Antecedent interventions for pediatric feeding problems.

Bigby et al. (2014) worked with one high-school student who had autism. The teen ate only a few foods and refused most new ones.

The team used a high-probability sequence. They gave three bites of a food the teen already liked, then quickly offered a bite of a new, less-liked food. They repeated this pattern across meals and used an ABAB design to show the sequence itself caused the change.

When the high-p sequence was in place, the teen accepted almost every new-food bite. When it stopped, acceptance dropped. It rose again when the sequence came back.

Seven months later the mother still ran the routine at home. Acceptance stayed high, though not quite at the first level.

Carr et al. (2003) looked like it disagreed. They tried a high-p sequence alone and saw no gain in food acceptance. The key difference: they never added escape extinction. Christine et al. show the sequence can work by itself when you use actual food bites, not just instructions.

Giallo et al. (2006) added escape extinction to the same sequence and got good results. Their study came first, so Christine et al. trims the package back and proves the high-p bite sequence is powerful even without extra procedures.

Peterson et al. (2019) later tested a full ABA package in preschoolers with ASD. They also saw big gains, showing the idea extends across ages and designs.

You can try this Monday: serve three tiny bites of a favorite food, then immediately present a small bite of the target food. Keep the pace fast and praise acceptance. No need for escape extinction at the start. If the learner has autism and refuses new foods, this simple sequence may quickly expand the menu, and parents can keep it going at home.