Food Selectivity Treatment Program for Children with Autism: A Comprehensive Scientific Approach

Introduction

Many children with Autism Spectrum Disorder (ASD) experience sensory and behavioral challenges that affect their relationship with food, leading to what is termed “food selectivity.” This refers to a strong preference for specific types of food or refusal to eat entire food groups, which can result in long-term nutritional and health issues. Studies show that between 46% and 89% of children with autism suffer from food selectivity (Bandini et al., 2010).

Theoretical Foundations

Food selectivity in autistic children arises from multiple factors, including:

1. Sensory Sensitivities: Children may have strong aversions to certain textures, smells, or colors.
2. Social Difficulties: A child may refuse new foods introduced by unfamiliar people or in unfamiliar settings.
3. Compulsive and Routine-Based Behavior: A strong preference for routines can lead to food rigidity.

Program Components

Treatment requires a multidisciplinary approach, involving ABA therapists, nutritionists, occupational therapists, and speech-language pathologists. The program typically includes:

1. Comprehensive Initial Assessment

Analyze the child’s current food-related behavior.

Collect parental reports of accepted and rejected foods.

Use tools like food diaries and behavioral questionnaires.

2. Behavior Modification Techniques

Based on Applied Behavior Analysis (ABA), including:

Shaping: Gradually increasing food interaction from touching to full consumption.

Positive Reinforcement: Rewarding the child for accepting new foods.

Systematic Desensitization: Slowly reducing anxiety through controlled exposure.

Modeling: Having the child observe others eating the food positively.

3. Sensory and Occupational Therapy

Used for children with strong sensory aversions.

Activities include exposure to different textures through play and sensory materials.

4. Parent Education and Support

Involving parents in the intervention plan.

Teaching food presentation techniques and stress-reduction strategies.

Implementation Strategies

1. Structured Individual Sessions:

Each session lasts 30–45 minutes.

Frequency depends on severity (usually 2–3 sessions per week).

2. Therapeutic Environment:

Distraction-free and comforting.

Use familiar and preferred utensils or plates.

3. Continuous Monitoring and Evaluation:

Track progress using data charts.

Monthly review of goals and adjustments.

4. Generalization of Skills:

Practice across different settings (home, school).

Engage teachers and caregivers in the program.

Evidence of Effectiveness

Sharp et al. (2013) demonstrated that ABA-based interventions increased acceptance of new foods.

Seiverling et al. (2018) found that systematic desensitization and positive reinforcement reduced food refusal behaviors.

Conclusion

Food selectivity in autistic children is not merely a dietary issue but a behavioral, psychological, and social one. Early, scientific, and comprehensive interventions—particularly those grounded in behavioral analysis—show promise, especially when combined with sensory and nutritional support and close collaboration between families and treatment teams.