Food selectivity is common among children with developmental disabilities, particularly those diagnosed with autism spectrum disorder (ASD). It has been estimated to be as high as 72% (Schreck et al., 2004). Unfortunately, picky eaters face a greater risk of nutrient inadequacy relative to children with a varied diet (Bachmeyer, 2009). In addition, parents of children with food selectivity often report limited food choices for other members in the family and an increase in spousal and family stress during mealtimes (Curtin et al., 2015). [Read further: Article]
The bite size, type, flavor, color, texture, and shape of food can all have a major affect on the probability of trying new foods. Even the the utensils used can increase or decrease consumption of novel or non-preferred foods. Ever encountered a child that consistently eats his school lunch but won’t touch the same food in the home setting? Changing the environment may not be possible, but changing the stimuli, or common features of the environment such as the plates used or sitting arrangement, can help target pickiness.
One study looked specifically at the taste of the food. Using preferred flavors (e.g., carrot puree), they gradually blended non-preferred flavors (e.g., broccoli puree) to expand the variety of foods consumed (Mueller et al., 2004). This may work best when textures and color is not an issue.
Another study (Luis et al., 2021) looked at the noncontingent presentation of a high-preferred reinforcer (i.e., reward) during mealtimes to reduce aggression and increase food acceptance. Noncontingent presentation is when regardless of whether or not the child tries the food presented, the child still has access to the reward. For example, some children become distracted by playing on the iPad, watching TV, or drawing. These distractions can help form an association with the non-preferred foods they are avoiding therefore allowing the child to try new foods.
A different study capitalized on a routine-based delivery of small bites of food. Patel et al. (2007) evaluated the repeated presentation of an empty spoon (3 times) followed by the presentation of a spoon with a non-preferred food. Children with picky eating in this study responded well to the treatment.
Three of the biggest recommendations regardless of the method used is to introduce new foods early, use strategies that encourage eating, and to always use positive reinforcement during the process. It may be common to recommend starving or forcing the child to try foods, but when dealing with autism, it is especially important to stay away from these methods. These punishing methods has negative long-term effects including malnutrition, aggression, and may cause or intensity an eating disorder.
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