A picky eater is a broad term covering many food issues.
This is a common topic when it comes to both students on the autism spectrum and those with developmental disabilities. Their food intake is often limited on texture, taste, and familiarity. Often, these children choose crunchy items such as crackers and cereals (Knox, et. al, 2012). Many students on the spectrum have both poor nutrition and behaviors around eating. Common feeding difficulties are trouble with mechanics, sensory processing issues, gastrointestinal distress, swallowing, restricted food preference, and nutritional concerns.
When treating picky eaters, it is important to consider the ethical issues.
Ethical and legal issues regarding the implementation of feeding interventions in schools may vary across training, location, and experience and consulting with a team of experienced professionals (i.e. SLP, OT, dietician, medical doctor, psychologist, BCBA, etc.) The team approach is a critical component of the treatment plan.
Professionals should look at scope of practice, using multidisciplinary teams, components of IDEA, and the related services (in the school). Most treatments of eating problems have been implemented in hospitals and clinical settings, but there is research that "some students with milder forms of extreme problem behavior can receive intervention at schools and as a component of their education program" (Knox, et, al 2012).
Assessment when planning an intervention for any behavior should look at the function. Is it escape, attention, access to a tangible, or sensory? Once the cause of the behavior has been identified, intervention strategies can be developed that address that function.
Research has shown that applied behavior analysis procedures such as antecedent interventions and escape extinction have been effective in treating feeding issues with students with autism.
Escape extinction is the most restrictive and is often used when difficult behaviors -- such as expelling or "packing food," resisting food presentation and disrupting meals - occur. Escape extinction is not easily implemented, is perceived poorly, and can increase in problem behavior. Antecedent procedures are implemented before acceptance of a bite or drink or immediately after acceptance of bite or drink, to promote eating.
-Knox, M, Rue, H. C., Wildenger, L., Lamb, K., & Luiselli, J. K., (2012). Intervention for
food selectivity in a specialized school setting: Teacher implemented prompting, reinforcement, and demand fading for an adolescent student with autism.
Education and Treatment of Children, 35
-Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric feeding
disorders: A quantitate synthesis of treatment outcomes.
Psychology Review, 13
-Sira, B. K. & Fryling, M. J. (2012). Using peer modeling and differential reinforcement in
the treatment of food and selectivity.
Education and Treatment of Children 35,
-Volkert, V. M. & Vaz, P. C. M. (2010). Recent studies on feeding problems in children
Journal of Applied Behavior Analysis, 43