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Use of functional communication to reduce inappropriate mealtime behavior: Treating individuals with multiple handicapping conditions for food refusal

Maria-Louisa Marjorie Knobel, University of Nebraska - Lincoln


Food refusal is potentially life-threatening and can lead to intrusive interventions (e.g., Luiselli, 1994). Behavior modification techniques have usually focused on increasing food intake. Inappropriate behaviors displayed at meals also merit serious attention because they can cause injury, create a stressful situation, reduce appropriate interactions with care providers, perpetuate the aversiveness of the task, and negate the effects of positive reinforcement of food acceptance. ^ The differential reinforcement of an alternative behavior-communication has been used successfully to decrease inappropriate behaviors serving different functions, including those maintained by escape. Despite its wide-ranging success in reducing a variety of behaviors in different settings, DRA communication has rarely been used in the context of meals. ^ The utility of DRA-communication with other behavioral techniques was investigated in this study. Five individuals with multiple disabilities, histories of food refusal and inappropriate behavior at meals received positive reinforcement for meal consumption and were given a break upon demonstration of an appropriate communicative response. Extinction procedures were also compared to a mild correction procedure. ^ The effects of functional communication on inappropriate behavior, and reinforcement on meal acceptance were equivocal. Three participants demonstrated fewer inappropriate behaviors during treatment than in baseline, but differences were not consistently significant. Only one individual ate significantly more bites during treatment than baseline. The effects of the extinction versus the correction procedure also varied and did not differentiate the results. Weight improved during treatment for two participants. ^ The results did not support the wealth of literature showing the utility of functional communication. Possible reasons for the weak results include that participants had a number of physiological conditions directly related to appetite that could affect behaviors at meals, and that treatment was conducted in the natural environment. Most importantly, procedures were not conducted with integrity. It is possible that the procedures would have produced clearer, more significant gains with a different treatment design and good treatment integrity. ^

Subject Area

Psychology, Behavioral|Education, Special

Recommended Citation

Knobel, Maria-Louisa Marjorie, "Use of functional communication to reduce inappropriate mealtime behavior: Treating individuals with multiple handicapping conditions for food refusal" (2001). ETD collection for University of Nebraska - Lincoln. AAI3022641.