Food Selectivity in ASD

What is food selectivity?

Food selectivity, also known as “picky eating” is often observed in young children and is always a cause for parental concern. It is more commonly reported in children with developmental disabilities, particularly in children with autism spectrum disorders (ASDs) than typically developing children.

There is a lack of standardised definition of food selectivity even though there are many reports that focus on pickiness, rigidity, selective eating, and mealtime food refusals in children with ASDs. Problems with social communication may further complicate the expansion of diet variety, as children with ASD may not imitate when other family members are eating a range of foods.

How to help food selectivity in children with autism?

Positive reinforcement

Using positive reinforcement when the child accepts new food and appropriate mealtime behaviour can be in the form of praise, access to preferred toys, foods, and activities (reinforcers). Reserved and restricting access to these reinforces only when the child accepts new foods, in order to keep your child motivated. A child may consume most food but when given new bites or nonpreferred foods, he/she may pack the bites in their mouth for long periods of time. Allow the child to watch his or her preferred video while eating but removed video when he or she packs the food in their mouth. Once the child swallows all the food, resume the video and give verbal praise. E.g. Placing a small piece of chocolate cookie (preferred food) behind the target food. Placing broccoli inside an apple slice (preferred food).When the child accepts a bite of the non-preferred food, he or she can receive a small plate of preferred foods such as chicken nuggets, french fries, Cheetos, and gummy bears. Simultaneous presentation and differential reinforcement were suggested to be the most effective intervention.

Planned ignoring

Planned ignoring involved providing as little attention as possible to the child’s inappropriate, disruptive, or unwanted behaviours during mealtime. This may be difficult to do especially after spending time and effort preparing a meal or a new food and your child yells, tantrums, and refuses to eat what is presented/given. Planned ignoring allows you, not your child, to set the tone of the meal. Inappropriate behaviours will eventually decrease when you ignore them, however a lot of patience is required.

Plan meal schedule

Establish a meal schedule to help your child to eliminate grazing/snacking between meals to increase the child’s appetite and motivation to eat during mealtimes. It may be helpful to use a data sheet to track your child’s progress. Indicate which foods you have introduced, the size of bites given to your child (e.g. pea-sized, teaspoon, half spoonful, full-spoonful) and whether your child accepted without a problem or if your child displayed behaviours such as crying or screaming. Tracking your child’s mealtime behaviours can help guide your decision when to increase the bite sizes of new foods introduced or when to adjust the intervention if there is no progression.

Plan food similar to your child’s diet

Introduce food that is similar in taste and texture to the foods that are already in your child’s diet such as those he/she has previously eaten well but no longer eats. It may be easier to introduce food that does not require chewing such as yogurt, purée or pudding. This reduces the tendency that your child will hold the food in their mouth or spit the food out. Allow your child to take a sip of a preferred beverage right after eating the food on the first few exposures.

Conclusion

There is a range of health benefits when one consumes a wide variety of foods, especially fruits and vegetables. This includes the prevention of chronic diseases such as diabetes, heart disease, and even cancer. Increasing diet variety also comes with social benefits. When children with ASD learn to eat new foods, they are learning how to tolerate change, which may help reduce their insistence on sameness and open them to new experiences. Additionally, efforts to increase diet variety involve teaching the child to follow directions and just as important, it allows parents to practice giving instructions, providing praise, ignoring inappropriate behaviours, and planning food and meal schedules.

Written by Carabelle.

References:

Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., Maslin, M., & Must, A. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. The Journal of Pediatrics, 157(2), 259–264. https://doi.org/10.1016/j.jpeds.2010.02.013

Google. (n.d.). [Feeding therapy | Autism and Picky Eating | Verbal Beginnings]. Retrieved April 16 2022, from https://images.app.goo.gl/3XuYEssgtwK9X97NA

Matson, J. L., & Fodstad, J. C. (2009). The treatment of food selectivity and other feeding problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(2), 455-461. https://doi.org/10.1016/j.rasd.2008.09.005

Seiverling, L., & Williams, K. (2016). Clinical Corner: Improving food selectivity of children with autism. Science in Autism Treatment, 13(4), 16-20.