The authors wish to acknowledge the support of Florida International University and the Center for Children and Families.

This protocol follows Florida International University&#8217;s guidelines for research with human subjects and consent is always obtained from parents/caregivers before any treatment is started. In addition, obtain clearance from a physician before the start of treatment. &#160;
NOTE: Although specific age ranges and individual variables have not been empirically validated, this protocol has been used clinically for children ages 2-7 with autism and developmental delays. Participants should be referred for behavioral intervention by their caregiver and a medical professional. Clear participants of any medical or physical underlying issues related to feeding as part of the screening for eligibility for behavioral intervention protocols to address food selectivity.
1. Session Structure and Clinical Environment
<ol>
	<li>Conduct treatment sessions in an outpatient treatment setting, between two and four times per week, for approximately 1 hr per session. Conduct sessions in treatment rooms equipped with a table, chairs, and items that are used during mealtimes (i.e., plates, napkins and utensils). Additionally, bring toys and other tangible items into the room to serve as reinforcers throughout out the intervention procedure.</li>
</ol>
2. Pre-treatment Assessments
<ol>
	<li>Preference Assessment.</li>
	<li>Conduct a brief, informal preference assessment at the start of each session, to determine tangible items that may function as reinforcers for compliance during that session. Present an array of toys on the table and the give the child the opportunity to choose the toys he/she wants to work for that day.</li>
	<li>Food Assessment
	<ol>
		<li>Ask parents or caregivers to indicate foods that the child is likely to eat 100% of the time when they are offered, 80% of the time, 60% of the time, and so on down to those foods the child would not accept (0%) in twenty percent increments.</li>
		<li>Begin the intervention with those foods the child is likely to eat (100% of the time when offered) and proceeded to more difficult foods that the child has never tried. &#160; 
		NOTE: The purpose of including a preferred (100%) food in the first intervention condition is to initially foster compliance with the demand fading steps.</li>
	</ol>
	</li>
</ol>
3. Sessions and Procedures
<ol>
	<li>During baseline present a bite of each of the target foods that have not yet been exposed to the intervention on a white plate in front of the child and say, &#8220;Eat this.&#8221; Do not provide any consequences contingent on any response emitted during baseline.</li>
	<li>If the child eats the food, then allow them time to consume it and then present the next bite. If the child does not eat the food after 10 sec the trials ends and then present the next food. &#160; 
	NOTE: Present each food should 5 times during baseline in an alternating order. Conduct at least 2 baseline sessions prior to beginning intervention for any target food. Continue to probe the remaining foods in baseline at least one time per week.</li>
	<li>Confirm parent report of the child&#8217;s food preferences by placing one food from each category (i.e., 100%, 80%, etc.) on a white plate in front of the child and say, &#8220;Eat this.&#8221; Present each of the foods five times in an alternating order. If the child eats the food, move on to the next trial. If the child does not eat the food after 10 sec, remove it from the plate and present the next food item. If the child throws the food or says they do not want it move on to the next food item without addressing the problem behavior. &#160; 
	NOTE: Only use those foods that are consistent with parent report for intervention. If there are foods that do not match the parent report, for example the parent reports that the child eats an item 20% of the time and they eat it 100% of the time during this phase, do not include this food as a target for intervention.</li>
	<li>Intervention Sessions.</li>
	<li>Conduct all treatment sessions as trials (rather than time based) and a session includes five trials. A trial begins when the target food is placed on the placemat and the instruction is delivered. A trial ends contingent on compliance or after 10s of noncompliance. Vary the number of sessions completed during each 1 hr visit depending on child variables and characteristics, including compliance with instructions. &#160; 
	NOTE: The mastery criterion for each step in the intervention is 80% or higher of compliance across two consecutive sessions. Compliance is defined as completing the presented task within 10 sec from the time the instruction is delivered.</li>
</ol>
4. Treatment Package
NOTE: The treatment package consists of shaping and sequential and simultaneous presentation procedures.
<ol>
	<li>Shaping
	<ol>
		<li>Implement a shaping procedure for each target food, where successive approximations to eating are reinforced. The shaping procedure is composed of seven steps; a) put the food in therapist&#8217;s hand, b) touch the food to the child&#8217;s cheek, c) touch food to nose; d) touch food to lips; e) touch food to tongue; f) bite down on food; g) eat food (i.e., mouth clean [swallowing the food so that none of it remains in the child&#8217;s mouth]). &#160; 
		NOTE: During each step the child has to complete the target behavior independently (e.g., the child has to put the food in the therapist&#8217;s hand).</li>
	</ol>
	</li>
	<li>Sequential Presentation
	<ol>
		<li>Use a placemat containing two different colored circles to serve as a visual representation of the sequential presentation procedure. Always place target foods on the left and less preferred foods on the right side of the placemat. &#160; 
		NOTE: This presentation is designed to foster predictability in the procedure and to acquire stimulus control for compliance with foods presented on the left side.</li>
		<li>Additionally, place preferred tangible items on the right side of the placemat. Use the prompt, &#8220;First [shaping step] then [name of preferred food and tangible]&#8221; to introduce the instruction for the sequential presentation procedure. For example, &#8220;first touch the pea to your nose and then you can have your cookie and crayons.&#8221;</li>
	</ol>
	</li>
	<li>Simultaneous Presentation
	<ol>
		<li>Present both the preferred and non-preferred foods together during the simultaneous procedure. Specifically, place the non-preferred food on top of the preferred food (e.g., a grain of rice is placed on top of a chip) and place this combination on the left side of the placemat.</li>
		<li>Place preferred tangible and edible items on the right side of the placemat, as is done in the sequential procedure. Slowly increase the amount of non-preferred food placed on top of the preferred food until equal amounts of non-preferred and preferred foods are presented.</li>
		<li>Present all foods in bite size pieces. Use pieces that are small enough that the child can consume it with one bite, but large enough so that the child will need to chew it several times before swallowing. Present foods with or without a utensil depending on individual needs. Require that participants feed themselves during all sessions.</li>
	</ol>
	</li>
</ol>
5. Intervention
<ol>
	<li>Training Phase (Preferred Food) 
	NOTE: Use the most preferred food (i.e., the food identified as most likely to be eaten 100% of the time in the food assessment) during the training phase, aimed at facilitating familiarity with and compliance with the steps in the shaping sequence.
	<ol>
		<li>Begin the training phase with the initial step of placing the food in the examiner&#8217;s hand and continue until the child reaches the mastery criterion (i.e., at least 80% compliance across two consecutive sessions) for the final step (i.e., eating).</li>
	</ol>
	</li>
	<li>Shaping and Sequential Presentation
	<ol>
		<li>Use the next food identified in the food assessment (child is likely to eat 80% of the time when offered) for this phase of the intervention. During each session, the participant and therapist sit side by side at the table.</li>
		<li>Place the placemat in front of the child and all food and tangible items are placed on the table next to the therapist.</li>
		<li>Begin each trial by placing the target food on the left side of the placemat and the potential reinforcers on the right side. The therapist then provides the first-then prompt.</li>
		<li>Contingent on compliance, allow the child to have access to the reinforcers (consumption of preferred food and access to tangible item for approximately 30 sec). Contingent on noncompliance (not completing the target behavior within 10 sec or throwing the target food), represent the first-then prompt.</li>
		<li>Begin this phase with step 1 of the shaping procedure (put the food in therapist&#8217;s hand) and tell the participant &#8220;first put ___in my hand and then you can have (reinforcer).&#8221; Continue until the mastery criteriais met (80% or higher compliance across two consecutive sessions).</li>
		<li>Move to step 2 of the shaping procedure (touch the food to the child&#8217;s cheek) when mastery criteria are met. Continue sessions in this manner until the last step of eating the food is mastered. Introduce the next food identified at this point starting with step 1 of the shaping procedure and repeating the shaping steps as described.</li>
	</ol>
	</li>
	<li>Shaping, Sequential, and Simultaneous Presentation 
	NOTE: Introduce a simultaneous presentation phase in instances when shaping and sequential presentation are not effective in increasing compliance for the last step in the shaping sequence (i.e., mouth clean).
	<ol>
		<li>Begin this phase by first combining the two foods so that the non-preferred food is not visible to the child. For example, place the non-preferred food inside of the preferred and placed on the placemat so that the child cannot see the non-preferred food.</li>
		<li>Systematically increase the size of the non-preferred food and decrease the preferred food until the non-preferred food is presented alone. The ratio of the two foods (i.e., preferred and non-preferred) is systematically changed when compliance reaches 80% or better across two consecutive sessions. Continue to use the placemat and first-then prompt in this phase.</li>
	</ol>
	</li>
</ol>
6. Data
<ol>
	<li>Record yes or no data on compliance for each trial. A trial begins when the if-then prompt is delivered and compliance is defined as initiating the behavior within 10 sec from the time the prompt is presented.</li>
	<li>Make separate graphs for each target food with the independent variable being the session (i.e., 5 trials) and the dependent variable the percent compliance for the session. Enter the percent compliance in spreadsheet in order to create a graphical display of the session data in a spreadsheet. Enter the data into columns.</li>
	<li>Then select the data, click Insert then Chart. When the chart choices are presented select the marked line chart choice. Draw vertical lines between the phases of the procedure. Insert a text box with the label &#8220;baseline&#8221; above the data for the baseline sessions.</li>
	<li>Insert a text box with a number corresponding to the step of the procedure at the top of the figure for each step of the procedure. Place a label at the top of the chart denoting which food is being displayed (e.g., &#8220;100% food&#8221;, &#8220;80% food). Copy and paste the first chart at the top of a blank page and copy and paste the subsequent charts below in order.</li>
</ol>

<ol>
	<li>Ahearn, W. H., Kerwin, M. E., Eicher, P. S., Shantz, J., Swearingin, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+alternating+treatments+comparison+of+two+intensive+interventions+for+food+refusal.">An alternating treatments comparison of two intensive interventions for food refusal.</a> Journal of Applied Behavior Analysis. 29 (3), 321-332 (1996).</li><li>Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., Must, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Food+selectivity+in+children+with+autism+spectrum+disorders+and+typically+developing+children.">Food selectivity in children with autism spectrum disorders and typically developing children.</a> The Journal of Pediatrics. 157 (2), 259-265 (2010).</li><li>Bachmeyer, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+selective+and+inadequate+food+intake+in+children:+A+review+and+practical+guide.">Treatment of selective and inadequate food intake in children: A review and practical guide.</a> Behavior Analysis in Practice. 2 (1), 43-50 (2009).</li><li>Cermak, S. A., Curtin, C., Bandini, L. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Food+selectivity+and+sensory+sensitivity+in+children+with+autism+spectrum+disorders.">Food selectivity and sensory sensitivity in children with autism spectrum disorders.</a> Journal of the American Dietetic Association. 110 (2), 238-246 (2010).</li><li>Cooper, L. J., Wacker, D. P., Brown, K., McComas, J. J., Peck, S. M., Drew, J., Asmus, J., Kayser, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+concurrent+operants+paradigm+to+evaluate+positive+reinforcers+during+treatment+of+food+refusal.">Use of concurrent operants paradigm to evaluate positive reinforcers during treatment of food refusal.</a> Behavior Modification. 23 (1), 3-40 (1999).</li><li>Dawson, J. E., Piazza, C. C., Sevin, B. M., Gulotta, C. S., Lerman, D., Kelley, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+the+high-probability+instructional+sequence+and+escape+extinction+in+a+child+with+food+refusal.">Use of the high-probability instructional sequence and escape extinction in a child with food refusal.</a> Journal of Applied Behavior Analysis. 36 (1), 105-108 (2003).</li><li>Dovey, T. M., Staples, P. A., Gibson, E. L., Halford, J. C. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Food+neophobia+and+'picky/fussy+eating+in+children:+A+review.">Food neophobia and 'picky/fussy eating in children: A review.</a> Appetite. 50, 181-193 (2008).</li><li>Kern, L., Marder, T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+simultaneous+and+delayed+reinforcement+as+treatments+for+food+selectivity.">A comparison of simultaneous and delayed reinforcement as treatments for food selectivity.</a> Journal of Applied Behavior Analysis. 29 (2), 243-246 (1996).</li><li>Ledford, J. R., Gast, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feeding+problems+in+children+with+autism+spectrum+disorders:+A+review.">Feeding problems in children with autism spectrum disorders: A review.</a> Focus on Autism and Other Developmental Disabilities. 21 (3), 153-166 (2006).</li><li>Munk, D. D., Repp, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Behavioral+assessment+of+feeding+problems+of+individuals+with+severe+disabilities.">Behavioral assessment of feeding problems of individuals with severe disabilities.</a> Journal of Applied Behavior Analysis. 27 (2), 241-250 (1994).</li><li>Patel, M. R., Piazza, C. C., Martinez, C. J., Volkert, V. M., Santana, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+evaluation+of+two+differential+reinforcement+procedures+with+escape+extinction+to+treat+food+refusal.">An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal.</a> Journal of Applied Behavior Analysis. 35 (4), 363-374 (2002).</li><li>Penrod, B., Gardella, L., Fernand, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+evaluation+of+a+progressive+high-probability+instructional+sequence+combined+with+low+probability+demand+fading+in+the+treatment+of+food+selectivity.">An evaluation of a progressive high-probability instructional sequence combined with low probability demand fading in the treatment of food selectivity.</a> Journal of Applied Behavior Analysis. 45 (3), 527-537 (2012).</li><li>Piazza, C. C., Patel, M. R., Santana, C. M., Goh, H., Delia, M. D., Lancaster, B. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+evaluation+of+simultaneous+and+sequential+presentation+of+preferred+and+non-preferred+food+to+treat+food+selectivity.">An evaluation of simultaneous and sequential presentation of preferred and non-preferred food to treat food selectivity.</a> Journal of Applied Behavior Analysis. 35 (3), 259-270 (2002).</li><li>Pizzo, B., Coyle, M., Seiverling, L., Williams, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plate+a-plate+b:+Use+of+sequential+presentation+in+the+treatment+of+food+selectivity.">Plate a-plate b: Use of sequential presentation in the treatment of food selectivity.</a> Behavioral Interventions. 27, 175-184 (2012).</li><li>Tarbox, J., Schiff, A., Najdowski, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Parent-Implemented+procedural+modification+of+escape+extinction+in+the+treatment+of+food+selectivity+in+a+young+child+with+autism.">Parent-Implemented procedural modification of escape extinction in the treatment of food selectivity in a young child with autism.</a> Education and Treatment of Children. 33 (2), 223-234 (2010).</li></ol>

The authors declare that they have no competing financial interests.

This paper presents a treatment package composed of antecedent manipulations that have demonstrated success in increasing food acceptance for children who exhibit food selectivity. Notably, this paper presents a set of procedures that may be effective without the use of escape extinction. These methods are consistent with previous literature (Penrod et al., 2012) that suggests that a shaping procedure can be used to increase food acceptance with children who engage in active food refusal (e.g., throwing...

Food selectivity, defined as a reluctance to try new foods based on some dimension of the food (e.g., texture, color, or presentation) often characterizes the feeding behavior of young children with autism spectrum disorders (ASD) and other developmental delays2,4,7,10.
Although children who exhibit food selectivity often eat some foods, these foods are frequently limited in variety (e.g., snacks and carbohydrates) and may not provide adequate nutrition. Food selectivity may never lead to total food refusal requiring medical attention (e.g., a diagnosis of failure to thrive or the insertion of a gastric feeding tube) however, the limited food repertoires of children with food selectivity may lead to nutritional inadequacies.
An effective intervention to increase food acceptance in children with acute food selectivity is escape extinction, in the forms of non-removal of the spoon and/or physical guidance1,6,11.
Children who engage in severe maladaptive feeding behavior often engage in total food refusal that leads to limited weight gain and growth and may require the use of gastric-tube feedings. When a child&#8217;s feeding behavior is impacting their development, escape extinction may be essential to quickly increase food acceptance. For example, Cooper and colleagues5 found that escape extinction was a necessary component in the treatment packages of 3 of 4 participants who all exhibited poor growth and engaged in tantrum behavior (e.g., gagging, spitting and screaming) when food was presented.
Escape extinction has been repeatedly demonstrated as a valuable component in treatment packages for children with chronic feeding problems, however; these procedures may not be necessary for children who engage in less severe feeding behavior (i.e., food selectivity). Children who engage in severe feeding behavior may differ from children who engage in food selectivity, in that severe feeding behavior may involve total food refusal where as children with food selectivity may consume some foods, although limited in range and nutritional value.
Consistent consumption of even a limited number of foods may lead to children being responsive to reinforcement-based interventions that do not require the addition of escape extinction. For children with autism, positive reinforcement procedures are viewed as best practice9 and should be implemented in the treatment of food selectivity when the child&#8217;s behavior may not warrant the use of escape extinction. Recent research on the use of antecedent manipulations and positive reinforcement methodologies as possible alternatives to the use of escape extinction suggest that these methods may be effective for some children who exhibit food selectivity3,11,12.
Studies evaluating the use of antecedent manipulations to treat food selectivity have incorporated a variety of procedures including, high-p sequences6,11,12, and sequential and simultaneous food presentation1,8,13. Results of studies evaluating these procedures have shown that antecedent manipulations are effective in increasing food acceptance for children who engage in food selectivity12,14. For example, Penrod and colleagues12 effectively increased food consumption in two children diagnosed with ASD who engaged in active food refusal (e.g., spitting, gagging and vomiting), using a treatment package consisting of a high-p sequence and demand fading procedure.
The way in which preferred and non-preferred foods are presented (e.g., sequential versus simultaneous presentation) may also contribute to the effectiveness of treatment packages for children who engage in food selectivity. Both sequential (i.e., presenting the non-preferred food followed by the preferred food) and simultaneous (i.e., combining a non-preferred and preferred food together) presentation methods have demonstrated some success in increasing food acceptance13,14. For example, Piazza et al.13, found that the simultaneous presentation procedure, without escape extinction was effective in increasing food acceptance in 3 of 4 participants and that sequential presentation was ineffective for 2 participants. In contrast, Pizzo and colleagues14 successfully used a treatment package consisting of sequential presentation and appetite manipulation to increase food acceptance in a 16-year-old boy with ASD. While the degree to which these presentation procedures are successful without the addition of escape extinction is unclear; some studies suggest that these procedures may be an effective antecedent manipulation for some children. More research is required to determine the utility of both sequential and simultaneous procedures in treatment packages that do not include an escape extinction component.
In designing treatment packages for children who engage in food selectivity, it is important to consider the differences between children who eat a limited number of foods and those who engage in total food refusal as this may impact responsiveness to intervention. For children who engage in food selectivity, parents and clinicians may be less willing to implement intrusive escape extinction procedures since they may not view the child&#8217;s behavior as severe enough to warrant these interventions. Tarbox, Schiff and Najdowski15 suggest that anecdotal reports indicate that escape extinction procedures may be difficult for parents to accept. The authors propose that it may be useful to evaluate the effectiveness of other behavioral treatment procedures that may be less intrusive for cases where escape extinction may be not accepted by the parents.
Results from the studies reviewed provide evidence that antecedent manipulations are an important and powerful component to treatment packages for food selectivity. Antecedent manipulations may take many forms (e.g., high-p sequences and sequential and simultaneous food presentation) and it is important that research focuses on which components may be combined in treatment packages to effectively increase food acceptance without the addition of escape extinction; as these interventions may provide less intrusive alternatives when escape extinction procedures are not necessary. This manuscript describes a treatment package that combines shaping, sequential and simultaneous presentation procedures. These procedures have been effective in increasing food acceptance when combined with other antecedent manipulations but have not previously been combined in a treatment package. The current protocol extends the literature on sequential and simultaneous presentation procedures by including them in a treatment package with a shaping procedure that may serve as a first line of treatment that could be implemented by parents, teachers, and clinicians with limited training before seeking more intensive treatment.

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>Small table</td>
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			<td>We have these at our site</td>
		</tr>
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			<td>small chairs</td>
			<td></td>
			<td></td>
			<td>We have these at our site</td>
		</tr>
		<tr>
			<td>paper plates</td>
			<td></td>
			<td></td>
			<td>We have these at our site</td>
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			<td>plastic silverware</td>
			<td></td>
			<td></td>
			<td>We have these at our site</td>
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			<td>toys</td>
			<td></td>
			<td></td>
			<td>We have these at our site</td>
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			<td>placemat</td>
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</table>

a treatment package without escape extinction to address food selectivity

Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including autism. Behavior analytic interventions for the treatment of feeding difficulties oftentimes include escape extinction as a primary component of treatment. The use of escape extinction, while effective, may be problematic as it is also associated with the emergence of challenging behavior (e.g., extinction burst). Such challenging behavior may be an acceptable side effect in treatment cases where feeding problems are severe and chronic (e.g., failure to thrive). However, in more acute cases (e.g., selective eating), the negative side effect may be unwarranted and undesired. More recent research on the behavioral treatment of food selectivity has begun to evaluate treatments for feeding difficulties that do not include escape extinction (e.g., demand fading, behavioral momentum), with some success. However, research to date reveals individual differences in responsiveness to such treatments and no clear preferable treatment has emerged. This manuscript describes a multi-component treatment package that includes shaping, sequential presentation and simultaneous presentation, for the treatment of food selectivity in four young children with developmental delays. This treatment package extends the literature on the behavioral treatment for food selectivity and offers a multi-component treatment protocol that may be clinically applicable across a range of treatment scenarios and settings.

The procedure of shaping and sequential presentation described can result in initial compliance with behaviors related to eating (e.g., touching the food) that can be strengthened through the use of reinforcement and shaping. By reinforcing successive approximations (shaping steps) behavior can be shaped slowly until reaching the target behavior of eating. The results depicted in Figure 1 show that the technique of shaping is capable of increasing compliance with food acceptance and the steps in...

Watch this Scientific Journal Video about A Treatment Package without Escape Extinction to Address Food Selectivity at JoVE.com

A Treatment Package without Escape Extinction to Address Food Selectivity

Feeding difficulties are a common problem for children with developmental disorders, including autism, and behavioral interventions often include escape extinction. Recent research has begun to evaluate treatments that do not include escape extinction. This manuscript describes a multicomponent treatment package that does not use escape extinction to treat feeding difficulties.

Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including ...

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11.4K vistas.  Florida International University. Feeding difficulties are a common problem for children with developmental disorders, including autism, and behavioral interventions often include escape extinction. Recent research has begun to evaluate treatments that do not include escape extinction. This manuscript describes a multicomponent treatment package that does not use escape extinction to treat feeding difficulties.

Video: A Treatment Package without Escape Extinction to Address Food Selectivity

A Procedure to Study the Effect of Prolonged Food Restriction on Heroin Seeking in Abstinent Rats

In human drug addicts, exposure to drug-associated cues or environments that were previously associated with drug taking can trigger relapse during abstinence. Moreover, various environmental challenges can exacerbate this effect, as well as increase ongoing drug intake.
The procedure we describe here highlights the impact of a common environmental challenge, food restriction, on drug craving that is expressed as an augmentation of drug seeking in abstinent rats.
Rats are implanted with chronic intravenous i.v. catheters, and then trained to press a lever for i.v. heroin over a period of 10-12 days. Following the heroin self-administration phase the rats are removed from the operant conditioning chambers and housed in the animal care facility for a period of at least 14 days. While one group is maintained under unrestricted access to food (sated group), a second group (FDR group) is exposed to a mild food restriction regimen that results in their body weights maintained at 90% of their nonrestricted body weight. On day 14 of food restriction the rats are transferred back to the drug-training environment, and a drug-seeking test is run under extinction conditions (i.e.&#160;lever presses do not result in heroin delivery).
The procedure presented here results in a highly robust augmentation of heroin seeking on test day in the food restricted rats. In addition, compared to the acute food deprivation manipulations we have used before, the current procedure is a more clinically relevant model for the impact of caloric restriction on drug seeking. Moreover, it might be closer to the human condition as the rats are not required to go through an extinction-training phase before the drug-seeking test, which is an integral component of the popular reinstatement procedure.

A procedure that allows a demonstration of robust augmentation of drug seeking in food-restricted rats is described. Following heroin self-administration training, rats go through an abstinence period, in a drug-free environment, during which they are mildly food restricted. Drug seeking is then tested in the drug-associated environment.

In human drug addicts, exposure to drug-associated cues or environments that were previously associated with drug taking can trigger relapse during ...

Measuring Sensitivity to Viewpoint Change with and without Stereoscopic Cues

The speed and accuracy of object recognition is compromised by a change in viewpoint; demonstrating that human observers are sensitive to this transformation. Here we discuss a novel method for simulating the appearance of an object that has undergone a rotation-in-depth, and include an exposition of the differences between perspective and orthographic projections. Next we describe a method by which human sensitivity to rotation-in-depth can be measured. Finally we discuss an apparatus for creating a vivid percept of a 3-dimensional rotation-in-depth; the Wheatstone Eight Mirror Stereoscope. By doing so, we reveal a means by which to evaluate the role of stereoscopic cues in the discrimination of viewpoint rotated shapes and objects.

We discuss a novel method forviewpoint-rotation of visual stimuli, and demonstrate using a mirror stereoscopethe three-dimensional percept of rotation-in-depth. The technique can be used to investigate the role of stereoscopic cues in encoding viewpoint-rotated figures.

The speed and accuracy of object recognition is compromised by a change in viewpoint; demonstrating that human observers are sensitive to this ...

Barnes Maze Testing Strategies with Small and Large Rodent Models

Spatial learning and memory of laboratory rodents is often assessed via navigational ability in mazes, most popular of which are the water and dry-land (Barnes) mazes. Improved performance over sessions or trials is thought to reflect learning and memory of the escape cage/platform location. Considered less stressful than water mazes, the Barnes maze is a relatively simple design of a circular platform top with several holes equally spaced around the perimeter edge. All but one of the holes are false-bottomed or blind-ending, while one leads to an escape cage. Mildly aversive stimuli (e.g.&#160;bright overhead lights) provide motivation to locate the escape cage. Latency to locate the escape cage can be measured during the session; however, additional endpoints typically require video recording. From those video recordings, use of automated tracking software can generate a variety of endpoints that are similar to those produced in water mazes (e.g.&#160;distance traveled, velocity/speed, time spent in the correct quadrant, time spent moving/resting, and confirmation of latency). Type of search strategy (i.e.&#160;random, serial, or direct) can be categorized as well. Barnes maze construction and testing methodologies can differ for small rodents, such as mice, and large rodents, such as rats. For example, while extra-maze cues are effective for rats, smaller wild rodents may require intra-maze cues with a visual barrier around the maze. Appropriate stimuli must be identified which motivate the rodent to locate the escape cage. Both Barnes and water mazes can be time consuming as 4-7 test trials are typically required to detect improved learning and memory performance (e.g.&#160;shorter latencies or path lengths to locate the escape platform or cage) and/or differences between experimental groups. Even so, the Barnes maze is a widely employed behavioral assessment measuring spatial navigational abilities and their potential disruption by genetic, neurobehavioral manipulations, or drug/ toxicant exposure.

The dry-land Barnes maze is widely used to measure spatial navigation ability in response to mildly aversive stimuli. Over consecutive days, performance (e.g.&#160;latency to locate escape cage) of control subjects improves, indicative of normal learning and memory. Differences between rats and mice necessitate apparatus and methodology changes that are detailed here.

Spatial learning and memory of laboratory rodents is often assessed via navigational ability in mazes, most popular of which are the water and dry-land ...

Studying Food Reward and Motivation in Humans

A key challenge in studying reward processing in humans is to go beyond subjective self-report measures and quantify different aspects of reward such as hedonics, motivation, and goal value in more objective ways. This is particularly relevant for the understanding of overeating and obesity as well as their potential treatments. In this paper are described a set of measures of food-related motivation using handgrip force as a motivational measure. These methods can be used to examine changes in food related motivation with metabolic (satiety) and pharmacological manipulations and can be used to evaluate interventions targeted at overeating and obesity. However to understand food-related decision making in the complex food environment it is essential to be able to ascertain the reward goal values that guide the decisions and behavioral choices that people make. These values are hidden but it is possible to ascertain them more objectively using metrics such as the willingness to pay and a method for this is described. Both these sets of methods provide quantitative measures of motivation and goal value that can be compared within and between individuals.

This article describes a set of methods for the measurement of food related motivation and food related goal values in humans.

A key challenge in studying reward processing in humans is to go beyond subjective self-report measures and quantify different aspects of reward such as ...

Assessment of Murine Exercise Endurance Without the Use of a Shock Grid: An Alternative to Forced Exercise

Using laboratory mouse models, the molecular pathways responsible for the metabolic benefits of endurance exercise are beginning to be defined. The most common method for assessing exercise endurance in mice utilizes forced running on a motorized treadmill equipped with a shock grid. Animals who quit running are pushed by the moving treadmill belt onto a grid that delivers an electric foot shock; to escape the negative stimulus, the mice return to running on the belt. However, avoidance behavior and psychological stress due to use of a shock apparatus can interfere with quantitation of running endurance, as well as confound measurements of postexercise serum hormone and cytokine levels. Here, we demonstrate and validate a refined method to measure running endurance in na&#239;ve C57BL/6 laboratory mice on a motorized treadmill without utilizing a shock grid. When mice are preacclimated to the treadmill, they run voluntarily with gait speeds specific to each mouse. Use of the shock grid is replaced by gentle encouragement by a human operator using a tongue depressor, coupled with sensitivity to the voluntary willingness to run on the part of the mouse. Clear endpoints for quantifying running time-to-exhaustion for each mouse are defined and reflected in behavioral signs of exhaustion such as splayed posture and labored breathing. This method is a humane refinement which also decreases the confounding effects of stress on experimental parameters.

A method to assess exercise endurance in laboratory mice without the use of a shock grid is demonstrated. This method is a humane refinement that can decrease the confounding effects of stress on experimental parameters.

Using laboratory mouse models, the molecular pathways responsible for the metabolic benefits of endurance exercise are beginning to be defined. The most ...

Vagus Nerve Stimulation as a Tool to Induce Plasticity in Pathways Relevant for Extinction Learning

Extinction describes the process of attenuating behavioral responses to neutral stimuli when they no longer provide the reinforcement that has been maintaining the behavior. There is close correspondence between fear and human anxiety, and therefore studies of extinction learning might provide insight into the biological nature of anxiety-related disorders such as post-traumatic stress disorder, and they might help to develop strategies to treat them. Preclinical research aims to aid extinction learning and to induce targeted plasticity in extinction circuits to consolidate the newly formed memory. Vagus nerve stimulation (VNS) is a powerful approach that provides tight temporal and circuit-specific release of neurotransmitters, resulting in modulation of neuronal networks engaged in an ongoing task. VNS enhances memory consolidation in both rats and humans, and pairing VNS with exposure to conditioned cues enhances the consolidation of extinction learning in rats. Here, we provide a detailed protocol for the preparation of custom-made parts and the surgical procedures required for VNS in rats. Using this protocol we show how VNS can facilitate the extinction of conditioned fear responses in an auditory fear conditioning task. In addition, we provide evidence that VNS modulates synaptic plasticity in the pathway between the infralimbic (IL) medial prefrontal cortex and the basolateral complex of the amygdala (BLA), which is involved in the expression and modulation of extinction memory.

Vagus nerve stimulation (VNS) has emerged as a tool to induce targeted synaptic plasticity in the forebrain to modify a range of behaviors. This protocol describes how to implement VNS to facilitate the consolidation of fear extinction memory.

Extinction describes the process of attenuating behavioral responses to neutral stimuli when they no longer provide the reinforcement that has been ...

Errors as a Means of Reducing Impulsive Food Choice

Nowadays, the increasing incidence of eating disorders due to poor self-control has given rise to increased obesity and other chronic weight problems, and ultimately, to reduced life expectancy. The capacity to refrain from automatic responses is usually high in situations in which making errors is highly likely. The protocol described here aims at reducing imprudent preference in women during hypothetical intertemporal choices about appetitive food by associating it with errors. First, participants undergo an error task where two different edible stimuli are associated with two different error likelihoods (high and low). Second, they make intertemporal choices about the two edible stimuli, separately. As a result, this method decreases the discount rate for future amounts of the edible reward that cued higher error likelihood, selectively. This effect is under the influence of the self-reported hunger level. The present protocol demonstrates that errors, well known as motivationally salient events, can induce the recruitment of cognitive control, thus being ultimately useful in reducing impatient choices for edible commodities.

Giving in to temptation of tasty food may result in long-term overweight problems. This protocol describes how to reduce imprudent preference for edible commodities during hypothetical intertemporal choices in women by associating them with errors.

Nowadays, the increasing incidence of eating disorders due to poor self-control has given rise to increased obesity and other chronic weight problems, and ...

Protocol for Data Collection and Analysis Applied to Automated Facial Expression Analysis Technology and Temporal Analysis for Sensory Evaluation

We demonstrate a method for capturing emotional response to beverages and liquefied foods in a sensory evaluation laboratory using automated facial expression analysis (AFEA) software. Additionally, we demonstrate a method for extracting relevant emotional data output and plotting the emotional response of a population over a specified time frame. By time pairing each participant's treatment response to a control stimulus (baseline), the overall emotional response over time and across multiple participants can be quantified. AFEA is a prospective analytical tool for assessing unbiased response to food and beverages. At present, most research has mainly focused on beverages. Methodologies and analyses have not yet been standardized for the application of AFEA to beverages and foods; however, a consistent standard methodology is needed. Optimizing video capture procedures and resulting video quality aids in a successful collection of emotional response to foods. Furthermore, the methodology of data analysis is novel for extracting the pertinent data relevant to the emotional response. The combinations of video capture optimization and data analysis will aid in standardizing the protocol for automated facial expression analysis and interpretation of emotional response data.

A protocol for capturing and statistically analyzing emotional response of a population to beverages and liquefied foods in a sensory evaluation laboratory using automated facial expression analysis software is described.

We demonstrate a method for capturing emotional response to beverages and liquefied foods in a sensory evaluation laboratory using automated facial ...

Feeding Experimentation Device (FED): Construction and Validation of an Open-source Device for Measuring Food Intake in Rodents

Food intake measurements are essential for many research studies. Here, we provide a detailed description of a novel solution for measuring food intake in mice: the Feeding Experimentation Device (FED). FED is an open-source system that was designed to facilitate flexibility in food intake studies. Due to its compact and battery powered design, FED can be placed within standard home cages or other experimental equipment. Food intake measurements can also be synchronized with other equipment in real-time via FED's transistor-transistor logic (TTL) digital output, or in post-acquisition processing as FED timestamps every event with a real-time clock. When in use, a food pellet sits within FED's food well where it is monitored via an infrared beam. When the pellet is removed by the mouse, FED logs the timestamp onto its internal secure digital (SD) card and dispenses another pellet. FED can run for up to 5 days before it is necessary to charge the battery and refill the pellet hopper, minimizing human interference in data collection. Assembly of FED requires minimal engineering background, and off-the-shelf materials and electronics were prioritized in its construction. We also provide scripts for analysis of food intake and meal patterns. Finally, FED is open-source and all design and construction files are online, to facilitate modifications and improvements by other researchers.

Feeding Experimentation Device FED: Construction and Validation of an Open-source Device for Measuring Food Intake in Rodents

Feeding Experimentation Device (FED) is an open-source device for measuring food intake in mice. FED can also synchronize food intake measurements with other techniques via a real-time digital output. Here, we provide a step-by-step tutorial for the construction, validation, and usage of FED.

Food intake measurements are essential for many research studies. Here, we provide a detailed description of a novel solution for measuring food intake in ...

Combining Quantitative Food-intake Assays and Forcibly Activating Neurons to Study Appetite in Drosophila

Food consumption is under the tight control of the brain, which integrates the physiological status, palatability, and nutritional contents of the food, and issues commands to start or stop feeding. Deciphering the processes underlying the decision-making of timely and moderate feeding carries major implications in our understanding of physiological and psychological disorders related to feeding control. Simple, quantitative, and robust methods are required to measure the food ingestion of animals after experimental manipulation, such as forcibly increasing the activities of certain target neurons. Here, we introduced dye-labeling-based feeding assays to facilitate the neurogenetic study of feeding control in adult fruit flies. We review available feeding assays, and then describe our methods step-by-step from setup to analysis, which combine thermogenetic and optogenetic manipulation of neurons controlling feeding motivation with dye-labeled food intake assay. We also discuss the advantages and limitations of our methods, compared with other feeding assays, to help readers choose an appropriate assay.

Combining Quantitative Food-intake Assays and Forcibly Activating Neurons to Study Appetite in Drosophila

Quantitative food-intake assays with dyed food provide a robust and high-throughput means to evaluate feeding motivation. Combining the food consumption assay with thermogenetic and optogenetic screens is a powerful approach to investigate the neural circuits underlying appetite in adult Drosophila melanogaster.

Food consumption is under the tight control of the brain, which integrates the physiological status, palatability, and nutritional contents of the food, ...