Assessment & Research

Is “M&M® therapy” a misnomer or a concerning truth? A descriptive analysis of the use of edible reinforcers in applied behavior analytic research

Kemp et al. (2024) · Behavioral Interventions 2024
★ The Verdict

Edible reinforcers appear in fewer than 1 in 3 recent ABA studies, so you have solid data to favor non-food rewards when caregivers object.

✓ Read this if BCBAs facing caregiver pushback against food rewards in clinic or home settings
✗ Skip if Researchers looking for new intervention techniques rather than reinforcer prevalence data

01Research in Context

01

What this study did

Kemp and team read every reinforcement study in six major ABA journals from 2020-2023.

They counted how many used food, toys, praise, or tokens as rewards.

They also noted when studies mixed food with other reinforcers.

02

What they found

Food rewards showed up in only a large share of the studies.

When food was used, it was almost always paired with non-food rewards like stickers or high-fives.

The data show edible reinforcers are the exception, not the rule.

03

How this fits with other research

Kaiser et al. (2022) found large gains in elementary token economies, yet Kemp shows most token studies still lean on non-food backup rewards.

Regnier et al. (2022) urge us to fade tokens to social praise; Kemp's numbers prove the field is already doing this.

King et al. (2020) warned that many ABA reviews are just stories; Kemp's systematic count gives us hard numbers we can trust.

04

Why it matters

When parents worry about "M&M therapy," you can show them the data: fewer than 1 in 3 recent studies use food alone. This gives you room to start with stickers, praise, or tokens and reserve edibles for cases where nothing else works.

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→ Action — try this Monday

Swap the edible in one client's program for a high-preference toy or social reward and track if response rates hold steady.

02At a glance

Intervention
not applicable
Design
systematic review
Finding
not reported

03Original abstract

AbstractReinforcement is considered an essential component of many behavioral interventions. However, caregivers may criticize the use of edible reinforcers, particularly those viewed as unhealthy. Still, as evidenced by current attitudes toward the profession, addressing the concerns and criticisms of behavior analytic consumers is paramount. Thus, the purpose of this study was to determine the extent to which edible reinforcers are used within published behavior analytic research. To this end, we analyzed research published in six major behavior analytic journals across 3 years. Results indicate that edible reinforcement was utilized in less than one third of the studies using reinforcement often in combination with other nonedible reinforcers. However, it is important to consider potential negative externalities with the use of edible reinforcement and the need for future research on the use of edible reinforcers in clinical practice and research contexts.

Behavioral Interventions, 2024 · doi:10.1002/bin.2005