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It is essential to understand that rumination and vomiting were once analogous but today are defined differently. Rumination involves contents from the stomach being brought back up and are typically described as tasting good or undigested (Talley, 2011). The content is then either re-swallowed or spat out. In comparison, vomiting refers to the forceful ejection of digested or partially digested gastric contents up from the stomach and out of the mouth (Talley, 2011). Vomiting is more forcible and spitting out the food that is regurgitated is described as uncontrollable. Rumination has always been defined to include both behaviors of regurgitating and re-swallowing.
In 1981, 6% of people institutionalized with a mental disorder were reported to be diagnosed with rumination syndrome (Singh, 1981). Due to the lack of recorded data, the prevalence of rumination today is unknown (Talley, 2011). Rumination has not always been considered a disorder that is harmful to individuals. We know today that rumination can cause esophagitis and tooth decay, severe weight loss, dehydration, gastric disorders, malnutrition, and in chronic cases, death (Rast, Johnston, Drum, and Conrin, 1981; Thibadeau, Blew, Reedy, & Luiselli, 1999). A study published in 1983 defined rumination as a benign disorder (Levine, Wingate, Pfeffer, & Butcher, 1983). The behavioral intervention used in the study was reported to be unsuccessful in all 8 out of 9 participants. The researchers were ignorant to the harmful effects of rumination and even told the participants who did not have significant results that the behavior was harmless (Levine et al., 1983). According to Talley (2011), professor of medicine, the cases of individuals diagnosed with rumination syndrome has increased. It was predicted that the increase in diagnoses is due to physicians noticing the disorder and asking patients about specific symptoms related to rumination and not because of an increase in people experiencing rumination. Individuals diagnosed with Autism Spectrum Disorder (ASD) are being treated for rumination with behavior analytical techniques after parents and caregivers report the symptoms to therapists and teachers. Without parents and caregivers speaking up, the behavior might never be treated for some individuals. Behavior analysts are expected to collaborate with families and stakeholders and without this collaboration, teachers and behavior analysts might not fully understand what the client needs (Leader Standards, 2013a). What behavior analytic intervention plans have been used to treat rumination and how successful were the interventions?
Researchers in the past have used different behavior analytic techniques to treat rumination. All researchers defined rumination to included re-swallowing of the regurgitated food, and thus the most common treatment interventions used in the recent literature were antecedent interventions involving food satiation for automatic reinforcement. According to Coop