Autism Resources About ABA Therapy

Navigating the Complexities of Food Selectivity and ASD

Dr. Vivian Ibañez June 21, 2024

Food is a big part of our lives! Most of us eat multiple times a day, in many places, with many different people, so we might not always think about the complexities of eating. For some, though, experiences with food might look a little different, and can become challenging for families to navigate. Many studies have shown that feeding difficulties are quite common in children with autism (ASD), typically presenting as food selectivity. 

You might think that food selectivity is just picky eating, but it is important to note that food selectivity can significantly impact a child’s growth and development. If left untreated, this type of food selectivity can lead to other health complications and cause stress for caregivers who must prepare the same foods daily and separately from what the rest of the family eats, or manage frequent challenging mealtime behavior. For instance, many children with ASD will only eat a very limited variety of foods, sometimes requiring specific brands, colors, shapes, textures, or temperatures.

How Can ABA Help with Food Selectivity?

The good news is that some behavior analysts have specialized training in the area of feeding. Treatments for food selectivity and other feeding challenges for children with ASD based on applied behavior analysis (ABA) therapy have shown positive and life-changing outcomes! 

Dr. Vivian Ibañez and her team at the specialty clinics, in partnership with the University of Florida Health Center for Autism and Neurodevelopment (UFCAN), represent one example of this type of service. Their approach to ABA therapy focused on feeding starts with a careful consideration of all possible medical variables that might impact feeding. This step is crucial because, although multiple children may have similar symptoms related to their feeding concerns, the underlying reasons for these challenges can differ. One child might indicate fullness after consuming a small amount of food, while another might appear motivated to eat but takes a long time to finish meals. Consulting with a holistic network of healthcare providers could reveal that delayed gastric emptying leads to quick feelings of fullness, or oral-motor-skill concerns make it difficult to finish meals. This multidisciplinary approach is important to support the safety and success of ABA feeding therapy. 

Related: Decreasing Rapid Eating 

Understanding Eating

A feeding therapist holds up a green visual aid

Another key to success is understanding the many steps involved in the eating process, particularly chewing! By breaking down the process, establishing a more positive relationship with food becomes attainable. For example, at our intensive feeding clinic, we might start with a small amount of food or a few bites, providing many practice opportunities that lead to fun breaks. This approach gradually builds the child’s ability to eat and drink more over time. The overarching goal is to promote age- and developmentally-appropriate feeding by systematically advancing gains, such as increasing food textures and teaching the child to self-feed and self-drink. This recovery process is akin to training for a marathon; it is gradual and requires a lot of practice. 

Finally, engaging family members as active participants in the treatment is crucial. Young children typically eat five times a day, so teaching caregivers how to manage meals is important. As clinicians, we must recognize the enormous time and energy caregivers exert to implement treatments consistently and provide them with the support they need to be successful. 

Photo credits: Michel Thomas, Multimedia Specialist at the University of Florida