An evaluation of a caregiver training protocol on the generalization and maintenance of successful pediatric feeding interventions

Aclan and team worked with families whose kids had feeding disorders. They wanted to know if simple instructions were enough for parents to run a feeding protocol at home.

Each caregiver first got written and spoken instructions. Later, the team added face-to-face feedback while the parent fed the child. They measured how well the parent followed each step and whether the child ate more food.

Instructions alone produced shaky results. Parents missed steps and kids made small gains.

Once feedback was added, caregiver accuracy jumped and kids began accepting more bites. The gains stayed after the team left.

Alaimo et al. (2018) ran a similar caregiver feeding package. They blended behavioral skills training with general-case training and saw the same boost in parent fidelity and child eating.

Ibañez et al. (2019) seems to disagree. They moved a clinic feeding treatment to home and saw problem behavior return, even with accurate parents. The key difference is starting point: Aclan trained parents from day one at home, while Ibañez started in clinic and later switched settings. Training in the final setting appears to prevent relapse.

Haney et al. (2021) added a brief renewal-mitigation step when handing treatment off. Their procedure stopped the return of mealtime problems, supporting Aclan’s view that caregiver coaching, not just instructions, keeps behavior gains intact.

If you send feeding treatment home, give parents real-time feedback, not a handout. Watch a meal, praise what they do right, and gently correct errors on the spot. This small step keeps the protocol accurate and the child’s eating progress steady.