procedure, they may not run it at home.
Begin every feeding plan with differential reinforcement—praise, bites-first reinforcement, or tiny breaks.
Save escape extinction for later and explain why if you must use it.
This small shift buys caregiver buy-in and keeps treatment in place long after you leave.
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02At a glance
03Original abstract
The present study evaluates the treatment acceptability and preference for behavioral interventions for feeding problems with parents of children with Autism Spectrum Disorder and other developmental disabilities. The impact of behavioral severity on acceptability and preference was also evaluated by comparing results of parents who responded with respect to a vignette of a child with food refusal with those who responded to a vignette of a child with food selectivity. Overall, parents rated differential reinforcement of alternative behavior as the most preferred and most acceptable strategy across both food selectivity and food refusal groups. Escape extinction was the least acceptable and least preferred across both groups, and the severity of the behavior had no impact on acceptability or preference scores. Implications for future research on the social validity of feeding interventions are provided.
Behavior modification, 2019 · doi:10.1177/0145445517751435