Ma. Werle et al., BROADENING THE PARAMETERS OF INVESTIGATION IN TREATING YOUNG CHILDRENS CHRONIC FOOD REFUSAL, Behavior therapy, 29(1), 1998, pp. 87-104
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.