Plate A – Plate B Protocol
Plate A - Plate B Treatment Plan
Give your child 4-6 meals per day, each meal should follow the same format. In the beginning, you may give more meals to provide your child more chances to eat. Use these Plate A – Plate B meals to replace all other meals and snacks.
Set a timer for the length of the meal (typically 10-20 minutes).
Present your child with a plate of4 new foods. Place 4 -6 pieces of each food, with each piece no bigger than a grain of rice on a plate. This is Plate A.
Also present your child with a plate of 4preferred foods. Place large pieces of these foods on this plate known as the “reward” plate. This is called Plate B.
At each meal offer a beverage that your child drinks.
After pressing start on the timer, offer plate A and tell your child to eat any bite from this plate and he or she may have anything from the other plate (plate B) as well as a drink.
Just calmly wait until the child accepts a bite from Plate A while ignoring any crying or refusal.
Repeat the rule approximately every 30 seconds, “take a bite from this plate (point to Plate A), then you may have a bite from that plate (point to Plate B) and a drink. You also can model taking a bite from Plate A followed by a bite from Plate B and a drink.
As soon as your child eats a bite from Plate A, immediately praise your child and offer both the drink and Plate B.
If your child accepts a bite from Plate A and then spits out the food, do not give a bite from Plate B or a drink. Give another bite from Plate A. Continue to give bites from Plate A until a bite from this plate is actually eaten without being expelled.
If your child gets up from his or her chair, return him or her to the table and redirect your child to eat. If this is not possible, you may end the meal and just wait until the next Plate A-Plate B meal to continue implementing the plan.
When the timer rings signaling the end of the meal or if your child eats all of the Plate A foods presented (whichever comes first), your child may leave the table. If the timer rings and your child wishes to continue eating, he or she may continue to stay at the table and eat; however, if your child continues to eat past the allotted time, your child must still follow the rules of the intervention.
Record the bites eaten on theMealtime Data Sheet (Appendix A) and the Food Exposure Data Sheet (Appendix B)Food Exposure Data Sheet to evaluate progress.
Between meals your child is allowed to drink as much water as he or she desires. Your child may also have any new food, but no favorite or preferred foods. If your child ate nothing or only a small amount at a particular meal, that is fine, just wait until the next meal. Initially, your child may eat very little and there may be meals in which your child eats nothing. It is important not to give preferred foods outside of the meals. Remember your child may have 4 to 6 meals per day.
Rules for increasing bite sizes:
When your child is eating a particular foodat a certain bite size without crying or gagging for three consecutive meals, we recommend increasing the bite size as follows:
Rice-sized
Pea-sized
½ spoonful
Spoonful