CONTINGENCY CONTACTING - COMBINING POSITIVE REINFORCEMENT AND ESCAPE EXTINCTION PROCEDURES TO TREAT PERSISTENT FOOD REFUSAL

Chronic food refusal has traditionally been treated with forced feedin g and other physical prompting-based procedures when positive reinforc ement procedures prove inadequate. Potential problems with such proced ures, however, include exacerbation of feeding difficulties and health risks, as well as low parental approval and probability of implementa tion. Contingency contacting maximizes contact between oral acceptance and positive reinforcement, prevents escape functions of inappropriat e behaviors, and requires minimal physical contact between feeder and child. Performances of two children exhibiting chronic food refusal we re observed under baseline, positive reinforcement, and contingency co ntacting conditions. Positive reinforcement increased acceptance only slightly and did not change negative vocalization or interruption for one child. Contingency contacting rapidly increased acceptance and gra ms of food consumed, and decreased negative vocalization and interrupt ion for both children. Withdrawal to positive reinforcement decreased acceptance for both children and grams consumed for one. Reinstituting contingency contacting rapidly increased acceptance and recovery of g rams consumed for one child. Parental approval ratings and treatment a nd research implications are discussed.