Noncontingent reinforcement in the treatment of pediatric feeding disorder: A concise review

Van Arsdale et al. (2024) read every 2018-2022 paper that used noncontingent reinforcement (NCR) for pediatric feeding problems. They found 15 studies and wrote a map of how each one used NCR.

The team recorded who the children were, what food problem was treated, and how NCR was given. They did not pool numbers to say if NCR works.

NCR shows up often in feeding treatments, but the label means different things. Some studies gave a bite of favorite food every 30 seconds no matter what. Others let the child watch a toy throughout the meal.

Few papers spelled out the exact schedule, the reinforcer, or why they picked NCR. This makes it hard to copy or compare treatments.

Rubio et al. (2021) found that finger-prompt and side-deposit reliably open the mouth. Van Arsdale shows many studies pair those same prompts with NCR, so the two tactics often work together, not against each other.

Chen et al. (2022) compared bite-by-bite versus saved-up reinforcers. Their careful timing contrasts with the loose NCR schedules Van Arsdale found, highlighting a gap you can fix in your own protocol.

Kirkwood et al. (2021) proved that treating both escape and attention functions beats treating only one. Several papers in Van Arsdale’s list used NCR for escape only and left attention intact, so those studies may have stopped too early.

If you write “NCR” in a feeding plan, define the schedule, the reinforcer, and the function it is meant to block. Without those details, technicians deliver different meals and outcomes swing. Use Van Arsdale’s map to pick a clear model, then add the precise prompts and multi-function focus that neighbor papers show work best.