A Synthesis of Research on Nonremoval of the Cup in Children with Liquid Refusal, and Brief Practice Guidelines




Whitlock, Kiana Jade

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This synthesis discusses the use of the nonremoval of the cup procedure for treating liquid refusal exhibited by children with pediatric feeding disorders. We conducted a multistep electronic database search to identify behavioral intervention studies that evaluated the effects of the nonremoval of the cup procedure on liquid refusal. We used these studies to characterize liquid refusal and describe how the use of the nonremoval of the cup procedure to treat this problem has evolved. Our findings suggest that NRC can increase liquid acceptance and consumption in children with a variety of feeding problems. We conclude with practice guidelines that include considerations for when, with whom, and under which circumstances nonremoval of the cup can be applied to treat liquid refusal in the context of the evidence-based practice of applied behavior analysis.


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consumption, escape extinction, feeding disorder, food selectivity, liquid refusal, nonremoval of cup



Interdisciplinary Learning and Teaching