Evaluation of two physical guidance procedures in the treatment of pediatric feeding disorder
Finger-prompt guidance works as well as spoon-prompt and parents like it more.
01Research in Context
What this study did
Rubio and team compared two ways to guide a child’s mouth to food. One way used a finger prompt. The other used a spoon prompt.
Kids with feeding disorder took part. Each child tried both prompts in an alternating pattern. The researchers counted how many bites the kids accepted.
What they found
Both prompts worked. Food acceptance went up with either the finger or the spoon.
Parents liked the finger prompt better. They said it felt gentler and easier to use at home.
How this fits with other research
Cowan et al. (2023) built a tool that helps you pick any prompt. Their tool says “match the prompt to the child and the skill.” Rubio’s results give a clear rule for feeding: finger and spoon both pass the test, so let the caregiver choose.
Kodak et al. (2013) also compared prompt tweaks. They found that repeating the question did not speed up learning. Rubio’s study adds a new prompt tweak—finger versus spoon—and again shows no skill difference, just a comfort difference.
Hawkins (1982) first showed that a quick physical prompt plus praise can get autistic-like kids to play with new toys. Rubio moves the same idea from play to feeding forty years later.
Why it matters
You now have two proven physical guidance options for feeding treatment. Start with the finger prompt if the caregiver feels unsure; it works and they are more likely to use it. If the child already tolerates a spoon, stay with it. Either way you can move forward without extra training.
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02At a glance
03Original abstract
Children with pediatric feeding disorder may refuse to consume an adequate variety and/or volume of food to maintain expected growth. They can consume food but may actively or passively refuse, resulting in escape or avoidance of eating. Behavioral interventions like positive reinforcement with escape extinction can increase consumption. However, sometimes these interventions are insufficient, especially in treating passive refusal. In these cases, physical guidance may be used to prompt an open mouth to deposit food. Research indicates open-mouth prompts are effective and rated as acceptable. This study replicated an existing physical guidance procedure, the finger prompt, and compared its efficacy and acceptability with that of a spoon prompt. This study extended research by defining and measuring passive refusal as a dependent variable and assessing social validity among different stakeholders and times. Both prompts were effective in treating food refusal, and caregivers rated the finger prompt as more preferred.
Journal of Applied Behavior Analysis, 2024 · doi:10.1002/jaba.1062