Treating overweight children through parental training and contingency contracting.
Parent-run response cost plus prizes trims extra pounds in children, but keep the rewards and plan for upkeep.
01Research in Context
What this study did
The team taught parents of overweight children to run a home token system.
Kids earned points for healthy eating and lost points for off-plan foods.
Some families added extra praise and prizes. Others used only the point loss.
All families met weekly for 12 weeks to check weight and adjust the contract.
What they found
Both point-loss groups lost more weight than kids with no plan.
The group with prizes lost the most at week 12.
Three months later the gap had shrunk, but the prize group still weighed less.
Parent-run response cost works best when you pair it with rewards.
How this fits with other research
Mueller et al. (2000) showed the same response-cost trick cuts destructive behavior by 87%.
The tool works across very different problems when parents stay consistent.
Burrell et al. (2023) later used parent contracts for food selectivity in autistic kids.
They kept the prize piece and saw similar gains, proving the idea travels.
Lee et al. (2022) tried a teen weight-loss app with no parent role and got zero change.
Their null result warns us: skip parent training and the effect can vanish.
Why it matters
You can hand parents a simple point chart and see real weight change in three months.
Add small prizes to keep the child engaged; the data say it boosts early success.
Plan a fade-out and monthly booster checks so the loss does not creep back.
If you work with feeding or weight goals, try parent-run response cost plus rewards first.
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02At a glance
03Original abstract
Fifteen overweight girls aged 5 to 11 yr were randomly assigned to one of two weight-reduction treatments: response-cost plus reinforcement, response-cost only, or a no-treatment control group. In the response-cost plus reinforcement group, parents contracted to facilitate their child's weight loss by carrying out reinforcement and stimulus control techniques, completing weekly charts and graphs, and encouraging their child to exercise. The response-cost only group parents did not contract to reinforce their child's performance. The response-cost program applied to both experimental groups was conducted in weekly meetings in which parents lost previously deposited sums of money. Twenty-five per cent was deducted for missing the weekly meeting, 25% for failing to fill out charts and graphs, and 50% if their child failed to meet her specified weekly weight-loss goal. At the end of the 12-week treatment period, both experimental groups had lost significantly more weight than the control group. After an eight-week, no-contact follow-up, some of the lost weight was regained. The response-cost plus reinforcement group was still significantly below the controls. The response-cost group just missed significance. A 31-week, no-contact follow-up failed to show a treatment effect, but did show a trend towards slower weight gain by the response-cost plus reinforcement group.
Journal of applied behavior analysis, 1975 · doi:10.1901/jaba.1975.8-269