Expanding the Diet of a Picky Eater

child-with-autism-at-restaurant By: Brandi Meuse, BCBA

A common issue that many parents share is food selectivity, or more commonly referred to as picky eating. Children go through stages where they are discovering what they like and don’t like, which can lead to a battle of how to get them to eat or increase the variety of what they will eat. Children with autism spectrum disorder are more likely to struggle with challenges when eating (Schreck & Williams, 2006). Anyone who is going through this battle is not alone! There are many suggestions available on how to tackle picky eating, but we will narrow it down to 3 evidence based tips to get started.

Before trying any suggestions, the first thing to consider is ensuring that the struggles during meal time are not the result of medical issues. Consulting the child’s doctor while help determine if a further assessment is needed to be completed (Cermak, Curtin, & Bandini, 2010). Once any potential medical issues are ruled out, consider these tips:

Tip #1 – If food is presented, follow through with having the child eat it

Studies have shown that not removing a food once it is presented is an effective way to increase the variety of foods eaten (Mueller et. al 2004, Piazza et. al 2003). By maintaining that the child must eat the food before having access either to something preferred or access to getting away from the table, they learn that the expectation is they have to eat the food. If the presentation of food is removed after problem behaviors occur (such as tantrums or noncompliance), the child will learn they can get out of having to eat the food. This will cause future attempts to be more difficult and the child will be less likely to be successful in trying new foods (Kern & Marder, 1996, LaRue et. al, 2011).

Tip # 2 – Present high probability requests before low probability requests

Many studies have paired not removing the food with presenting a sequence in which a high probability request is presented and then a low probability request is presented (Dawson et.al, 2003, Meier, Fryling, & Wallace, 2012). A high probability request is one in which the child is very likely to complete the request, such as eating a preferred food or even just putting an empty spoon in their mouth. The low probability request is one that they are less likely to complete, such as eating a spoonful of a new food. If they are likely to eat mashed potatoes but is resistant to trying peas, you would present a spoonful of mashed potatoes and then a spoonful of peas.

Tip# 3 – Pair new food with already preferred food

Another strategy is to present a highly preferred food simultaneously with the new food. Studies have shown that by pairing new food with highly preferred food, children increased the number of new food they ate (Bachmeyer, 2009). Some studies combined food together such as presenting condiments on vegetables (Ahearn, 2003), while others placed the new food on utensil with the preferred food (Kern & Marder, 1996, Buckley & Newchok, 2005).

Utilizing these tips will likely increase the variety of new foods that children will eat. It may also help in the amount of consumption of new foods. Remember, many parents are facing the difficulties of their child being a picky eater. Use these tips and see the success!

Carolina Center for ABA & Autism Treatment has Board Certified Behavior Analysts on staff that can write an individualized program to address your child's specific needs. Please don't hesitate to reach out to us if we can be of assistance.

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References

Ahearn, W.H. (2003). Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism. Journal of Applied Behavior Analysis, 36, 361 – 365.

Buckley, S.D., & Newchok, D.K. (2005). An evaluation of simultaneous presentation and differential reinforcement with response cost to reduce packing. Journal of Applied Behavior Analysis, 38, 405 – 409.

Cermak, S. A., Curtin C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of American Diet Association, 110 (2) 238 – 246. doi: 10.1016/j.jada.2009.10.032.

Dawson, J. E., Piazza, C. C., Sevin, B. M., Gulotta, C. S., Lerman, D., & Kelley, M. (2003). Use of the highprobability instructional sequence and escape extinction in a child with a feeding disorder. Journal of Applied Behavior Analysis, 36, 105–108.

Kern, L., & Marder, T. J. (1996). A comparison of simultaneous and delayed reinforcement as treatments for food selectivity. Journal of Applied Behavior Analysis, 29, 243–246.

LaRue, R. H., Stewart, V., Piazza, C. C., & Volkert, V. M. (2011). Escape as reinforcement and escape extinction in the treatment of feeding problems. Journal of Applied Behavior Analysis44, 719-735.

Meier, A. E., Fryling, M. J., & Wallace, M. D. (2012). Using high-probability foods to increase the acceptance of low-probability foods. Journal of Applied Behavior Analysis, 45, 149 – 153.

Mueller, M. M., Piazza, C. C., Moore, J. W., Kelley, M. E., Bethke, S. A., Pruett, A. E., Oberdorff, A. J., & Layer, S. A. (2003). Training parents to implement pediatric feeding protocols. Journal of Applied Behavior Analysis, 36, 545-562

Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. M., & Layer, S. A. (2003). On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal. Journal of Applied Behavior Analysis, 36, 309–324.

Schreck K. A. & Williams K. (2006). Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research in Developmental Disabilities, 27, 353–363.

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