INDUCTION AND MAINTENANCE OF SWALLOWING RESPONSES IN INFANTS WITH DYSPHAGIA

A treatment package was used to induce and maintain swallowing with three infants who did not swallow food or liquid. Prior to treatment, they received all nutrition and hydration via gastrostomy tube feedings. The treatment package consisted of least-to-most intrusive physical prompts, an eliciting stimulus, contingent social reinforcement, and repeated trials to induce and maintain swallowing. The design combined elements of reversal and changing criterion designs for all three infants. The package was applied across feeding devices (nipple, cup, spoon), situations (liquid, pureed foods), and persons (trainer, primary nurses, mothers). The number of swallows or ounces per feeding (from 0 to 8 ounces) and the number of feeding sessions per day (from one to five) were progressively increased. In each case, the infant received baseline conditions alternated with the treatment package. Follow-up probes were done at 15 months, 21 months, or 24 months, respectively, after the last phase for the three patients. The package was successful in that the gastrostomy tube was no longer needed for Patients 1 and 3. Patient 2 maintained functional swallowing responses but received supplemental gastrostomy feedings because of unrelated medical problems. Results are discussed in terms of the need to isolate components of the package. The package can be used in cases in which the preexisting treatments (reinforcement with preferred foods, force-feeding) are not feasible because of age, physical fragility, or the lack of a swallowing response following the presentation of food.     

Nonregulation of food intake in restrained,emotional, and external eaters

In the present study, regulation of ice cream intake after a preload was examined in 20 high and 20 low scorers (median split) on subscales of the Restraint Scale (RS) (Herman, Polivy, Pliner, Threshold, & Munic, 1978) and the Dutch Eating Behavior Questionnaire (DEBQ) (van Strien, 1986). For each subscale it was hypothesized that low scorers would regulate their ice cream intake. High scorers on disinhibitive scales (i.e., the RS and the DEBQ-emotional and -external subscales) were expected to counterregulate after a preload. In contrast, high scorers on the inhibitive DEBQ-restraint scale were expected to regulate their ice cream intake. A robust effect was found: high scorers never regulated ice cream intake after a preload on either the disinhibitive or the inhibitive scales, while low scorers always did. For the RS a significant interaction effect was found [F(1,39)=4.97, p=.03]. None of the other subscales showed interaction effects. The t tests showed that low scorers on all subscales ate significantly less after a preload than without one, while high scorers on all subscales did not differ in intake after a preload or without one. This nonregulation appears to be characteristic of people preoccupied with caloric intake, regardless of the content of the preoccupation.     

A parametric analysis of the relationship between food quantity and rumination

Rumination is the chronic regurgitation, chewing, and reswallowing of previously ingested food. The study reported here, using a parametric design, examined the control of rumination by the quantity of food eaten at meals. The subjects were three profoundly retarded individuals who chronically emitted this behavior. The quantity of food by weight ingested daily was varied in 10-oz steps in both ascending and descending series (data were collected only after breakfasts and lunches). Ruminating decreased when food quantity increased and increased when food quantity decreased. In addition, there was a similar inverse interaction between breakfast food quantity and post-lunch ruminating. The data showed relatively rapid transitions in both frequency and duration at each meal size for all subjects. The data establish a clear functional relation between the quantity of food ingested and ruminating.     

EFFECTS OF A PROCEDURE DERIVED FROM THE OVERCORRECTION PRINCIPLE ON MANIPULATED AND NONMANIPULATED BEHAVIORS

Positive practice overcorrection has been shown to be effective in reducing stereotypic self-stimulatory behaviors displayed by retarded and autistic individuals. In addition, the procedure also may increase the occurrence of appropriate behavior through intensive practice. In the present study, several stereotypic and one appropriate behavior (appropriate toy play) displayed by two autistic children were measured before and during treatment by a positive practice in appropriate toy play overcorrection procedure. Overcorrection was introduced for each of the targeted inappropriate behaviors in succession for both children. Results showed that overcorrection reduced all stereotypic behaviors displayed by both children. In addition, one subject displayed marked increases in the behavior practised during overcorrection, appropriate toy play, relative to its baseline rate of occurrence. The results indicate that for some individuals, overcorrection may be effective in teaching and motivating appropriate forms of behavior as well as in reducing stereotypy.     

BEHAVIORAL NUTRITION: CONSUMPTION OF FOODS OF THE FUTURE BY TODDLERS1

Behavioral measures of food consumption and tasting were combined with nutrient analysis of foods served at a toddler day-care center to determine whether children at the stage of initial exposure to adult diets would accept textured vegetable protein (TVP) and nonfat dry milk as well as they ate other sources of protein and calcium. Main dishes were prepared alternately with TVP, meat, or neither; others were prepared with or without nonfat dry milk. The variation in ingredients appeared not to affect the amount children ate, the percentage sampling the foods, or the percentage eating half a portion or more. Dishes made with TVP increased protein intake comparable to the amount obtained with meat supplements, and calcium intake increased with nonfat dry-milk supplements. In light of these findings, it appears that TVP and nonfat dry milk are practical alternative sources of protein and calcium in menus for young children.     

DESCRIPTIVE ANALYSIS OF EATING REGULATION IN OBESE AND NONOBESE CHILDREN

Bite rate, sip rate, and concurrent activities of six 7-yr-old children, three obese and three nonobese, were observed at lunchtime over a six-month period. A procedure for decreasing bite rate, putting eating utensils down between bites, was implemented in a multiple-baseline across-subjects design. Sip rates and concurrent activities were observed to assess behavioral covariations. In addition, bite rate and amount of food completed were computed over six food categories to analyze food preferences. Results indicated the control of bite rate across all subjects, with a significant reduction in amount of food consumed. Correlations between the response classes indicated they were at least partially independent. Differences in eating behavior of obese and nonobese subjects were observed for breadstuffs and milk drinking.     

Concurrent-schedule performance in dairy cows: persistent undermatching.

Performance of dairy cows responding under concurrent variable-interval variable-interval schedules of food delivery was examined, with results analyzed in terms of the generalized matching equation. In Experiment 1, bias measures indicated that crushed barley was preferred over meatmeal when these foods were available under the alternative schedules. For whole-session data, substantial undermatching of response and time-allocation ratios to obtained reinforcement ratios was evident. Postreinforcement pause time ratios approximately matched obtained reinforcement rates. Subtracting these times from total time-allocation values yielded net time-allocation ratios that undermatched obtained reinforcement ratios to a greater degree than did whole-session time-allocation ratios. In Experiment 2, substantial undermatching was evident when the same foods (hay for 2 cows, crushed barley for 2 others) were available under the alternative schedules. Food-related activities and other defined behavior not related to food were quantified by direct observation, and were found to occupy a substantial proportion (roughly 40% to 80%) of experimental sessions. Subtracting the time spent in these activities from the time allocated to each component schedule did not reduce the degree of undermatching obtained. Across all conditions in both experiments, slopes of regression lines relating behavioral outputs to environmental inputs characteristically were below 0.6, which agrees with prior findings and suggests that, contrary to suggestions in the literature, undermatching in dairy cows is not the result of using different foods under alternative schedules or differential pausing under those schedules.     

THE COSTS OF EATING: A BEHAVIORAL ECONOMIC ANALYSIS OF FOOD REFUSAL

Behavioral economic concepts were applied to the analysis and treatment of pediatric feeding disorders in a clinical setting. In Experiment 1, children who chronically refused food were presented with varying amounts of food on a spoon (empty, dipped, quarter, half, and level). Each child exhibited a different but orderly demand function of response (acceptance, expulsion, and mouth clean) by cost (increasing spoon volume) for a constant pay-off of toys and social interaction. In Experiment 2, physical guidance or nonremoval of the spoon for food refusal was initiated at the smallest spoon volume with low levels of acceptance, and was subsequently introduced at the largest spoon volume with moderate levels of acceptance. Treatment was effective in increasing acceptance, and these effects generalized hierarchically across untargeted spoon volumes. The results of both studies provide preliminary support that increasing spoon volume can be equated conceptually with increasing response effort, and that the change from differential reinforcement to physical guidance or nonremoval of the spoon appears to have altered the elasticity of each child's demand function.     

TRIADIC INSTRUCTION OF CHAINED FOOD PREPARATION RESPONSES: ACQUISITION AND OBSERVATIONAL LEARNING

This research examined whether constant time delay would be effective in teaching students with moderate mental retardation in triads to perform chained tasks and whether observational learning would occur. Three chained snack preparation tasks were identified, and each student was directly taught one task. The other 2 students observed the instruction. The instructed student told the observers to watch and to turn pages of a pictorial recipe book. The teacher provided frequent praise to the instructed student based on performance and to the observers for watching the instruction and turning pages. A multiple probe design across students and tasks was used to evaluate the instruction. The results indicated that each student learned the skill he or she was taught directly, and the observers learned nearly all of the steps of the chains they observed. The implications for classroom instruction and future research in observational learning are discussed.     

Scaling pigeons' choice of feeds: bigger is better.

Preferences of hungry pigeons among 10 grains and pellets were analyzed using a Thurstone scaling procedure. The recovered scales were positively correlated with size of the feed. The correlations improved when the Thurstonian assumption of equal-sized discriminal dispersions (Case V) was replaced with the assumption of proportional-sized dispersions (Case VI), as entailed by Weber's law. The correlations weakened when the experiments were conducted with the pigeons close to their free-feeding weights, where the probability of sampling alternative grains increased. In the final experiment, exposure to a large pellet shifted the preferences between two smaller pellets.