Rumination in infancy: Recent behavioral approaches

The published literature on behavioral treatments of rumination is reviewed, and new case material on two recently reported procedures is presented. Rumination, a medical condition of infancy involving repeated regurgitation of previously ingested food, has historically been treated from a psychodynamic approach involving extended in‐patient treatment by mother surrogates. This procedure is both time‐consuming and very costly. The initial behavioral approach involved electric shock. Single‐case studies reflect the utility of this procedure, but widespread resistance to this form of punishment makes this a difficult procedure to utilize. More recent behavioral procedures reported in single‐case studies have included delivering aversive taste stimuli as consequences for ruminating. This procedure has met with mixed success, and has the added drawback of being difficult to implement technically and because of staff resistance. A combination of punishment by scolding, time‐out, and reinforcement of retaining the food constitutes a useful alternative. This procedure has the added advantage of being more acceptable to staff and implementable at home. The possibility of individual differences among ruminators that might predict success is also raised.