A Behavior-Based Approach to Food Refusal in Children with Autism and Pervasive Developmental Disorder

Abstract

Four children (ages 4-5 years) with autism or pervasive developmental disorder (PDD) participated in a four week, single-case design intervention study. Each child had a behavior-based feeding problem that included food refusal and selectivity. Individual interventions were carried out in the classroom during lunchtime over four weeks. Small positive changes were observed in each child's feeding behavior without any negative impact on nutrient intake.The results of this study generated general principles and strategies for intervention in behavior-based feeding problems: 1) Interventions should be individually designed and appropriate to the child's developmental age. 2) More exposures to new foods may be required by children with autism than by typically developing children, and progress toward food acceptance may require a greater number of intervention-based steps. 3) Increased exposure to new foods and manipulation of foods offered increases acceptance for some children. 4) Food preferences are selective and relatively constant; offering at least one preferred food may help to ensure that food is consumed at that meal. 5) The opportunities for social interaction and the development of family relationships that mealtimes provide should not be compromised. 6) With the cooperation of the school, interventions can be incorporated into a child's educational goals.Individually designed interventions for these four children demonstrated an increased acceptance of texture and variety in food choices.