An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal

Meeta R. Patel, Cathleen C. Piazza, Cheryl J. Martinez, Valerie M. Volkert, Christine M. Santana

Research output: Contribution to journalReview articlepeer-review

91 Scopus citations


Consumption of solids and liquids occurs as a chain of behaviors that may include accepting, swallowing, and retaining the food or drink. In the current investigation, we evaluated the relative effectiveness of differential reinforcement of the first behavior in the chain (acceptance) versus differential reinforcement for the terminal behavior in the chain (mouth clean). Three children who had been diagnosed with a feeding disorder participated. Acceptance remained at zero when differential reinforcement contingencies were implemented for acceptance or mouth clean. Acceptance and mouth clean increased for all 3 participants once escape extinction was added to the differential reinforcement procedures, independent of whether reinforcement was provided for acceptance or for mouth clean. Maintenance was observed in 2 children when escape extinction was removed from the treatment package. The mechanism by which consumption increased is discussed in relation to positive and negative reinforcement contingencies.

Original languageEnglish (US)
Pages (from-to)363-374
Number of pages12
JournalJournal of applied behavior analysis
Issue number4
StatePublished - 2002
Externally publishedYes


  • Differential reinforcement of alternative behavior
  • Escape extinction
  • Food refusal
  • Negative reinforcement
  • Pediatric feeding disorder

ASJC Scopus subject areas

  • Philosophy
  • Sociology and Political Science
  • Applied Psychology


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