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Treatment of Food Selectivity in an Adult With Autism Spectrum Disorder

Abstract

Food selectivity is common among individuals with autism spectrum disorder (ASD). Left untreated, food selectivity may continue into adulthood, leading to social and nutritional deficits. Although effective treatments have been identified for young children and the school-aged population, these treatments may not be feasible with adults. As such, effective treatments for adults with ASD need to be identified. In this study, the participant was a 26-year-old male with ASD and a history of food selectivity. We compared two treatments that used differential reinforcement of alternative behaviors—one using positive reinforcement and the other negative reinforcement—to increase acceptance of novel fruits and vegetables. Both treatments resulted in increases in the acceptance of grapes and red bell peppers. When given the choice, the participant preferred the positive reinforcement contingency. Additionally, his food acceptance occurred in the presence of novel foods (e.g., carrots and lettuce) and settings. This study represents one of the only studies examining the treatment of food selectivity in adults with ASD.

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References

  1. Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., Maslin, M., & Must, A. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. Journal of Pediatrics, 157(2), 259–264. https://doi.org/10.1016/j.jpeds.2010.02.013

    Article  Google Scholar 

  2. Bandini, L. G., Curtin, C., Phillips, S., Anderson, S. E., Maslin, M., & Must, A. (2017). Changes in food selectivity in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(2), 439–446. https://doi.org/10.1007/s10803-016-2963-6

    Article  PubMed  PubMed Central  Google Scholar 

  3. Beighley, J. S., Matson, J. L., Rieske, R. D., & Adams, H. L. (2013). Food selectivity in children with and without an autism spectrum disorder: Investigation of diagnosis and age. Research in Developmental Disabilities, 34(10), 3497–3503. https://doi.org/10.1016/j.ridd.2013.07.026

    Article  PubMed  Google Scholar 

  4. Chawner, L. R., Blundell-Birtill, P., & Hetherington, M. M. (2019). Interventions for increasing acceptance of new foods among children and adults with developmental disorders: A systematic review. Journal of Autism and Developmental Disorders, 49(9), 3504–3525. https://doi.org/10.1007/s10803-019-04075-0

    Article  PubMed  PubMed Central  Google Scholar 

  5. Curtin, C., Hubbard, K., Anderson, S. E., Mick, E., Must, A., & Bandini, L. G. (2015). Food selectivity, mealtime behavior problems, spousal stress, and family food choices in children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(10), 3308–3315. https://doi.org/10.1007/s10803-015-2490-x

    Article  PubMed  PubMed Central  Google Scholar 

  6. DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple-stimulus presentation format for assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29(4), 519–533. https://doi.org/10.1901/jaba.1996.29-519

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dietz, P. M., Rose, C. E., McArthur, D., & Maenner, M. (2020). National and state estimates of adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(12), 4258–4266. https://doi.org/10.1007/s10803-020-04494-4

    Article  PubMed  Google Scholar 

  8. Fisher, W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 45(2), 491–498. https://doi.org/10.1901/jaba.1992.25-491

    Article  Google Scholar 

  9. Fodstad, J. C., & Matson, J. L. (2008). A comparison of feeding and mealtime problems in adults with intellectual disabilities with and without autism. Journal of Developmental and Physical Disabilities, 20(6), 541–550. https://doi.org/10.1007/s10882-008-9116-6

    Article  Google Scholar 

  10. Hyman, S. L., Levy, S. E., Myers, S. M., & Council on Children With Disabilities, Section on Developmental and Behavioral Pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), e20193447. https://doi.org/10.1542/peds.2019-3447

    Article  PubMed  Google Scholar 

  11. Kuschner, E. S., Eisenberg, I. W., Orionzi, B., Simmons, W. K., Kenworthy, L., Martin, A., & Wallace, G. L. (2015). A preliminary study of self-reported food selectivity in adolescents and young adults with autism spectrum disorder. Research in Autism Spectrum Disorders, 15–16, 53–59. https://doi.org/10.1016/j.rasd.2015.04.005

    Article  PubMed  PubMed Central  Google Scholar 

  12. Leader, G., Tuohy, E., Chen, J. L., Mannion, A., & Gilroy, S. P. (2020). Feeding problems, gastrointestinal symptoms, challenging behaviors and sensory issues in children and adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(1), 1401–1410. https://doi.org/10.1007/s10803-019-04357-7

    Article  PubMed  Google Scholar 

  13. Ledford, J. R., & Gast, D. L. (2006). Feeding problems in children with autism spectrum disorders: A review. Focus on Autism and Other Developmental Disabilities, 21(3), 153–166. https://doi.org/10.1177/2F10883576060210030401

    Article  Google Scholar 

  14. Mari-Bauset, S., Zazpe, I., Mari-Sanchis, A., Llopis-Gonzalez, A., & Morales-Suarez-Varel, M. (2014). Food selectivity in autism spectrum disorders: A systematic review. Journal of Child Neurology, 29(11), 1554–1561. https://doi.org/10.1177/2F0883073813498821

    Article  PubMed  Google Scholar 

  15. Nadon, G., Feldman, D. E., Dunn, W., & Gisel, E. (2011). Mealtime problems in children with autism spectrum disorder and their typically developing siblings: A comparison study. Autism, 15(1), 98–113. https://doi.org/10.1177/1362361309348943

    Article  PubMed  Google Scholar 

  16. Sharp, W. G., Berry, R. C., McCracken, C., Nuhu, N. N., Marvel, E., Saulnier, C. A., Klin, A., Jones, W., & Jaquess, D. L. (2013). Feeding problems and nutrient intake in children with autism spectrum disorders: A meta-analysis and comprehensive review of the literature. Journal of Autism and Developmental Disorders, 43(9), 2159–2173. https://doi.org/10.1007/s10803-013-1771-5

    Article  PubMed  Google Scholar 

  17. Sharp, W. G., Postorino, V., McCracken, C. E., Berry, R. C., Criado, K. K., Burrell, T. L., & Scahill, L. (2018). Dietary intake, nutrient status, and growth parameters in children with autism spectrum disorder and severe food selectivity: An electronic medical record review. Journal of the Academy of Nutrition and Dietetics, 118(10), 1943–1950. https://doi.org/10.1016/j.jand.2018.05.005

    Article  PubMed  Google Scholar 

  18. SNAP Education Connection. (n.d.). Seasonal produce guide. https://snaped.fns.usda.gov/seasonal-produce-guide

  19. St. Peter Pipkin, C., & Vollmer, T. R. (2009). Applied implications of reinforcement history effects. Journal of Applied Behavior Analysis, 42(1), 83–103. https://doi.org/10.1901/jaba.2009.42-83

    Article  PubMed  Google Scholar 

  20. Tanoue, K., Takamasu, T., & Matsui, K. (2016). Food repertoire history in children with autism spectrum disorder in Japan. Pediatrics International, 59(3), 342–346. https://doi.org/10.1111/ped.13160

    Article  PubMed  Google Scholar 

  21. Thullen, M., & Bonsall, A. (2017). Co-parenting quality, parenting stress, and feeding challenges in families with a child diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(3), 878–886. https://doi.org/10.1007/s10803-016-2988-x

  22. Volkert, V. M., & Vaz, P. C. M. (2010). Recent studies on feeding problems in children with autism. Journal of Applied Behavior Analysis, 43(1), 155–159. https://doi.org/10.1901/jaba.2010.43-155

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zimmer, M. H., Hart, L. C., Manning-Courtney, P., Murray, D. S., Bing, N. M., & Summer, S. (2012). Food variety as a predictor of nutritional status among children with autism. Journal of Autism and Developmental Disorders, 42(4), 549–556. https://doi.org/10.1007/s10803-011-1268-z

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to SungWoo Kahng.

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We have no known conflicts of interest to disclose.

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This study was approved by the university institutional review board.

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We would like to thank the Rutgers Center for Adult Autism Services and all those involved for their participation.

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Pubylski-Yanofchick, W., Zaki-Scarpa, C., LaRue, R.H. et al. Treatment of Food Selectivity in an Adult With Autism Spectrum Disorder. Behav Analysis Practice (2021). https://doi.org/10.1007/s40617-021-00650-z

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Keywords

  • Adult
  • Autism spectrum disorder
  • Food selectivity
  • Feeding disorders