Incorporating social validity into practice: Treatment progression across pediatric feeding skill domains
Let caregivers vote each week on food and bite size to guide demand fading in feeding sessions.
01Research in Context
What this study did
Taylor et al. (2024) worked with one 3.5-year-old who had a feeding disorder.
They used nonremoval of the spoon, re-presentation, and demand fading across six feeding skills.
Caregivers gave feedback every step to keep the plan useful and kind.
What they found
The child met big goals in all six areas, like taking bites and swallowing new textures.
Caregiver check-ins kept stress low and progress steady.
The whole package worked because parents helped shape each step.
How this fits with other research
Taylor et al. (2022) first showed parents like these tactics; the new study moves from liking to live coaching.
Demchuk et al. (2026) got gains without nonremoval for one autistic child. That seems to clash, but their kids had autism, not feeding disorder, and milder refusal.
Flanagan et al. (2021) also added nonremoval when modeling alone stalled, matching the 2024 choice to keep the spoon in place.
Why it matters
You can copy the weekly caregiver vote: show two bite sizes or two foods, let the parent and child pick, then fade demands from that choice. One minute of voting keeps social validity high and avoids rigid protocols that feel harsh.
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02At a glance
03Original abstract
AbstractA small but growing body of research in pediatric feeding disorders asserts the importance of comprehensively measuring social significance of goals, procedures, and effects of intervention, and incorporating social validity into practice to inform treatment. This report sought to extend this literature by detailing procedures to measure and improve social validity during a clinical case of a 3.5‐year‐old during a home‐based intensive feeding program. A multiple baseline design demonstrated effectiveness of nonremoval and re‐presentation added to a treatment package. Repeated choice via direct child preference assessments informed demand fading and gradual progression across six feeding skill domains (medication, cup drinking, independence, texture, volume, variety) and arrangements of response effort (preference, skill) with layers of reinforcer parameters (quality, magnitude, rate, immediacy). Indices of happiness definitions were modified, and extinction bursts examined. Fostering a collaborative approach, caregivers provided detailed input on social validity measures pretreatment, at discharge, and long‐term follow‐up (6‐month, 1‐year), inclusive of both qualitative and quantitative responses, written and verbal communication, and permanent product data. Further implications for practitioners included detailing the process for caregiver training and generalization to family meals with siblings and community settings, and providing adaptable full‐text guidelines for free access/choice contexts.
Behavioral Interventions, 2024 · doi:10.1002/bin.2003