Food Selectivity

Children who develop an unhealthy relationship with eating often experience short and long-term implications (Gale, Eikeseth, & Rudrud, 2010). Generally, children progress through a predictable sequence of feeding skills (Vaz, Volkert, & Piazza, 2011); however, children who are selective or picky eaters will only consume certain foods and no other variations (Ahearn, 2003). Feeding difficulties, such as food selectivity, are common among children with developmental disabilities (Cooper, Heron, & Heward, 2014, p. 317), and are estimated to develop in about one third of this population (Palmer, Thompson, & Linscheid, 1975). Bandini and colleagues (2010) noted that a standardised definition of food selectivity was absent in current literature. Consequently, they operationalised food selectivity to include three components: 1) food refusal; 2) limited food repertoire; and 3) high frequency single food intake (Bandini et al., 2010, p. 2).

Food selectivity is often exhibited by children with developmental disabilities and can be a major concern for caregivers (Bandini et al., 2010). Positively, research shows much promise in ameliorating parental concerns as well as improving the lives of those who exhibit such eating disorders. In children with ASDs, the literature suggests that food selectivity can be successfully treated with a multitude of intervention strategies such as: stimulus fading (Koegel et al., 2012), taste exposure and behavioural skills training (Seiverling et al., 2012), antecedent manipulations (Najdowski et al., 2012), differential reinforcement and non-contingent reinforcement (Allison et al., 2012), high-p request sequences (Penrod et al., 2012), modeling (Fu et al., 2015), and escape extinction (Allison et al., 2012; Fu et al., 2015). Escape extinction is not always a necessary supplement for positive outcomes (Najdowski et al., 2012; Penrod et al., 2012). Moreover, caution should be advised if utilising an escape extinction procedure as it can lead to extinction bursts (Najdowski et al., 2012) and aggression (Allison et al., 2012).

Food selectivity covers a wide range of problematic eating behaviours (Bandini et al., 2010). Therefore, the intervention strategies above could possibly be applied to client’s presenting with many topographies of feeding disorders. Considering that maladaptive feeding behaviours may be the product of environmental factors (Penrod et al., 2012), observing others (Bandura, 1965; Fu et al., 2015), or even sensory functions (Koegel et al., 2012), challenges lie in selecting interventions that best match the individual’s learning history. Despite these interventions showing promise for treating food selectivity, the literature is relatively recent and the subjects relatively young. Longitudinal follow-ups on such clients may ultimately be the illuminating factor on the efficacy of the current plethora of interventions available.

Selected readings:

Ahearn, W. H. (2003). Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism. Journal of Applied Behavior Analysis, 36(3), 361–365.

Allison, J., Wilder, D. A., Chong, I., Lugo, A., Pike, J. & Rudy, N. (2012). A comparison of differential reinforcement and noncontingent reinforcement to treat food selectivity in a child with autism. Journal of Applied Behavior Analysis, 45(3), 613-617.

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.

Bandura, A. (1965). Influence of models’ reinforcement contingencies on the acquisition of imitative responses. Journal of Personality and Social Psychology, 1, 589-595.

Cooper, J., Heron, T., & Heward, W. (2014). Applied Behavior Analysis (Pearson New International Edition, 2nd Ed.) UK: Pearson Education.

Fu, S. B., Penrod, B., Fernand, J. K., Whelan, C. M., Griffith, K., & Medved, S. (2015). The Effects of Modeling Contingencies in the Treatment of Food Selectivity in Children With Autism. Behavior Modification, 39(6), 771-784.

Gale, C. M., Eikeseth, S., & Rudrud, E. (2011). Functional assessment and behavioural intervention for eating difficulties in children with autism: a study conducted in the natural environment using parents and ABA tutors as therapists. Journal of Autism and Developmental Disorders, 41(10), 1383-96.

Koegel, R. L., Bharoocha, A. A., Ribnick, C. B., Ribnick, R. C., Bucio, M. O., Fredeen, R. M., & Koegel, L. K. (2012). Using individualized reinforcers and hierarchical exposure to increase food flexibility in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(8), 1574-1581.

Najdowski, A. C., Tarbox, J., & Wilke, A. E. (2012). Utilizing antecedent manipulations and reinforcement in the treatment of food selectivity by texture. Education and Treatment of Children, 35(1), 101-110.

Palmer, S., Thompson, R. J., & Linscheid, T. R. (1975). Applied Behavior Analysis in the Treatment of Childhood Feeding Problems. Developmental Medicine & Child Neurology, 17(3), 333.

Penrod, B., Gardella, L., Fernand, J. (2012). An evaluation of a progressive high-probability instructional sequence combined with low probability demand fading in the treatment of food selectivity. Journal of Applied Behavior Analysis, 45(3), 527-537.

Seiverling, L. Williams, K., Sturmey, P., & Hart, S. (2012). Effects of behavioral skills training on parental treatment of children’s food selectivity. Journal of Applied Behavior Analysis, 45(1), 197-203.

Vaz, P. C. M., Volkert, V. M., & Piazza, C. C. (2011). Using negative reinforcement to increase self-feeding in a child with food selectivity. Journal of Applied Behavior Analysis, 44(4), 915– 920.