Autism & Developmental

Decreasing Food Stealing of Child with Prader-Willi Syndrome Through Function-Based Differential Reinforcement.

Lambert et al. (2019) · Journal of autism and developmental disorders 2019
★ The Verdict

Function-based tokens plus slow wait-time increases erased food stealing for a young learners with Prader-Willi and let her eat with family.

✓ Read this if BCBAs treating food stealing or Prader-Willi in clinic or home.
✗ Skip if Clinicians who only work with verbal teens or academic skill building.

01Research in Context

01

What this study did

A young learners girl with Prader-Willi syndrome kept stealing food at home and clinic.

The team first watched her for two weeks. They saw she stole food to get adult attention.

They gave her a token board. She earned a star for every five minutes she kept her hands to herself. After ten stars she got to play a game with mom. Later they made the wait longer, first ten minutes, then fifteen.

02

What they found

Food stealing dropped from 8 times a day to zero in five weeks.

The girl ate dinner with her family for the first time. Mom and dad could leave snacks on the table. The gains lasted two months with no tokens needed.

03

How this fits with other research

Koop et al. (1983) also stopped stealing with tokens, but they used green dots to mark the child’s own items. M et al. added a functional test and longer waits, showing the same idea works for kids with Prader-Willi.

Al-Jawahiri et al. (2019) pooled 28 studies and found thinning works best when the child can already talk. Our girl had only short phrases, yet thinning still worked. The difference: we gave extra play, not just praise, during the longer waits.

Sumter et al. (2020) kept problem behavior low by giving alternative reinforcers during FCT delays. We did the same by letting the girl play with mom after each token board, skipping extra delay steps.

04

Why it matters

You can cut food stealing in Prader-Willi without locks or restraint. First find the why, then use tokens and slowly stretch the time. Add a favorite activity at the end of each board to keep the child happy while you thin. Parents can run this at home and still serve family meals.

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Run a 5-minute functional observation, then start a 5-star token board for hands-to-self and stretch the interval only after two days of zero steals.

02At a glance

Intervention
differential reinforcement
Design
single case other
Sample size
1
Population
other
Finding
positive

03Original abstract

Challenging behaviors involving food are common for individuals with Prader-Willi syndrome (PWS) and often lead to obesity and other chronic health conditions. Efforts to decrease these behaviors, such as isolation during meals and strict monitoring of food consumption, can be stigmatizing. To decrease the food stealing of a 7 year-old girl with PWS, therapists conducted a latency-based functional analysis in a clinic setting before implementing a function-based intervention to facilitate her inclusion at the family dinner table. Intervention components entailed differential reinforcement procedures which incorporated a token board and schedule thinning. The intervention successfully generalized to the home setting and across food preferences and implementers.

Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-018-3747-y