Autism & Developmental

Pediatric feeding disorders.

O'Brien et al. (1991) · Behavior modification 1991
★ The Verdict

The first big map of behavioral feeding tricks still guides today’s refined tactics.

✓ Read this if BCBAs starting a feeding case or writing a literature review.
✗ Skip if Clinicians who only want step-by-step protocols with effect sizes.

01Research in Context

01

What this study did

Christopher et al. (1991) wrote a story-style review about feeding problems in kids with developmental delays.

They listed every behavioral trick clinics were using: Premack, time-out plus praise, and ending meals right after a bite.

The paper did not run new kids; it just sorted old reports and told researchers what to test next.

02

What they found

The review said all these tactics "work," but gave no numbers.

It ended with a wish list: clearer definitions, single-case designs, and parent-run plans.

03

How this fits with other research

Haney et al. (2023) later tested one of the wished-for ideas. They let six kids stop the meal right after they self-fed. Every child ate more bites, showing the 1991 hunch was right.

Rubio et al. (2021) updated another 1991 tip. The old review said "physical prompts help." The 2021 review counted studies and found finger prompts work, jaw prompts do not.

Van Arsdale et al. (2024) looked at noncontingent reinforcement, a tactic barely named in 1991. Their map of 15 recent studies shows the field has moved past the old toolbox.

04

Why it matters

This 1991 paper is the grandparent of modern feeding work. If you run a feeding case today, you are using ideas it first gathered. Read it to see which tricks have stayed (negative reinforcement) and which have been sharpened (precise physical prompts). Then update your plan with the 2020s evidence.

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→ Action — try this Monday

Try Haney’s meal-termination rule: let the child leave the table right after one self-fed bite.

02At a glance

Intervention
feeding intervention
Design
narrative review
Population
developmental delay, intellectual disability
Finding
not reported

03Original abstract

Feeding problems occur in children who have normal development, who have failure to thrive, and who have developmental disabilities. This article focuses on the latter two groups. The characteristics and developmental concerns include family characteristics, parent-child interactions, cognitive development, and oral-motor development. The evaluation process for children with feeding problems should include an interdisciplinary approach with a medical, nutritional, occupational therapy, and behavioral evaluation. The behavioral treatments include the Premack principle, time-out plus reinforcement, and negative reinforcement. Future research should focus on the parent-child interaction process in both mealtime and nonmealtime situations, along with demonstrating parents' and teachers' ability to implement mealtime treatment protocols.

Behavior modification, 1991 · doi:10.1177/01454455910153007