Simultaneous presentation and differential reinforcement to increase consumption

Peterson et al. (2024) tried a gentle feeding fix for two autistic children who ate only a few foods. They put a new food on the fork next to a favorite food. The child got praise and a small toy for biting the new food. No one held the fork in place or blocked escape.

The team tracked bites across meals to see if the combo of simultaneous presentation plus differential reinforcement could expand the menu without tears.

The authors did not report summary numbers, so we cannot say how many bites were gained. The paper is a pilot meant to show the idea is worth a larger test.

Flanagan et al. (2021) used a similar no-force plan. They gave praise and toys for bites after the child watched an adult eat the food. When that stalled, they added nonremoval of the spoon and bites rose again. Peterson keeps the gentle start but swaps in simultaneous presentation instead of adult modeling.

Demchuk et al. (2026) also start mild. They paired new foods with games and shaped tiny tastes. One child moved forward; the other needed nonremoval of the spoon. The pattern across all three studies is the same: try DR first, then add a firmer prompt only if needed.

Briere et al. (2025) and Stuesser et al. (2020) show the same DR-first rule works outside feeding. They taught kids to accept nasal swabs and medical exams by fading in the steps while giving rewards. No escape extinction was required for most children.

You now have a clear, low-stress entry point for feeding therapy. Start with simultaneous presentation plus praise and a preferred item. If bites do not rise after a few sessions, layer in stimulus fading or, if still needed, nonremoval of the spoon. This sequence keeps therapy friendly while still giving you a path to stronger tactics.