A pilot study to increase chewing in children with feeding disorders.
A quick “chew it up” prompt plus praise can finish the job when escape extinction alone leaves food in the cheek.
01Research in Context
What this study did
Two kids with feeding disorders still pocketed food after nonremoval-of-spoon training.
The team added a simple prompt and praise. In Study 1 they used least-to-most prompting. In Study 2 they just said “chew it up” and gave praise for each chew.
They counted chews per bite during meals to see if the extra cue helped.
What they found
Both children started chewing more right away. Pocketing dropped.
The easy verbal prompt plus praise was enough to finish the job that escape extinction had started.
How this fits with other research
Harkins et al. (2023) later grouped this paper with other single-case chewing studies. Their review says multicomponent packages work, but we still don’t know which parts matter most.
Feldman et al. (1999) did almost the same thing 14 years earlier. One teen with esophageal stricture got prompting plus praise and also chewed more. Capio et al. (2013) shows the same trick still works in younger kids.
Rubio et al. (2020) looks different at first glance. They added a finger prompt to boost bite acceptance, not chewing. Both studies start with escape extinction then layer on a quick prompt, so the logic matches even though the target moves from “take the bite” to “chew the bite.”
Why it matters
If you already use nonremoval of the spoon but the child still stores food in his cheek, try adding a brief verbal cue and immediate praise. It takes two seconds, needs no extra gear, and this study shows it can turn acceptance into real chewing. Start with “chew it up,” deliver a smile and “nice chewing” after each mouth movement, and track chews per bite for a week to see if it works for your client.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →After the spoon stays at the lips, say “chew it up” and praise each chew—count chews for five bites to see change.
02At a glance
03Original abstract
Children with feeding disorders often display chewing deficits. Unfortunately, there is a paucity of research examining procedures to increase or teach chewing to children with feeding disorders. The few studies on this topic have utilized multicomponent treatments typically involving a shaping procedure. In addition, to our knowledge, studies on chewing have not yet incorporated a product measure of chewing (whether the food is broken down enough to swallow after chewing), which we have termed mastication. In the current investigation, we evaluated relatively simple treatments to increase chewing with two children with a feeding disorder who were not chewing at clinically acceptable levels after treatment with nonremoval of the spoon. We also developed a product measure of chewing. In Study 1, we used a least-to-most prompting plus praise procedure to increase chews per bite in a typically developing child with a feeding disorder. We then used the results of Study 1 to refine treatment and develop our mastication measure for Study 2. In Study 2, we implemented a descriptive verbal prompt and praise procedure to increase chews per bite and percentage of mastication with one child with developmental delays and a feeding disorder.
Behavior modification, 2013 · doi:10.1177/0145445512474295