Further examination of behavior during extinction-based treatment of pediatric food refusal

Researchers have demonstrated the effectiveness of extinction-based treatments to reduce challenging behavior. Although bursts and temporary increases in emotional responding may occur in some basic and applied studies, recent studies on their prevalence have shown that side effects are far from ubiquitous. Woods and Borrero (2019) determined that bursts of inappropriate mealtime behavior and increases in emotional responding occurred in 30% of data sets during extinction-based treatment of pediatric feeding difficulties. In the current study, we conducted a retrospective consecutive-controlled case series by evaluating treatment graphs of inappropriate mealtime behavior, negative vocalizations, active acceptance, and mouth clean for 60 children admitted to an intensive day-treatment feeding disorders program. We discuss the implications of these findings and provide general recommendations for the use of extinction-based treatment.