Clinical Application and Fading of Synchronous Reinforcement for Increasing Self-Feeding for a Child with Autism Spectrum Disorder and History of Trauma

In the current case study, we evaluated synchronous reinforcement (SSR) as an intervention to increase self-feeding for a 5-year-old male diagnosed with ASD and a pediatric feeding disorder who also had a history of trauma. Synchronous reinforcement is a schedule of covariation where reinforcement is delivered continuously contingent on responding. Synchronous reinforcement has not been previously reported in the literature in a feeding context. A benefit of reinforcement-based procedures, such as SSR, is that they may align with recommendations for trauma-informed care by preventing or limiting the necessity of physical guidance procedures for those with a history of physical trauma. This is of particular significance given children with disabilities are more likely to experience traumatic events and abuse. We demonstrated that SSR was an effective intervention for increasing self-feeding, as well as methods for fading SSR as a treatment component. We discuss the potential for SSR as a trauma-informed approach, and the importance of caregiver collaboration and programming for generalization.