Motivating children with feeding disorders to self‐feed: An evaluation of using differential reinforcement and manipulation of establishing operations to increase self‐feeding

Hansen et al. (2023) worked with two children who refused to feed themselves. The team taught parents to give a favorite toy or snack right after the child took a bite on their own. They also made the child a little hungry before meals so the food looked better.

The study ran at home during normal meals. Parents recorded every bite. The design was a multiple baseline across kids, so the treatment started at different times to show the change was real.

Both kids began feeding themselves the target foods once the package was in place. Caregivers kept the steps correct almost every time.

The gains held without any escape extinction, meaning no one forced bites or held the spoon.

Dowdy et al. (2018) got teens with autism to accept nail cutting using only reinforcement. Hansen shows the same no-extinction trick works for self-feeding, giving the idea a second home.

Rubio et al. (2018) used backward chaining to teach self-feeding, but they had to guide hands. Hansen skips the physical prompt and still wins, so the field now has a less intrusive option.

Patel et al. (2023) and Bloomfield et al. (2021) got big feeding gains through telehealth. Their success with caregiver delivery matches Hansen’s high parent fidelity, showing the procedure travels well across in-person and screen.

If escape extinction feels too harsh or has failed, try this first. Boost reinforcer value by withholding the favorite item until mealtime, then deliver it right after a self-fed bite. Train parents with a short script and five-minute model. You can start Monday with one target food, one hungry window, and one clear reward.