Selective Eating in Children with Autism: How Great Strides Supports Food Expansion

Many children with autism have strong preferences about food. A child may eat only a small group of familiar foods, prefer a certain brand or shape, avoid foods that touch, or become upset when something looks, smells, or tastes different than expected. Even a small change like a different package, a chicken nugget shaped differently, or a familiar food served on a different plate can sometimes make a food feel unfamiliar.

Selective eating can look very different from one child to another. For some children, sensory differences related to taste, smell, texture, temperature, or appearance play a role. Others may rely heavily on familiar routines and predictability around meals. For many families, the goal is not simply to get a child to “eat more foods.” It is to help the child become more comfortable and flexible around food while supporting positive and safe eating experiences.

Before We Work on Eating, We Look at the Whole Picture

Food refusal or a very limited diet is not always primarily behavioral. Medical, nutritional, sensory, oral motor, swallowing, or other feeding concerns may contribute to a child’s eating patterns.

ABA does not diagnose or treat medical conditions or feeding concerns that fall outside a behavior analyst’s scope of practice. When these concerns are identified or suspected, Great Strides may recommend that families consult with their child’s pediatrician or another appropriate provider before beginning behavioral food expansion programming. Once a child can safely participate and relevant medical, nutritional, or feeding-skill concerns have been appropriately evaluated or addressed, ABA may be used to support individualized food expansion goals.

How Do We Decide Where to Begin?

Food-related concerns may first come up during a child’s initial ABA assessment, through observation, or during conversations with the family. Assessment tools used at Great Strides, including the Early Start Denver Model Curriculum Checklist and the Vineland Adaptive Behavior Scales, include skills related to eating and daily living that may help identify areas for further discussion. These tools are not specialized feeding assessments, but they can help the team recognize when additional information or evaluation may be needed.

Families also provide an important part of the picture. Parents can tell us:

· What foods their child currently eats

· What happens when a new or different food is offered

· Whether certain textures, temperatures, shapes, brands, or presentations are especially difficult

· What mealtimes look like at home

· Which food related skills would be most meaningful for their family

From there, the BCBA can determine whether a food related ABA goal is appropriate and where the child’s starting point should be.

What Does Food Expansion Look Like at Great Strides?

Food expansion usually happens in small, manageable steps. A child is not expected to move immediately from refusing a food to eating an entire serving.The appropriate starting point depends on the child.

For one child, progress may begin with comfortably having an unfamiliar food nearby. Another child may already tolerate new foods on the plate but need support touching, smelling, or tasting them. A different child may be comfortable trying a small bite but have difficulty accepting the same food when its appearance or presentation changes.

Goals might involve becoming more comfortable with:

· Having a new food nearby

· Allowing a new food on the table or plate

· Touching or interacting with a food

· Exploring its smell, texture, or other characteristics

· Bringing a food near the mouth

· Tasting a small amount

· Becoming more flexible with different versions or presentations of familiar foods

There is no single sequence that every child must follow.

The BCBA uses observation and data to determine how the child is responding and whether the current goal should stay the same, move forward, or be adjusted. Children are also given meaningful opportunities for choice whenever possible. Significant distress or avoidance provides important information about whether the goal, pace, or approach needs to be reconsidered. The goal is not to force a child to eat a particular food. Instead, food expansion programming is intended to build comfort, flexibility, and useful skills while helping maintain a positive relationship with food.

Why Is Food Practice Often Scheduled Outside of Lunch?

At Great Strides, structured food expansion practice will often occur outside of a child’s regular lunch or mealtime. Regular meals give children the opportunity to eat familiar foods, meet their nutritional needs, and participate in a typical mealtime routine. Repeatedly introducing challenging food expectations during lunch could interfere with that purpose.

Scheduling structured food practice at another point in the day allows the team to introduce a small amount of food and focus on an individualized goal without disrupting the child’s regular meal. As a child becomes more comfortable and develops new skills, the team can also work with families to determine how those skills may generalize to everyday meals and other natural settings.

Families Are an Important Part of the Process

Parents know their child’s eating habits and family routines better than anyone, which makes family input essential when selecting meaningful food related goals. Through parent training, the BCBA can explain what the child is practicing, review progress, demonstrate strategies, and learn what the family is seeing at home.

This communication is especially important because children may respond differently to the same food depending on where it is served, who is present, how it is prepared, or what routine surrounds the meal. When appropriate, parents may also practice parts of the child’s plan at home so that new skills can become useful beyond the clinic.

Food Exploration Can Happen Outside of Individual Treatment Goals

Not every opportunity to interact with a new food needs to be part of a formal food expansion program. Great Strides also incorporates food exploration into some clinic activities. During our Fall Taste Test Week, for example, children were introduced to seasonal foods such as pumpkin, cranberry sauce, apple cider, potatoes, and corn muffins.

Participation looked different for different children. Some children may have practiced simply being near a new food or having it on their plate. Others may have touched, smelled, or tasted it. Children also had the opportunity to observe peers and staff interacting with the same foods. Activities like these can provide positive, low-pressure opportunities for children to experience unfamiliar foods without creating an expectation that every child must eat them.

Small Steps Can Be Meaningful Progress

Food expansion can take time, and progress does not always begin with taking a bite. For one child, success may be allowing an unfamiliar food on the table without distress. For another, it may be touching or smelling a food they previously avoided. Over time, those small steps can help build greater comfort and flexibility. When food-related goals are appropriate, Great Strides works with families to identify a starting point that is safe, realistic, and meaningful for the child and family and then builds from there.

Sources and Further Reading

Williams, K. E., & Seiverling, L. J. (2018). Broccoli Boot Camp: Basic Training for Parents of Selective Eaters. Woodbine House.

Additional professional resources regarding autism, pediatric feeding concerns, and behavioral approaches to food selectivity may also be used to guide individualized clinical decision making.