Food-Related Disorders and Applied Behavior Analysis

Abstract

Many children with Autism Spectrum Disorder (ASD) display feeding difficulties, which is often diagnosed as Avoidant Restrictive Food Intake Disorder (ARFID). Children with ARFID consume a limited variety of unhealthy foods and often restrict their diet to an unsafe degree (e.g., poor nutrition, insufficient calories; (Bandini, et al., Journal of Autism and Developmental Disorders 47:439–446, 2017)). Given the negative consequences of ARFID (e.g., family stress, growth and developmental concerns, comorbid medical problems; (Auslander, et al., Family Relations 52:12–21, 2003)) and the empirical support for behavior-analytic interventions (Volkert and Piazza, Handbook of evidence-based practice in clinical psychology. Wiley, Chichester, 2012), behavior analysts should make it a priority to seek the necessary training, support, and infrastructure to treat symptoms of ARFID in children with ASD. Recently, our team developed a hybrid early intervention and feeding-disorders program that addresses skill acquisition from a specific domain. The hybrid program targets ARFID directly, but also addresses what we view as important adaptive skills that can affect or impact a child’s overall development relative to feeding, such as social skills, appropriate toileting, self-care routines, and mealtime independence. In this chapter, we review critical aspects of this hybrid program to provide guidance for other practitioners who might wish to expand their services to treat ARFID. We review research and provide general recommendations for how behavior analysts could provide a similar service.KeywordsAutismAvoidant restrictive food intake disorderFeeding disordersEarly intensive behavioral interventionHybrid services