Note

The successful use of the techniques of operant conditioning to eliminate anorexia nervosa (disruption of normal eating and subsequent weight loss) has been reported in hospitals and out-patient setrings (Bachrach, Erwin, & Mohr, 1965) . The purpose of this study was to determine i f contingency management procedures could be successfully implemented by parents trained in a series of behavioral child management classes, to treat such a possible disorder in their 11-yr.-old child. S's parents were referred to thc first author by a pediatrician and gastro-enterologist after two hospitalizations for a 14-lb. weight loss in 2 mo., without any diagnosable physical disorder. The parents listed many problem behaviors, such as, failure to initiate conversations, oversleeping, listlessness, infrequent social conmcts with peers, frequent somatic complaints (stomach pa in) , and failure to eat (S was on a bland baby food diet) . N o t eating was selected as the target behavior because of its obvious debiliating effect upon S as well as its potential relationship to S's observed listlessness and frequent somatic complaints. Ten baseline observations were made on the number of bites mken by S at home and school. S's weight was recorded daily. Such data indicated S weighed 71 pounds and was taking an average of 25 bites per meal. A contingency contract was drawn up benveen the first author, parenrs and S, utilizing reinforcers taken from lists developed independently by S and his parents. The goal was to increase the number of bites, taken by S at the evening meal, in increments of five (above baseline) until he was taking 50 bites. When S met criterion, reinforcers specified in the contract were available to him, such as, TV, a trip to his grandfather's farm, and a penny for each bite in excess of that day's criterion. The parents were instructed to ignore somatic complaints and to praise increased number of bites and weight. During the 11 wk. of the program S's weight increased 8 Ib.; 15 wk. after the study was terminated S weighed 91 Ib. These data indicate that the parents trained in behavioral (child) management techniques successfully implemented the contingency program to increase the weight and eating behavior of their child. The parents noted improvement in all of the specified problem a r e a . The program required 2 hr. of family therapy, 1 hr. before the child management classes and 1 hr. after the classes had ended. Five 2-hr. weekly sessions were given

Anorexia · Anorexia nervosa · Contingency management · Developmental psychology · Eating disorders · Evening · Intervention (counseling · Meal · Obesity · Psychiatry · Weight loss · Child Nutrition and Feeding Issues · Infant Development and Preterm Care · Medicine · Obesity, Physical Activity, Diet · Psychology · Pediatrics

• Case studies in behavior modification

  Leonard Krasner, Leonard P Ullmann•Case studies in behavior…

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