Feeding Therapy in a Child With Autistic Disorder: Sequential Food Presentation

The authors describe a feeding intervention for a 9-year-old male diagnosed with autistic disorder and mild mental retardation (also known as intellectual disability) who experienced food refusal related to food selectivity. Based on the results of a functional behavioral assessment, food refusal was found to be maintained by escape and tangible functions. Therefore, an intervention using escape extinction (i.e., nonremoval of nonpreferred foods with physical guidance as a secondary procedure), positive reinforcement (i.e., preferred foods and toys), and sequential food presenta-tion was implemented. The child was successful in eating many novel foods both within the clinic and home environments. A 1-year follow-up found the effects of treatment to be maintained with significant increases in number of foods eaten and significant decreases in mealtime-related be-havioral challenges. The treatment implications, recommendations to clinicians, and areas of future research are discussed