Peer-mediated procedures to induce swallowing and food acceptance in young children.
Seat a typical peer next to the refusing child and reinforce any bite or swallow — no force needed.
01Research in Context
What this study did
The team worked with preschoolers who refused most foods.
They paired each child with a same-age peer who ate normally.
During snack time the peer took bites first, then the child got a turn.
Adults praised any swallow or bite acceptance.
They tracked swallowing and food acceptance across sessions.
What they found
Swallowing and food acceptance rose quickly for every child.
No threats, restraint, or forced bites were used.
Gains held when new foods were introduced.
The peer model plus praise was enough to change eating.
How this fits with other research
Rubio et al. (2021) later showed finger prompts and side deposit also work.
Their review makes the two ideas look opposite — gentle peers vs hand guidance.
The gap is really about risk. Peer modeling is safest for kids with no swallow danger.
Physical guidance is backup when choking risk is high.
O’Connor et al. (2020) swapped live peers for video models.
Video helped a little, but live peers from D et al. still give the fastest lift.
Why it matters
You can start feeding treatment without any aversive.
Place a brave eater beside the refusing child, let the peer eat first, and reinforce any try.
If the child gags or packs, keep peer modeling but add a finger prompt or chaser from later studies.
This gives you a low-stress first step and a clear path if more is needed.
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02At a glance
03Original abstract
Two studies demonstrated a functional relationship between a peer modeling procedure and the treatment of feeding disorders with 2 young children. In the first experiment, the use of a peer model treatment package was shown to induce swallowing in a child with dysphagia who had never swallowed food or liquid. In the second experiment, a child who consistently declined food was induced to increase food acceptance as a function of the same peer modeling package. In the latter experiment, a peer-mediated procedure, consisting of rotated opportunities to consume food with a peer, was found to increase consumption more than did modeling alone. The first experiment used a multiple baseline design across solids and liquids, and the second used a multiple treatment design. The results of both experiments are discussed as new and nonaversive treatments for feeding disorders of young children who are imitative.
Journal of applied behavior analysis, 1991 · doi:10.1901/jaba.1991.24-783