BROADENING THE PARAMETERS OF INVESTIGATION IN TREATING YOUNG CHILDRENS CHRONIC FOOD REFUSAL

We evaluated the relationship of contextual variables and contingent m other-child interactions to feeding behaviors at home for 3 children ( ages 18 to 43 months) with chronic food refusal problems. Previous res earch suggests that contingent attention (i.e., specific prompts, appr oval) affects feeding, but contextual variables (i.e., mealtime locati on, seating arrangement, number of meals and snacks offered daily, per sons present during meals) have not been systematically examined. Usin g a nonconcurrent multiple baseline design across mother-child dyads, we assessed the effects of parent training in contingency management s kills on maternal contingent attention, child food intake, and context ual variables of mealtimes. Parent training resulted in planned increa ses in contingent attention and child acceptances of target foods for each dyad. Concomitant with this training, 2 children showed positive changes in contextual variables (e.g., reduced frequency of daily meal s and snacks to a recommended level, increased proportion of meals eat en at a table), and 1 child evidenced mild deterioration in contextual variables. A second parent training condition directed at correcting specific ecological parameters with 2 dyads effectively modified these variables, but its impact on child food acceptance was unclear. These findings suggest that some contextual conditions covary with children 's feeding patterns and should be monitored in planning and evaluating feeding intervention.