Avoidant/Restrictive Food Intake Disorder

Behavior Analytic Approach

Treatment Summary: The behavior analytic viewpoint is that positive and negative reinforcement are at the heart of most feeding/eating problems. Research supports negative reinforcement as the culprit in perpetuating feeding problems. Negative reinforcement, such as the parent removing the food when the child cries, throws a tantrum, throws the food, or plain refuses the food, greatly increases the likelihood of continued future food refusal. Research-based behavioral interventions have been found to be effective treatments of feeding disorders in childhood. Through the use of behavioral interventions such as extinction, shaping, response-cost, and differential reinforcement, food disorders can be successfully treated. Using a behavioral feeding intervention may constitute conveying a signal to the child, such as placing food in front of them coupled with a verbal prompt. The spoon of food is presented for a time of 3-5 seconds. If the child accepts the food within that time frame, contingent access to some type of positive reinforcer (praise, different food, preferred activities) is given. If the child does not accept the spoon of food within the 3-5 seconds allotted, either he or she receives no type of positive reinforcement, or the spoon is left at the mouth until the food is accepted, or the spoon may be manually guided into the child's mouth. At the end of either outcome, acceptance of food by choice or by manual manipulation, the reinforcer is removed.

• Reference: Kerwin, Mary Louise E. (2003). Pediatric feeding problems: A behavior analytic approach to assessment and treatment. The Behavior Analyst Today, 4 (2), 162-176.
• Submitter: Jill Guerin