Treatment for inappropriate mealtime behavior often includes extinction and differential reinforcement of alternative behavior (DRA) in a distributed arrangement in which delivery of brief reinforcer access immediately follows each appropriate mealtime response. Alternatively, DRA may be arranged using accumulated reinforcement wherein delivery of longer, continuous access to reinforcers follows the consumption of multiple consecutive bites. Research has suggested that individuals prefer and perform better under accumulated arrangements in academic settings; however, no research to date has evaluated the efficacy of accumulated arrangements with children with feeding disorders. We compared preference for and efficacy of distributed and accumulated (with and without tokens) reinforcement with nonremoval of the spoon. All three treatments effectively reduced inappropriate mealtime behavior and increased acceptance for two participants and decreased packing and increased mouth clean for one participant. Two participants preferred distributed reinforcement and one preferred accumulated reinforcement without tokens. Findings differ from some previous research, which demonstrated that participants favored accumulated arrangements in academic contexts.

中文翻译：

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治疗具有挑战性的进餐时间行为的累积和分布式强化剂安排

对不适当的进餐时间行为的治疗通常包括以分布式排列的替代行为 (DRA) 的消退和差异强化，其中在每个适当的进餐时间响应之后立即提供简短的强化物访问。或者，DRA 可以使用累积的强化物来安排，其中在多次连续咬合后，对强化物进行更长、连续的访问。研究表明，个人更喜欢在学术环境中的累积安排下表现更好；然而，迄今为止，还没有研究评估累积安排与喂养障碍儿童的效果。我们比较了分布式和累积（有和没有令牌）强化与不移除勺子的偏好和有效性。所有三种治疗都有效地减少了不适当的进餐行为并增加了两名参与者的接受度，并减少了一名参与者的包装并增加了口腔清洁。两名参与者更喜欢分布式强化，一名更喜欢没有代币的累积强化。调查结果与之前的一些研究不同，后者表明参与者更喜欢学术环境中的累积安排。