Using Individualized Reinforcers and Hierarchical Exposure to Increase Food Flexibility in Children with Autism Spectrum Disorders
Robert L. Koegel et al.
J Autism Dev Disord (2012) 42:1574–1581
Article Review written by: Corey Saradarian
This article represents a common behavioral issue found in many individuals with Autism Spectrum Disorders; inflexible mealtime behaviors. Inflexible mealtime behaviors were defined as disruptive behaviors such as aggression, elopement and noncompliance when presented with food items outside the child’s restricted daily food menu.
The participants in this study were 3 school-aged boys who were strongly inflexible when it came to mealtime. These 3 boys had daily food menus as low as 6 food items and as high 13 food items at the beginning of this study. The parent’s of the participants had chosen 25 new food items they wanted their boy’s to try. The food items were those that the family regularly consumed as well as healthier alternatives to the boy’s current menus.
Those conducting the study had the participants choose a highly preferred food item in which to use as a reinforcer for trying new foods. In order for the child to receive his preferred food item he must try the new food item he is presented with. The conductor’s of the study along with the boy’s parent’s presented the boy’s with their preferred food items as well as social praise when the boys tried new food items. As the boys displayed increased food flexibility, the boys were then told they would receive their preferred food item after consumption of the new food items. This means the boys were no longer reinforced for only trying the new food items; rather they must swallow the new food items in order to receive the preferred food items.
After 22 weeks all 3 boys added between 5 and 9 new food items to their daily food menus. Not only were the boys enjoying new food items that had previously been rejected, they were spontaneously requesting for the new items as well. This study shows that by use of consistent positive reinforcement individuals can overcome great obstacles and make strides in daily living.
The most important part to take from this article is the consistency of rewarding your child’s good behavior.
Here are a few helpful hints for expanding your child’s daily food menu:
- Make sure the meal consists of preferred foods so your child is excited about eating his/her meal.
- Be sure to tell your child of the reward they will receive when they try the new food item. “first try the carrot, then you can have the chip” or more simply, “first carrot, then chip”
- Start slowly, present one new food item per meal. Have your child try the new food item 2 or 3 times throughout the duration of the meal. Once your child is accepting the new food item with fewer behaviors, try presenting the new food item more often throughout the meal (every few bites of meal).
- Select one of your child’s very favorite food items to use as a reward for when your child tries a new food.
- Reward your child immediately following trying the new food item. Also,
remember to reward your child with specific praise as well. (“Great eating Jeff!”)
- Consistently reward your child. This means EVERY time your child tries a new food he/she should be rewarded! (At least at the beginning!) If your child knows a reward will be presented for trying a new food, your child will then be more motivated to continue trying new foods.