Reduction of unsafe eating in a patient with esophageal stricture.

A teen with developmental delay and a narrow esophagus kept eating too fast and too big.

The team gave a verbal cue (“take small bites”) and praise for each safe bite.

They tracked bite size, bite speed, and chews per bite during every lunch.

Prompts plus praise cut bite rate and bite size.

Chews per bite went up, so food was safer to swallow.

The changes stayed through the final meals.

Capio et al. (2013) later showed the same trick—just saying “chew it up” and giving praise—boosted chews in two kids with feeding disorders.

Jenkins et al. (2017) stretched the idea further: they faded bite-specific prompts to a simple “eat your lunch” and ended approval-seeking bites.

Davis et al. (1976) looked like a clash: slowing bites in typical obese kids also cut total food intake. The difference? The teen in the 1999 study had a medical need for slower eating; intake drop was not a goal, and it did not happen here.

If a client eats too fast or takes huge bites, try a quick verbal prompt and immediate praise.

Track bite rate, size, and chews for a few meals to see change.

No extra gear is needed, and the same plan has since helped kids with other feeding issues.