Comparisons of interventions for rumination maintained by automatic reinforcement

The effectiveness of four antecedent treatments for rumination was compared for two individuals with autism, severe intellectual disabilities and long histories (at least 20 years) of rumination. Comparisons of increased meal size, supplemental feedings, fixed-time provision of peanut butter, and liquid rescheduling found liquid rescheduling to be the most effective intervention for both clients. However, within-session analyses, both during intervention and for 30 min after the meal, showed individualized schedules of fluid provision were needed to increase the effectiveness of the treatment.

► Antecedent-based interventions for rumination were compared in adults with autism.
► Liquid rescheduling was the most effective intervention in decreasing rumination.
► Within-session analyses showed that liquid rescheduling delayed rumination onset.
► Individualised schedules of liquid provision were required.