Utensil Fading to Increase Appropriate Utensil Acceptance

Escape extinction is an empirically supported treatment to increase food and drink acceptance in children with feeding difficulties. However, nonremoval of the spoon or cup may not be effective in isolation when children press their lips closed or clench their teeth. Physical guidance procedures may circumvent this concern, though this is not always the case and may require the bite or drink be deposited with an alternate utensil. Previous research has demonstrated the effectiveness of spoon-to-cup, syringe-to-cup, and syringe-to-spoon fading in typically developing children with gastrostomy tube dependence. The current study extends the existing research literature by replicating spoon-to-cup fading with a child with autism spectrum disorder who was an oral feeder, and by demonstrating the effectiveness of finger-to-spoon fading. We also provide an additional clinical example for syringe-to-cup fading for a child with autism spectrum disorder who was an oral feeder.