Comparing the High-Probability Instructional Sequence with and without Food to Increase Consumption of Nonpreferred Foods in Children with Food Selectivity

Abstract

The high-probability (high-p) instructional sequence is a non-intrusive procedure involving the presentation of a series of high-p instructions followed by 1 low-probability instruction. To date, 9 studies – with mixed findings – examined its effectiveness to treat food selectivity in children. We used a multielement within a reversal design to compare the effectiveness and efficiency of 2 iterations of the high-p sequence to increase food consumption in 2 food-selective children: high- p with preferred food on a spoon and high-p with an empty spoon. For both participants, neither high-p sequence alone increased consumption. For one participant, consumption increased in the high-p empty spoon condition with the introduction of non-removal of the spoon (NRS). For the other participant, consumption initially increased in the high-p with food condition with the introduction of NRS plus re-presentation but subsequently decreased. Results are discussed within the context of treatment implications and suggestions for future research.