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Chronic ruminative vomiting: A comparison of four treatment procedures

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Abstract

An experimental analysis of a case of chronic ruminative vomiting in a 15-year-old, profoundly retarded, Down's syndrome boy addressed the consequences of vomiting in the postmealtime environment. The experiment compared four treatments in each hour-long session using a multiple reinforcement schedule with order of the following procedures counterbalanced over days in a Latin square design: (a) differential reinforcement of any behaviors other than vomiting (DRO) in which periods of no vomiting were followed by reinforcement and vomiting postponed reinforcement; (b) differential reinforcement of specific behaviors alternative to vomiting (DRI) in which conjoint periods of no vomiting and sustained toy play were followed by reinforcement and the lack of either postponed reinforcement; (c) extinction plus reinforcement of alternative behavior in which vomiting was ignored but toy play was reinforced; (d) extinction in which vomiting was ignored. Data revealed an orderly dual cyclical pattern of vomiting throughout the day, with increased vomiting in the morning and immediately following food ingestion. Postluncheon treatments emphasizing reinforcement of alternative behavior were more successful in decreasing vomiting than DRO or extinction alone.

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This research was supported by DDSA H.I.P. Grant 51-P-20521/4, NICHD Grant HD-10570, and NIEHS Grant ES-01104 to Stephen R. Schroeder at Murdock Center, and Grant HD-03-110 from the National Institutes of Health to the Child Development Research Institute of the University of North Carolina.

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Mulick, J.A., Schroeder, S.R. & Rojahn, J. Chronic ruminative vomiting: A comparison of four treatment procedures. J Autism Dev Disord 10, 203–213 (1980). https://doi.org/10.1007/BF02408471

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