An overview of strategies to address food selectivity and refusal in individuals with autism

Feeding difficulties are common in typically developing children (2-35%), and are even more common in children with developmental problems (33-80%; Babbitt, Hoch, & Coe, 1994; Burklow, Phelps, et al, 1998). Feeding difficulties in individuals with autism is one of the most challenging presenting problems faced by clinicians. These problems come in several forms, including food refusal and extreme food selectivity. Specific issues may include inadequate intake of food, inadequate range of foods consumed, refusal to consume food, and challenging behaviors. Often, individuals with these issues have had them for many years, have been treated unsuccessfully with a variety of strategies, and have developed health consequences as a result of the longevity and severity of the problem. Efforts to intervene may be met with escalations of challenging behaviors, and with increased refusal to eat. Documented health consequences of food selectivity in autism include rickets, vitamin deficiencies, bone loss, and stunted growth (Williams, 2010).