REFERENCE: Stark, L. J., Knapp, L. G., Bowen, A. M., Powers, S. W., Jelalian, E., Evans, S., Passero, M. A., Mulvihill, M. M., Hovell, M. (1993). Increasing calorie consumption in children with cystic fibrosis: Replication with 2-year follow-up. Journal of Applied Behavior Analysis, 26, 435-450.
Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.