SEARCH

SEARCH BY CITATION

An individualized levels system was implemented to increase independent eating in two children with food refusal. Participants earned access to different status levels associated with varying availability of preferred items/activities outside of meals according to criteria based on low levels of prompting throughout the meal. A reversal design was implemented to evaluate the effects of the intervention on independent mealtime behavior. Results demonstrated that the levels system was effective in increasing independent eating and in decreasing prompted bites for both participants. Although the effectiveness of an individualized levels system has been previously demonstrated in the treatment of severe problem behavior, it has not been empirically evaluated in the context of increasing appropriate behavior or with children with food refusal. These findings provide support for such a treatment to promote mealtime independence during an intensive feeding program and at two months follow-up. Copyright © 2013 John Wiley & Sons, Ltd.