Incorporating Mealtime Barriers During Caregiver Training of Behavior‐Analytic Feeding Interventions
Rehearse feeding interventions while you add real-life noise—siblings, phones, lunch—so caregivers keep high integrity when they fly solo.
01Research in Context
What this study did
Three caregivers learned a feeding protocol in a university clinic. Trainers used behavioral skills training: explain, model, rehearse, give feedback.
After caregivers hit 90 % correct steps, the team added real-life barriers. Siblings ran through, phones rang, or the caregiver had to eat while treating.
What they found
Every caregiver kept high treatment integrity even with chaos in the room. Scores stayed above 90 % when barriers were present.
The barriers did not break the skill. They seemed to lock it in.
How this fits with other research
Shingleton-Smith et al. (2024) showed telehealth parent training works for toddlers at-risk for autism. McDevitt adds the twist: once parents learn the skill, throw real-life mess at them before they go home.
Williams et al. (2023) found caregiver nonadherence can relapse when child escape behavior returns. McDevitt’s barrier drill may act like an inoculation, exposing caregivers to stress before it naturally happens.
Lord et al. (1986) first showed that unpredictable, thinned reinforcement keeps child behaviors alive. McDevitt uses the same logic for caregiver behavior: practice under tough conditions so the skill survives later.
Why it matters
You can copy this Monday. After a caregiver nails the protocol, have a sibling run laps, turn on the TV, or ask the parent to eat lunch while treating. Five minutes of planned chaos may save you from weeks of later retraining.
Get CEUs on This Topic — Free
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Run one probe session with the parent while a coworker acts as a loud sibling; give feedback until integrity stays above 90 %.
02At a glance
03Original abstract
ABSTRACT Previous research has shown that behavioral skills training is effective for training caregivers to implement behavior‐analytic feeding interventions with high integrity. However, less is known about the generality of caregiver treatment integrity outside of the training context. Caregivers may experience challenges with generalizing their skills to the home as the training context (e.g., clinic) may not include stimuli necessary for caregiver skill generalization. Thus, the purpose of the current study was to evaluate caregiver integrity in the presence of mealtime barriers relevant to the home mealtime setting (e.g., eating while implementing treatment, attending to siblings during meals) and train caregivers to implement interventions with high integrity in the presence of these barriers. We trained three caregivers to implement behavior‐analytic feeding interventions in the absence and presence of caregiver‐identified mealtime barriers relevant to their home mealtime setting. Although treatment integrity decreased across caregivers in the presence of the mealtime barriers, all caregivers implemented interventions with high integrity with the mealtime barriers present by the end of the study. We discuss these results in terms of considerations for improving the generality of caregiver treatment integrity outside of the clinical setting.
Behavioral Interventions, 2026 · doi:10.1002/bin.70079