Using a Nuk® brush to increase acceptance of solids and liquids for two children diagnosed with autism

Escape extinction (EE) procedures, such as non-removal of the spoon (NRS) and physical guidance, have been shown to be effective for increasing the acceptance of previously refused foods in children with feeding disorders. NRS typically involves presenting a utensil at a child's lips until he/she accepts a bite/drink or until an arbitrary meal duration is met. As a result, some children may learn to “wait out” the meal duration thus avoiding bites/drinks altogether. Physical guidance procedures are implemented in a similar manner but also include physically guiding the child's mouth open by applying pressure on the mandibular joint (i.e., jaw prompt). In some cases, the jaw prompt may harm the child if too much pressure is applied to his/her face. Due to the limitations of these procedures we evaluated an alternative PG strategy by using a Nuk® brush to increase the acceptance of bites and drinks in two participants.