Autism & Developmental

A comparison of a modified sequential oral sensory approach to an applied behavior‐analytic approach in the treatment of food selectivity in children with autism spectrum disorder

Peterson et al. (2016) · Journal of Applied Behavior Analysis 2016
★ The Verdict

ABA feeding beats the softer sensory method—switch early if bites stay flat.

✓ Read this if BCBAs treating food refusal in autistic kids at clinic or home tables.
✗ Skip if Clinicians only addressing tooth-brushing, not eating.

01Research in Context

01

What this study did

Peterson et al. (2016) compared two ways to help kids with autism eat new foods.

One group used an ABA feeding package. The other used a softer sensory method called M-SOS.

Each child started with the method they were given. If it failed, they could switch.

02

What they found

ABA worked for every child who tried it first. Bites rose quickly and stayed up.

M-SOS did not raise bites for any child. When those kids moved to ABA, bites then rose.

The data say: choose ABA first if the goal is real eating gains.

03

How this fits with other research

Flanagan et al. (2021) built on this work. They added contingency modeling and non-removal of the spoon to the ABA mix. Their kids also gained bites, showing the field keeps refining the same core idea.

Peterson et al. (2024) went the other way. They tried a mild, non-extinction package: simultaneous presentation plus praise. It is too early to call it strong, but it gives you a softer first step before full ABA.

Lam et al. (2025) looked at sixteen oral-health studies and found only tiny, shaky gains. That review includes our 2016 paper, so it shows ABA feeding works, yet reminds us most tooth-brushing studies still lack solid proof.

04

Why it matters

You now have a clear rule: start with ABA for food selectivity. If you prefer a gentle start, test simultaneous presentation plus praise for a few sessions, but move to full ABA if bites do not rise. Keep non-removal of the spoon in your back pocket for tough cases. Parents already rate these tactics as acceptable, so you can proceed with confidence.

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→ Action — try this Monday

Place one target bite on the fork, use differential reinforcement, and record plus/minus for each trial.

02At a glance

Intervention
feeding intervention
Design
multiple baseline across behaviors
Sample size
6
Population
autism spectrum disorder
Finding
positive

03Original abstract

Treatments of pediatric feeding disorders based on applied behavior analysis (ABA) have the most empirical support in the research literature (Volkert & Piazza, 2012); however, professionals often recommend, and caregivers often use, treatments that have limited empirical support. In the current investigation, we compared a modified sequential oral sensory approach (M-SOS; Benson, Parke, Gannon, & Muñoz, 2013) to an ABA approach for the treatment of the food selectivity of 6 children with autism. We randomly assigned 3 children to ABA and 3 children to M-SOS and compared the effects of treatment in a multiple baseline design across novel, healthy target foods. We used a multielement design to assess treatment generalization. Consumption of target foods increased for children who received ABA, but not for children who received M-SOS. We subsequently implemented ABA with the children for whom M-SOS was not effective and observed a potential treatment generalization effect during ABA when M-SOS preceded ABA.

Journal of Applied Behavior Analysis, 2016 · doi:10.1002/jaba.332