Cueing, demand fading, and positive reinforcement to establish self-feeding and oral consumption in a child with chronic food refusal

A 3-year-old child with multiple medical disorders and chronic food refusal was treated successfully using a program that incorporated antecedent cont rol procedures combined with positive reinforcement. The antecedent manipul ations included visual cueing of a criterion number of self-feeding respons es that were required during meals to receive reinforcement and a gradual i ncrease in the imposed criterion (demand fading) that was based on improved frequency of oral consumption. As evaluated in a changing criterion design , the child learned to feed himself as an outcome of treatment. One year fo llowing intervention, he was consuming a variety of foods and had gained we ight. Advantages of antecedent control methods for the treatment of chronic food refusal are discussed.