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...

食品の選択、食品のいくつかの寸法に基づいて、新しい食品を試して不本意のように定義された（ 例えば 、質感、色、またはプレゼンテーション）は、多くの場合、自閉症スペクトラム障害（ASD）と幼児の摂食行動を特徴付け、他の発達の遅れ2、 4,7,10。 食品の選択性を示す子どもたちは、多くの場合、いくつかの食品を食べるが、これらの食品は、しばしば様々な限定されている（ 例えば 、スナック、炭水化物）と十分な栄養を提供することはできません。食品の選択は、（ 例えば 、成長障害や胃栄養チューブの挿入の診断が）しかし、食品の選択を持つ子どもの限定された食品のレパートリーは、栄養不備につながる可能性があり医師の手当てを必要とする総食物拒否につながることはありませんがあります。 急性食物選択性を有する小児における食品の受け入れを高めるための効果的な介入は、非除去の形で、絶滅を逃れるありますスプーンおよび/ ​​または物理的なガイダンス1,6,11。 重度の不適応な摂食行動に従事する子どもたちは、多くの場合、制限された体重増加と成長をもたらし、胃管栄養の使用が必要な場合があり、全食品の拒否に従事します。子供の摂食行動は、その開発に影響を与えるされている場合、絶滅を逃れる迅速食品の受け入れを高めるために不可欠であってもよいです。例えば、クーパーと同僚5は、エスケープ絶滅はすべてが悪いの成長を示し、食品が提示されたとき、かんしゃくの動作（ 例えば 、吐き気、吐きと叫び）に従事して3〜4の参加者の治療パッケージで必要なコンポーネントがわかりました。 エスケープ絶滅を繰り返ししかし、慢性摂食障害を持つ子どものための治療パッケージで貴重なコンポーネントとして実証されています。これらの手順は、重症度の低い摂食行動に従事する子ども（ すなわち 、食品selectivのために必要ではないかもしれません性）。重度の摂食行動に従事する子どもは、範囲と栄養価に制限されているが、食品の選択と子供たちは、いくつかの食品を消費する可能性があるとして、ここで総食物拒絶に関与し得るという深刻な摂食行動に、食品の選択に従事する子どもたちと異なる場合があります。 食品のさえ限られた数の一貫した消費は、エスケープ絶滅の添加を必要としない強化ベースの介入に応答する子どもたちにつながる可能性があります。自閉症児のために、正の強化手順は、ベストプラクティス9と見ていると、子供の行動は、エスケープ絶滅の使用を保証するものではありませ可能性がある場合、食品の選択の治療で実施されるべきです。先行操作およびエスケープ絶滅の使用に可能な選択肢として、正の強化方法論の利用に関する最近の研究では、これらの方法は、食品の選択3,11,12を示すいくつかの子供たちのために有効であり得ることを示唆しています</s&gt;アップ。 食品の選択性を治療するための先行操作の使用を評価する研究は、高Pシーケンス6,11,12、および順次同時食品プレゼンテーション1,8,13を含む種々の手順が組み込まれています。これらの手順を評価する研究の結果は、先行操作が食品選択12,14に従事する子どもたちのための食品の受け入れを増加させるのに有効であることが示されています。例えば、Penrodや同僚12を効果的に高P配列からなる処理パッケージを使用して、アクティブな食品拒否（ 例えば 、唾吐き、吐き気および嘔吐）に従事してASDと診断された二人の子供の食物消費量が増加し、手順をフェージング求めています。 優先および非優先の食品が提示される方法（ 例えば 、同時提示対シーケンシャル）も従事する子どもたちのための治療パッケージの有効性に寄与することができます食品の選択。 （すなわち、好適な食品に続いて非優先の食品を提示する）と同時（すなわち、一緒に非優先であり、好ましい食品を組み合わせた）の提示方法は、食品の受け入れ13,14の増加にある程度の成功を実証している。シーケンシャル両方例えば、広場ら 13は 、エスケープ絶滅せずに同時提示手順は、3〜4の参加者が増加し、食品の受け入れに有効で、そのシーケンシャルプレゼンテーションは2参加者には無効であることがわかりました。これとは対照的に、ピッツォ、同僚14が正常にASDと16歳の少年で、食品の受け入れを高めるために、順次発表して食欲操作からなる処理パッケージを使用していました。これらのプレゼンテーション手順はエスケープ絶滅を添加せずに成功している度合いは不明であるが、いくつかの研究は、これらの手順は、いくつかの子供のための効果的な先行操作であることを示唆しています。もっとresearCHは、エスケープ消光成分を含まない治療パッケージでシーケンシャルと同時プロシージャの両方の有用性を決定するために必要です。 食品の選択に従事する子どもたちのための治療パッケージを設計するには、食品の限られた数を食べる子供や介入に対する応答性に影響を与える可能性がある。このような総食物拒否に従事する人たちとの違いを考慮することが重要です。食品の選択に従事する子どもたちのために、親と臨床家は、彼らがこれらの介入を正当化するのに十分なような重篤な子供の行動が表示されない可能性があるため侵入エスケープ絶滅手順を実施に消極であってもよいです。 Tarbox、シッフとNajdowski 15は、事例報告がエスケープ絶滅手順は両親が受け入れることは困難であり得ることを示すことを示唆しています。著者らは、ケースにはあまり侵入し得る他の行動療法処置の有効性を評価するのに有用であり得ることを提案しますここで、エスケープ絶滅は両親によって受け入れられないことがあります。 レビュー研究の結果からは、先行操作は、食品の選択のための治療パッケージへの重要かつ強力なコンポーネントであるという証拠を提供します。先行操作は、多くの形態（ 例えば 、高Pシーケンスと逐次同時食品プレゼンテーション）をとることができ、それは研究を効果的に逃がし消滅を添加することなく、食品の受け入れを高めるために処理パッケージに組み合わせることができる構成要素に焦点を当てていることが重要です。エスケープ消光手順が必要でない場合、これらの介入は、より少ない侵入選択肢を提供することができます。この原稿は、シェーピング、シーケンシャルと同時提示の手順を組み合わせた治療パッケージを説明します。これらの手順は、他の先行操作と組み合わせた場合に増加する食品の受け入れで有効であったが、以前に治療パッケージに組み合わされていません。現在プロトcolがより集中的な治療を求める前に、親、教師、および限られた訓練と臨床医によって実現することができ、治療の最初の行としての役割を果たすことができる成形手順で処理するパッケージに含めることにより、順次および同時提示手続きに関する文献を拡張します。

<table><tbody><tr><td>Small table</td><td></td><td></td><td>We have these at our site</td></tr><tr><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></tr><tr><td>plastic silverware</td><td></td><td></td><td>We have these at our site</td></tr><tr><td>toys</td><td></td><td></td><td>We have these at our site</td></tr><tr><td>placemat</td><td></td><td></td><td>We have these at our site</td></tr></tbody></table>

a treatment package without escape extinction to address food selectivity

困難を供給し、供給障害は幼児、自閉症などの発達の遅れと、特に子供のための一般的に生じる問題です。摂食困難の治療のための行動分析的な介入は、しばしば治療の主要な構成要素として絶滅を逃れるあります。それはまた、問題行動（ 例えば 、消光バースト）の出現と関連しているようなエスケープ絶滅の使用は、有効ではあるが、問題となる可能性があります。このような挑戦的な動作は、給紙の問題（ 例えば 、障害が繁栄する）重度慢性であり、治療の場合に許容可能な副作用であってもよいです。しかし、より深刻な場合（ 例えば 、選択的摂食）に、負の副作用は、不当な、不要とすることができます。食品の選択の行動療法のより最近の研究は、エスケープ絶滅を含まない困難を供給するための治療法を評価するために始めている（ 例えば 、需要フェージング、行動momentuいくつかの成功を収めてM）、。しかし、これまでの研究では、このような治療に対する反応の個人差を明らかにし、明確な好ましい治療が出現していません。この原稿は、発達の遅れを持つ4つの幼児の食品選択の治療のための整形、シーケンシャルプレゼンテーションと同時提示を含む多成分治療パッケージを説明します。この処理パッケージは、食品の選択のための行動療法に関する文献を拡張し、治療のシナリオおよび設定の範囲にわたって臨床的に適用することができる多成分治療プロトコルを提供しています。

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.

食品選択性に対処するためのエスケープ絶滅せずに治療パッケージ

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

a-treatment-package-without-escape-extinction-to-address-food

Universidad San Sebastian

Research

JoVE Journal

Behavior

11.5K ビュー.  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.

ビデオ: A Treatment Package without Escape Extinction to Address Food Selectivity

The Attentional Set Shifting Task: A Measure of Cognitive Flexibility in Mice

Cognitive impairment, particularly involving dysfunction of circuitry within the prefrontal cortex (PFC), represents a core feature of many neuropsychiatric and neurodevelopmental disorders, including depression, post-traumatic stress disorder, schizophrenia and autism spectrum disorder. Deficits in cognitive function also represent the most difficult symptom domain&#160;to successfully treat, as serotonin reuptake inhibitors and tricyclic antidepressants have only modest effects. Functional neuroimaging studies and postmortem analysis of human brain tissue implicate the PFC as being a primary region of dysregulation in patients with these disorders. However, preclinical behavioral assays used to assess these deficits in mouse models which can be readily manipulated genetically and could provide the basis for studies of new treatment avenues have been underutilized. Here we describe the adaptation of a behavioral assay, the attentional set shifting task (AST), to be performed in mice to assess prefrontal cortex mediated cognitive deficits. The neural circuits underlying behavior during the AST are highly conserved across humans, nonhuman primates and rodents, providing excellent face, construct and predictive validity.

The goal of this protocol is to perform a behavioral assay such as the attentional set shifting task (AST) to assess prefrontal cortex-mediated cognitive flexibility in mice.

注意のセットシフトタスク：マウスにおける認知の柔軟性の測定

Cognitive impairment, particularly involving dysfunction of circuitry within the prefrontal cortex (PFC), represents a core feature of many ...

行動学

How to Create Conditioned Taste Aversion for Grazing Ground Covers in Woody Crops with Small Ruminants

Conditioned taste aversion (CTA) is a learning behavior process where animals are trained to reject certain feed after gastrointestinal discomfort has been produced. Lithium chloride (LiCl) is the preferred agent used in livestock to induce CTA because it specifically stimulates the vomit center. In addition, LiCl is commercially available, and easy to prepare and administer using a drenching gun. Nevertheless, some factors have to be considered to obtain an effective long-lasting CTA, which allows small ruminants to graze during the cropping season. A key aspect is to use animals with no previous contact with the target plant (the plant chosen to be avoided; new feed). Due to their native neophobic feeding behavior, small ruminants can easily associate the negative feedback effects with the new feed, resulting in a strong and persistent CTA. The recommended doses are 200 and 225 mg LiCl/kg body weight (BW) for goats and sheep, respectively. To induce CTA, 100 g of the target plant should be individually offered for at least 30 min, and LiCl administered thereafter if the intake is greater than 10 g. Each time the animal eats the target plant without negative consequences, the CTA becomes weaker. Consequently, to minimize the risk of target plant consumption, it is essential to have sufficient palatable ground cover available. The presence of an alternative feed (of quality and quantity) prevents the accidental consumption of the target plant. A close monitoring of the flock is recommended to remove and re-dose any animal consuming more than 4 bites or 10 g of the target plant. At the beginning of each grazing season, check the CTA status of each animal before moving them to the crop.

Feeding behavior preferences in livestock can be modified to implement a grazing management plan in woody crops. Here, we present a protocol to show a lithium chloride dose after eating a new plant that induces conditioned taste aversion.

放牧グラウンドは小型反芻動物でウッディ作物にカバーするために条件づけ味覚嫌悪を作成する方法

Conditioned taste aversion (CTA) is a learning behavior process where animals are trained to reject certain feed after gastrointestinal discomfort has ...

環境学

Signal Attenuation as a Rat Model of Obsessive Compulsive Disorder

In the signal attenuation rat model of obsessive-compulsive disorder (OCD), lever-pressing for food is followed by the presentation of a compound stimulus which serves as a feedback cue. This feedback is later attenuated by repeated presentations of the stimulus without food (without the rat emitting the lever-press response). In the next stage, lever-pressing is assessed under extinction conditions (i.e., no food is delivered). At this stage rats display two types of lever-presses, those that are followed by an attempt to collect a reward, and those that are not. The latter are the measure of compulsive-like behavior in the model. A control procedure in which rats do not experience the attenuation of the feedback cue serves to distinguish between the effects of signal attenuation and of extinction. The signal attenuation model is a highly validated model of OCD and differentiates between compulsive-like behaviors and behaviors that are repetitive but not compulsive. In addition the measures collected during the procedure eliminate alternative explanations for differences between the groups being tested, and are quantitative, unbiased and unaffected by inter-experimenter variability. The major disadvantages of this model are the costly equipment, the fact that it requires some technical know-how and the fact that it is time-consuming compared to other models of OCD (11 days). The model may be used for detecting the anti- or pro-compulsive effects of pharmacological and non-pharmacological manipulations and for studying the neural substrate of compulsive behavior.

The goal of the protocol described in this paper is to induce compulsive-like behavior in rats for the study of obsessive-compulsive disorder (OCD). This behavior is precipitated by attenuating a signal indicating that a lever-press response was effective in producing food.

強迫性障害のラットモデルとして信号の減衰

In the signal attenuation rat model of obsessive-compulsive disorder (OCD), lever-pressing for food is followed by the presentation of a compound stimulus ...

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.

インパルス食品の選択を減少させる手段としてのエラー

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

A General Method for Evaluating Incubation of Sucrose Craving in Rats

For someone on a food-restricted diet, food craving in response to food-paired cues may serve as a key behavioral transition point between abstinence and relapse to food taking 1. Food craving conceptualized in this way is akin to drug craving in response to drug-paired cues. A rich literature has been developed around understanding the behavioral and neurobiological determinants of drug craving; we and others have been focusing recently on translating techniques from basic addiction research to better understand addiction-like behaviors related to food 2-4.
As done in previous studies of drug craving, we examine sucrose craving behavior by utilizing a rat model of relapse. In this model, rats self-administer either drug or food in sessions over several days. In a session, lever responding delivers the reward along with a tone+light stimulus. Craving behavior is then operationally defined as responding in a subsequent session where the reward is not available. Rats will reliably respond for the tone+light stimulus, likely due to its acquired conditioned reinforcing properties 5. This behavior is sometimes referred to as sucrose seeking or cue reactivity. In the present discussion we will use the term "sucrose craving" to subsume both of these constructs.
In the past decade, we have focused on how the length of time following reward self-administration influences reward craving. Interestingly, rats increase responding for the reward-paired cue over the course of several weeks of a period of forced-abstinence. This "incubation of craving" is observed in rats that have self-administered either food or drugs of abuse 4,6. This time-dependent increase in craving we have identified in the animal model may have great potential relevance to human drug and food addiction behaviors.
Here we present a protocol for assessing incubation of sucrose craving in rats. Variants of the procedure will be indicated where craving is assessed as responding for a discrete sucrose-paired cue following extinction of lever pressing within the sucrose self-administration context (Extinction without cues) or as responding for sucrose-paired cues in a general extinction context (Extinction with cues).

Responding for food or drug-paired cues increases over the course of a period of abstinence and this may relate to an increased susceptibility to relapse behaviors. Here we detail a procedure for evaluating this "incubation of craving" in rats that have self-administered sucrose.

ラットのショ糖の渇望のインキュベーションを評価するための一般的な方法

For someone on a food-restricted diet, food craving in response to food-paired cues may serve as a key behavioral transition point between abstinence and ...

神経科学

Assessment of Social Transmission of Food Preferences Behaviors

Olfactory recognition deficits are suggested to be able to serve as clinical marker to differentiate Alzheimer&#39;s disease (AD) subjects from healthy aging groups. For example, olfactory dysfunction in AD can present as impairment in olfactory recognition, emerging during early stages of the disease and worsening while the disease progresses. The social transmission of food preferences (STFP) task is based on a rudimentary form of communication between rodents concerning distant foods dependent on the transmission of olfactory cues. Healthy wild-type mice would prefer to eat a novel, flavored food that was previously cued by a conspecific, and this food preference would be hampered in transgenic AD mice, such as the APP/PS1 model. Indeed, a strong preference for the cued food in C57Bl6/J mice of 3 months of age was found, and this was reduced in 3 months old transgenic APP/PS1 mice. In summary, STFP task could be a powerful measure to be integrated in present subclinical detection assays of AD.

This paper presents a protocol for the investigation of social transmission of food preference in mice. The advantages and possible applications for this procedure, for instance, in detecting early changes in AD mouse models, are highlighted. To conclude, interpretation of the results in light of critical details are discussed.

食品の好み行動の社会的伝達の評価

Olfactory recognition deficits are suggested to be able to serve as clinical marker to differentiate Alzheimer&#39;s disease (AD) subjects from healthy ...

Progressive-ratio Responding for Palatable High-fat and High-sugar Food in Mice

Foods that are rich in fat and sugar significantly contribute to over-eating and escalating rates of obesity. The consumption of palatable foods can produce a rewarding effect that strengthens action-outcome associations and reinforces future behavior directed at obtaining these foods. Increasing evidence that the rewarding effects of energy-dense foods play a profound role in overeating and the development of obesity has heightened interest in studying the genes, molecules and neural circuitry that modulate food reward1,2. The rewarding impact of different stimuli can be studied by measuring the willingness to work to obtain them, such as in operant conditioning tasks3. Operant models of food reward measure acquired and voluntary behavioral responses that are directed at obtaining food. A commonly used measure of reward strength is an operant procedure known as the progressive ratio (PR) schedule of reinforcement.4,5 In the PR task, the subject is required to make an increasing number of operant responses for each successive reward. The pioneering study of Hodos (1961) demonstrated that the number of responses made to obtain the last reward, termed the breakpoint, serves as an index of reward strength4. While operant procedures that measure changes in response rate alone cannot separate changes in reward strength from alterations in performance capacity, the breakpoint derived from the PR schedule is a well-validated measure of the rewarding effects of food. The PR task has been used extensively to assess the rewarding impact of drugs of abuse and food in rats (e.g.,6-8), but to a lesser extent in mice9. The increased use of genetically engineered mice and diet-induced obese mouse models has heightened demands for behavioral measures of food reward in mice. In the present article we detail the materials and procedures used to train mice to respond (lever-press) for a high-fat and high-sugar food pellets on a PR schedule of reinforcement. We show that breakpoint response thresholds increase following acute food deprivation and decrease with peripheral administration of the anorectic hormone leptin and thereby validate the use of this food-operant paradigm in mice.

The present report details the protocol employed to measure the rewarding effects of high-fat food in mice using a progressive ratio operant conditioning task.

プログレッシブ比マウスの嗜好性は高脂肪·高砂糖食の応答

Foods that are rich in fat and sugar significantly contribute to over-eating and escalating rates of obesity. The consumption of palatable foods can ...

Extinction Training During the Reconsolidation Window Prevents Recovery of Fear

Fear is maladaptive when it persists long after circumstances have become safe. It is therefore crucial to develop an approach that persistently prevents the return of fear. Pavlovian fear-conditioning paradigms are commonly employed to create a controlled, novel fear association in the laboratory. After pairing an innocuous stimulus (conditioned stimulus, CS) with an aversive outcome (unconditioned stimulus, US) we can elicit a fear response (conditioned response, or CR) by presenting just the stimulus alone1,2 . Once fear is acquired, it can be diminished using extinction training, whereby the conditioned stimulus is repeatedly presented without the aversive outcome until fear is no longer expressed3. This inhibitory learning creates a new, safe representation for the CS, which competes for expression with the original fear memory4. Although extinction is effective at inhibiting fear, it is not permanent. Fear can spontaneously recover with the passage of time. Exposure to stress or returning to the context of initial learning can also cause fear to resurface3,4.
Our protocol addresses the transient nature of extinction by targeting the reconsolidation window to modify emotional memory in a more permanent manner. Ample evidence suggests that reactivating a consolidated memory returns it to a labile state, during which the memory is again susceptible to interference5-9. This window of opportunity appears to open shortly after reactivation and close approximately 6hrs later5,11,16, although this may vary depending on the strength and age of the memory15. By allowing new information to incorporate into the original memory trace, this memory may be updated as it reconsolidates10,11. Studies involving non-human animals have successfully blocked the expression of fear memory by introducing pharmacological manipulations within the reconsolidation window, however, most agents used are either toxic to humans or show equivocal effects when used in human studies12-14. Our protocol addresses these challenges by offering an effective, yet non-invasive, behavioral manipulation that is safe for humans.
By prompting fear memory retrieval prior to extinction, we essentially trigger the reconsolidation process, allowing new safety information (i.e., extinction) to be incorporated while the fear memory is still susceptible to interference. A recent study employing this behavioral manipulation in rats has successfully blocked fear memory using these temporal parameters11. Additional studies in humans have demonstrated that introducing new information after the retrieval of previously consolidated motor16, episodic17, or declarative18 memories leads to interference with the original memory trace14. We outline below a novel protocol used to block fear recovery in humans.

Conditioned fear can be diminished through an inhibitory process called extinction, but can resurface under conditions such as the passage of time or exposure to stress. Our protocol presents a novel way of preventing fear recovery by introducing extinction during the reconsolidation window (the re-storage phase of a reactivated memory).

再固定ウィンドウの間に絶滅の訓練は恐怖の回復を防ぎ

Fear is maladaptive when it persists long after circumstances have become safe. It is therefore crucial to develop an approach that persistently prevents ...

Assessment of Mouse Judgment Bias through an Olfactory Digging Task

Judgment biases (JB) are differences in the way that individuals in positive and negative affective/emotional states interpret ambiguous information. This phenomenon has long been observed in humans, with individuals in positive states responding to ambiguity 'optimistically' and those in negative states instead showing 'pessimism'. Researchers aiming to assess animal affect have taken advantage of these differential responses, developing tasks to assess judgment bias as an indicator of affective state. These tasks are becoming increasingly popular across diverse species and fields of research. However, for laboratory mice, the most widely used vertebrates in research and a species heavily relied upon to model affective disorders, only one JB task has been successfully validated as sensitive to changes in affective state. Here, we provide a detailed description of this novel murine JB task, and evidence of its sensitivity to mouse affect. Though refinements are still necessary, assessment of mouse JB opens the door for answering both practical questions regarding mouse welfare, and fundamental questions about the impact of affective state in translational research.

This article provides a detailed description of a novel mouse judgment bias protocol. Evidence of this olfactory digging task's sensitivity to affective state is also demonstrated and its utility across diverse research fields is discussed.

嗅覚掘削作業によるマウス判定バイアスの評価

Judgment biases (JB) are differences in the way that individuals in positive and negative affective/emotional states interpret ambiguous information. This ...

マウスモデルにおけるストレス感受性またはレジリエンスの脅威安全性試験

Social Threat-Safety Test Uncovers Psychosocial Stress-Related Phenotypes

Social stress is a major cause of the development of mental disorders. To enhance the translational value of preclinical studies, social stress experience and its behavioral impact on mice should be comparable to humans. Chronic social defeat (CSD) utilizes a type of social stress involving physical attacks and sensory threats to induce mental dysfunctions resembling human affective disorders. To strengthen the psychosocial component of CSD, a 10-day CSD protocol was applied in which daily physical attacks are standardized to three 10 s episodes followed by a 24 h sensory phase. After the 10th sensory phase, the CSD protocol is followed by a refined behavioral assay called the social threat-safety test (STST). Post-stress behavioral assays need to determine how and to what extent the social stressor has influenced behavior. The STST allows chronically socially defeated male mice to interact with 2 novel male individuals (social targets): one social target from the attacking strain encountered during the CSD days and the other from a novel strain. Both are presented simultaneously in different compartments of a three-chambered test arena. The test enables a simultaneous assessment of social avoidance development to measure successful aversive conditioned learning and social threat-safety discrimination ability. The development of social avoidance towards both strains reflects a generalized aversive response and thus, a measurement of stress susceptibility. Meanwhile, the development of social avoidance towards only the attacking strain reflects threat-safety discrimination and thus, a measurement of stress resilience. Finally, the absence of social avoidance towards the attacking strain reflects impaired aversive conditioned learning. The protocol aims to refine the currently used mouse models of stress susceptibility/resilience by including translational criteria, specifically threat-safety discrimination and aversive response generalization, to categorize a single group of chronically socially defeated animals into resilient and susceptible subgroups, eventually advancing future translational approaches.

著者スポットライト:ストレスレジリエンスのメカニズムの解明-重要な発見、進歩、および将来の研究

The social threat-safety test allows a simultaneous assessment of social avoidance development as a measurement of aversive conditioned learning and social threat-safety discrimination ability, both utilized to identify stress-susceptible and stress-resilient individuals within a single group of chronically socially defeated male mice.

社会的脅威安全性テストは、心理社会的ストレス関連の表現型を明らかにします

Social stress is a major cause of the development of mental disorders. To enhance the translational value of preclinical studies, social stress experience ...