A systematic evaluation of food textures to decrease packing and increase oral intake in children with pediatric feeding disorders

This study examined packing (pocketing or holding accepted food in the mouth) in 3 children who were failing to thrive or had inadequate weight gain due to insufficient caloric intake. The results of an analysis of texture indicated that total grams consumed were higher when lower textured foods were presented than when higher textured foods were presented. The gram intake was related directly to levels of packing. That is, high levels of packing were associated with higher textured foods and low gram intake, and low levels of packing were associated with lower textured foods and high gram intake. All participants gained weight when texture of foods was decreased. Packing remained low during follow-up for 2 participants even when the texture of food was increased gradually over time. These data are discussed in relation to avoidance, response effort, and skill deficit.     

The spread of attention to hidden portions of occluded surfaces

We report two experiments in which the two-rectangles method of Egly, Driver, and Rafal (1994) was used to test whether object-specific attentional cuing advantages can spread to hidden portions of occluded objects. Displays began with portions of two rectangles hidden by a third, occluding object. One end of one of the two rectangles was cued, after which the occluder rotated around its center point and target stimuli were presented. In one condition, the occluder was removed from in front of the other objects, either by rotating away from them (Experiment 1B) or by rotating and then slipping behind them (Experiment 1B). In another condition, the occluder first rotated away but then returned to its original position. In both experiments, an object-specific cuing advantage occurred in the occluderremoved condition for targets that appeared in what had been hidden locations of the cued object. No analogous advantage occurred in the occluder-returned condition.     

The Order of Widows: what the early church can teach us about older women and health care.

This article argues that the early Christian "order of widows" provides a fruitful model for Christian ethicists struggling to address the medical and social problems of elderly women today. After outlining the precarious state of the "almanah"--or widow--in biblical times, it describes the emergence of the order of widows in the early Church. Turning to the contemporary situation, it argues that demographics both in the United States and around the globe suggest that meeting the needs of elderly women will become an enormous challenge in the years to come. The order of widows illustrates a three-fold conception of solidarity that has immediate implications today. That conception of solidarity encourages us: 1) to identify the unique medical needs of elderly women (e.g., osteoporosis); 2) to find ways of overcoming their societal isolation, which can increase their risk of medical and psychological problems; and 3) to develop strategies for enabling them to remain contributing members of the community for as long as possible.     

Increasing variety of foods consumed by blending nonpreferred foods into preferred foods

A treatment with differential or noncontingent reinforcement and nonremoval of the spoon increased the acceptance of one or two of 16 foods for 2 participants with severe food refusal. These differential levels of acceptance were demonstrated empirically in an ABAB design in which A was the presentation of the accepted (preferred) foods and B was the presentation of foods the participants refused (nonpreferred foods). Subsequently, we implemented a blending treatment that consisted of mixing (blending) nonpreferred foods into preferred foods in various ratios (e.g., 10% nonpreferred/90% preferred, 20% nonpreferred/80% preferred). We then presented nonpreferred foods that had been exposed to blending to determine if consumption of nonpreferred foods would increase following the blending treatment. We also conducted periodic reversals in which we presented nonpreferred foods that had not been exposed to the blending treatment. Following initial implementation of the blending treatment, consumption was high for nonpreferred foods that had been blended and low for nonpreferred foods that had not been blended. Consumption increased for all foods (i.e., foods that had been exposed to blending and foods that had not been exposed to blending) after seven or eight foods had been exposed to the blending treatment. Thus, the variety of foods consumed by the participants increased from one or two to 16. These results are discussed in terms of stimulus fading, conditioned food preferences, and escape extinction. DESCRIPTORS: conditioned food preferences, food refusal, negative reinforcement, stimulus fading     

Varying response effort in the treatment of pica maintained by automatic reinforcement

Pica is a life-threatening behavior displayed by many individuals with developmental disabilities. In the current study, automatic reinforcement maintained the pica of 3 participants. Following functional analyses of pica, response-effort manipulations were conducted in which the effort to obtain pica or alternative items was varied systematically. Several general relations emerged as a result of the study. First, levels of pica were reduced relative to baseline when alternative items were available independent of the effort required to obtain alternative items or pica. Second, increasing the effort for alternative items resulted in increases in pica relative to when effort for alternative items was low. Third, increasing response effort for pica produced reductions in pica relative to baseline when alternative items were unavailable. Fourth, the highest levels of pica occurred when the effort to engage in pica was low or medium and no alternative items were available. These findings are discussed in terms of the relative effects of quality of reinforcement and response effort on behavior.     

Acquisition of cup drinking using previously refused foods as positive and negative reinforcement

We used previously refused foods as positive and negative reinforcement in the acquisition of cup drinking. Cup drinking increased with positive and negative reinforcement, both alone and in combination (without escape extinction), indicating that treatment of food refusal can establish some foods as appetitive stimuli whereas others remain aversive.     

COMBINING STIMULUS FADING,REINFORCEMENT, AND EXTINCTION TO TREAT FOOD REFUSAL

The food refusal of a 6-year-old girl with destructive behavior was treated using stimulus fading, reinforcement, and escape extinction. Intake increased and compliance with prompting procedures remained relatively stable despite the increased consumption requirement.     

EFFECTS OF WRIST WEIGHTS ON SELF-INJURIOUS AND ADAPTIVE BEHAVIORS

The effects of wrist weights on the self-injurious and adaptive behaviors of a young boy with profound mental retardation were evaluated. Application of wrist weights reduced SIB by 92% and was associated with either increases or stable levels of multiple novel and preexisting adaptive behaviors.     

ON THE RELATION OF MANDS AND THE FUNCTION OF DESTRUCTIVE BEHAVIOR

When standard analogue functional analysis procedures produce inconclusive results in children with conversational speech, the child's mands may help to identify the function of destructive behavior. In the current investigation, functional analyses conducted with 2 children who exhibited self-injury, aggression, and property destruction were undifferentiated across conditions. Based on informal observations and school and parental report, an analysis was conducted using mands to help determine the function of the destructive behavior. Using a multielement design, the therapist's compliance with the child's mands occurred either on a fixed-ratio (FR) 1 schedule or contingent on destructive behavior. Destructive behavior occurred at high and consistent levels when reinforcement of mands was contingent on destructive behavior and at near-zero levels when reinforcement of mands occurred on the FR 1 schedule. Based on these results, a second analysis was conducted in which compliance to mands occurred only when the child appropriately requested it (i.e., functional communication training plus extinction) and, for 1 child, compliance with mands was terminated contingent upon destructive behavior (i.e., functional communication training plus response cost). For both children, the rates of destructive behavior decreased markedly. The results suggest that assessing the child's mands may be useful in decreasing destructive behavior when a functional analysis is inconclusive.     

USING A CHOICE ASSESSMENT TO PREDICT REINFORCER EFFECTIVENESS

A choice assessment has been found to be a more accurate method of identifying preferences than is single-item presentation. However, it is not clear whether the effectiveness of reinforcement varies positively with the degree of preference (i.e., whether the relative preference based on the results of a choice assessment predicts relative reinforcer effectiveness). In the current study, we attempted to address this question by categorizing stimuli as high, middle, and low preference based on the results of a choice assessment, and then comparing the reinforcing effectiveness of these stimuli using a concurrent operants paradigm. High-preference stimuli consistently functioned as reinforcers for all 4 clients. Middle-preference stimuli functioned as reinforcers for 2 clients, but only when compared with low-preference stimuli. Low-preference stimuli did not function as reinforcers when compared to high- and middle-preference stimuli. These results suggest that a choice assessment can be used to predict the relative reinforcing value of various stimuli, which, in turn, may help to improve programs for clients with severe to profound disabilities.