Using Behavioral Skills Training to Train New Parents to Reduce Choking Risks: Three Single-Subject Study

Abstract

Purpose

Choking on items is a highly prevalent issue among young children which can lead to injury and death. This study assessed the effects of behavioral skills training (BST) for new three parents in identifying choking hazards and preparing food that will not be a choking hazard for young children.

Method

This study used multiple exemplar training using 160 nonfood items and 73 food items. Generalization was programed for by using an environment that was set up to resemble a naturalistic setting.

Results

The participants responding was low and variable responding in baseline and improved to high consistent rates of correct responding of identifying choking hazards and preparing foods to a nonhazardous size following BST.

Discussion

The success of this training package is attributed to the use of a performance-based training which included direct observation of the target behavior and immediate feedback following the participant's performance.

Keywords

Behavioral skills training choking prevention safety skills parent training child welfare

Get full access to this article

View all access options for this article.

References

American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome. (2022). Sleep-related infant deaths: Updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics, 150(1), e2022057990. https://doi.org/10.1542/peds.2022-057990

Bartlett

J. D.

Easterbrooks

M. A.

(2012). Links between physical abuse in childhood and child neglect among adolescent mothers. Children and Youth Services Review, 34(11), 2164–2169. https://doi.org/10.1016/j.childyouth.2012.07.011

Bentivegna

K. C.

Borrup

K. T.

Clough

M. E.

Schoem

S. R.

(2018). Basic choking education to improve parental knowledge. International Journal of Pediatric Otorhinolaryngology, 113, 234–239. https://doi.org/10.1016/j.ijporl.2018.08.002

Carrow

J. N.

Vladescu

J. C.

Reeve

S. A.

Kisamore

A. N.

(2020). Back to sleep: Teaching adults to arrange safe infant sleep environments. Journal of Applied Behavior Analysis, 53(3), 1321–1336. https://doi.org/10.1002/jaba.681

Centers for Disease Control and Prevention. (2001). Nonfatal choking-related episodes among children — United States, 2001. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5142a1.htm#:∼:text=In%202001%2C%20an%20estimated%2017%2C537,140.4)%20and%20decreased%20with%20age.

Choking prevention for children. Department of Health. (2022). https://www.health.ny.gov/prevention/injury_prevention/choking_prevention_for_children.htm .

Fuller

A. A.

Molve

M. L.

Crosland

K. A.

(2023). Behavioral skills training to teach identification of choking hazards to substitute caregivers. Research on Social Work Practice, 34(4), 402–414. https://doi.org/10.1177/10497315231192982

Grenawitzke

Rappaport

Ruiz

Kalami

(2025). What is baby-led weaning? benefits of BLW. Solid Starts. https://solidstarts.com/baby-led-weaning/?hcUrl=%2Fen-US.

Higuchi

Adachi

Y. S.

Taneichi

Ichimaru

Kawasaki

(2013). Mothers’ knowledge about foreign body aspiration in young children. International Journal of Pediatric Otorhinolaryngology, 77(1), 41–44. https://doi.org/10.1016/j.ijporl.2012.09.026

10.

Himle

M. B.

Miltenberger

R. G.

Gatheridge

B. J.

Flessner

C. A.

(2004). An evaluation of two procedures for training skills to prevent gun play in children. Pediatrics, 113(1), 70–77. https://doi.org/10.1542/peds.113.1.70

11.

Johnson

B. M.

Miltenberger

R. G.

Egemo-Helm

Jostad

C. M.

Flessner

Gatheridge

(2005). Evaluation of behavioral skills training for teaching abduction-prevention skills to young children. Journal of Applied Behavior Analysis, 38(1), 67–78. https://doi.org/10.1901/jaba.2005.26-04

12.

Lerman

D. C.

(2024). Putting the power of behavior analysis in the hands of nonbehavioral professionals: Toward a blueprint for dissemination. Journal of Applied Behavior Analysis, 57(1), 39–54. Https://doi.org/10.1002/jaba1036

13.

Lorenzoni

Lanera

Azzolina

Baldas

Messi

Gregori

(2021). Assessing school-based intervention strategies to foster the prevention of choking injuries in children: The results of the CHOP (CHOking Prevention) trial. Health & Social Care in the Community, 29(6), 1858–1867. https://doi.org/10.1111/hsc.13298

14.

Mandel

Bigelow

K. M.

Lutzker

J. R.

(1998). Using video to reduce home safety hazards with parents reported for child abuse and neglect. Journal of Family Violence, 13(2), 147–162. https://psycnet.apa.org/doi/10.1023/A:1022841623317. https://doi.org/10.1023/A:1022841623317

15.

McMullen

S. L.

Fioravanti

I. D.

Brown

Carey

M. G.

(2016). Safe sleep for hospitalized infants. The American Journal of Maternal/Child Nursing, 41(1), 43–50. https://doi.org/10.1097/NMC.0000000000000205

16.

Mery

Vladescu

Sidener

Reeve

Day-Watkins

(2021). Safe to sleep: A systematic review of the safe infant sleep training literature across relevantpersonnel. Journal of Neonatal Nursing, 27(6), 381–395. https://doi.org/10.1016/j.jnn.2021.06.001

17.

Mery

J. N.

Vladescu

J. C.

Day-Watkins

Sidener

T. M.

Reeve

K. F.

Schnell

L. K.

(2022). Training medical students to teach safe infant sleep environments using pyramidal behavioral skills training. Journal of Applied Behavior Analysis, 55(4), 1239–1257. https://doi.org/10.1002/jaba92

18.

Nemours (Ed.). (2022). Choosing safe toys for toddlers and preschoolers (for parents) | Nemours kids health. KidsHealth. https://kidshealth.org/en/parents/safetoys-young.html#:∼:text=Keep%20these%20age%2Dspecific%20guidelines,a%20toy%20is%20too%20small.

19.

Schnell-Peskin

Day-Watkins

Mery

J. N.

Vladescu

J. C.

(2023). The influence of video-based training on caregiver arrangement of infant sleep environments. Journal of Applied Behavior Analysis, 56(3), 656–663. https://doi.org/10.1002/jaba997

20.

USDA. (2020). Reducing the Risk of Choking in Young Children at Mealtimes. WIC Works Resource System. https://wicworks.fns.usda.gov/sites/default/files/media/document/English_ReducingRiskofChokinginYoungChildren.pdf.

21.

Vladescu

J. C.

Day-Watkins

Schnell

L. K.

Carrow

J. N.

(2020). Safe to sleep: Community-based caregiver training. Journal of Applied Behavior Analysis, 53, 1922–1934.

22.

Watson

P. J.

Workman

E. A.

(1981). The nonconcurrent multiple baseline design across-individuals design: An extension of the traditional multiple baseline design. Journal of Behavioral Therapy and Experimental Psychiatry, 12(3), 257–259. https://doi.org/10.1016/0005-7916(81)90055-0