Increasing meal consumption in individuals with competing protective equipment
Loosen restrictive safety gear and jazz up the meal itself to get students with autism eating again.
01Research in Context
What this study did
Fleck et al. (2019) worked with two high-school students who wore helmets and mitts to stop self-hitting. The gear also blocked them from lifting food to their mouths.
The team loosened the straps so the students could move their arms. They also made the meals more fun by adding music, colorful plates, and favorite foods. One student earned extra praise for eating without help.
What they found
Both students started eating more right away. The gear change plus richer meals did the heavy lifting.
Extra praise gave one student a second boost. Gains stayed high when staff kept the new plan in place.
How this fits with other research
Older studies used the same kind of gear the opposite way. Luiselli (1986) and Rayfield et al. (1982) strapped helmets and mitts on tight to stop self-injury. Fleck flips the script: loosen the gear so eating can happen.
Thakore et al. (2024) show the middle path. They kept the gear tight but only after a child poked his mouth. Their gear was a consequence, not a barrier. Fleck’s gear is an accommodation, not a punisher.
Volkert et al. (2016) never touched helmets, but they also boosted eating by tweaking effort and reward. Both papers say the same thing: make the bite easier and the payoff bigger.
Why it matters
If a client wears protective gear, check whether it blocks meals. Loosen straps first, then sweeten the dining experience with color, music, or favorite foods. Add praise if needed. You may solve feeding and keep safety in one quick shift.
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Join Free →Slide a finger under each helmet strap and mitt cuff—if you feel a mark, loosen one notch and serve lunch on a bright plate with music playing.
02At a glance
03Original abstract
Individuals diagnosed with autism spectrum disorder may engage in self‐injurious behavior that can cause tissue damage. Protective equipment is sometimes used to decrease the severity of tissue damage when self‐injury occurs. However, wearing protective equipment may be incompatible with some forms of adaptive behavior, such as meal consumption. The purpose of the present analysis was to identify a treatment for increasing meal consumption in two adolescent males diagnosed with an autism spectrum disorder who wore protective equipment that interfered with self‐feeding. Three interventions were evaluated: modifying the protective equipment, manipulating the reinforcing efficacy of the meal, and arranging additional positive reinforcement for meal consumption in the absence of protective equipment. Modifying protective equipment and manipulating the reinforcing efficacy of the meal were effective for both participants. Additional positive reinforcement was evaluated and effective for one participant.
Behavioral Interventions, 2019 · doi:10.1002/bin.1681