Vibrating pagers: fading intensity, not frequency, is most successful approach for slowing rapid eating

Using a vibrating pager to slow overly rapid eating by individuals with autism spectrum disorders (ASD) may be more successful if the intervention is faded by reducing the intensity of the pager vibration rather than the frequency of the prompt, according to a new study. 

In a single-case study, Amber Valentino and colleagues tested the effects of a pager intervention on a 10-year-old boy who ate very rapidly. Once or twice each day at lunchtime, the researchers conducted a brief session (one to eight minutes) in which they presented the boy with a favored food. An experimenter remotely controlled a pager clipped to the boy’s waistband, activating it an average of every 20 seconds. The experimenter physically guided the boy to put his hand on the pager and wait until it vibrated before taking a bite, blocking attempts to eat before the vibration occurred. The boy received verbal praise for waiting between vibrations. The experimenter gradually faded the prompting from full physical prompts to partial physical prompts and then gave no physical prompts at all. 

After nine sessions, the boy was able to successfully wait for the pager prompt 100% of the time. At this point, the experimenter clipped the pager to the boy’s waistband, and it was set to vibrate every 18 seconds with no other prompts or reinforcement provided. 

Once this phase was successful, the researchers tested the results of fading the procedure by reducing the pager intensity from the high setting to the low setting and then muffling it with bubble wrap and a towel. They also tested the effects of fading the number of prompts. They report, “Fading by frequency was ineffective in maintaining an appropriate pace of eating while intensity fading was successful.” 

While vibrating pagers are an increasingly popular intervention due to their relatively non-intrusive nature, the researchers note that successful techniques for fading pager prompts have not yet been established. They comment, “Fading by intensity may prove more effective because features of the antecedent stimulus (i.e., the vibration) can be altered more gradually with intensity and without any abrupt transfer.”

Citations

“Evaluation of stimulus intensity fading on reduction of rapid eating in a child with autism,” Amber L. Valentino, Linda A. LeBlanc, and Paige B. Raetz, Journal of Applied Behavior Analysis, Vol. 51, No. 1, January 2018, pages 177-82. Address: Amber Valentino, TBH, 6475 Sierra Lane, Dublin, CA 94568, [email protected].