A Stepwise Evaluation of Pairing and Shaping for Children With Autism and Feeding Difficulties
Start food therapy with pairing and shaping; save nonremoval of the spoon for kids who need the extra push.
01Research in Context
What this study did
Demchuk et al. (2026) tested a gentle first step for kids with autism who refuse most foods. They used pairing (letting the child play with the food) plus shaping (rewarding tiny tastes). No high chair straps. No "you must swallow" rule at first.
Two children took part. The team tracked how many new foods each child would accept when pairing and shaping were the only tools.
What they found
One child began eating four new foods with just pairing and shaping. The second child made no real gains until the team added nonremoval of the spoon (the bite stays put until swallowed).
Both kids ended up eating more foods, but only one needed the stricter step.
How this fits with other research
Flanagan et al. (2021) ran a similar step-up plan. They started with contingency modeling and praise, then added nonremoval of the spoon only when needed. Their data match the new study: some kids move forward without the stricter tactic.
Peterson et al. (2016) showed that any ABA feeding package beats the SOS sensory method. The 2026 paper extends that idea by showing which ABA pieces you can try first.
Peterson et al. (2024) tested simultaneous presentation plus rewards, another low-pressure start. Together these studies build a ladder: begin nice, escalate only if progress stalls.
Why it matters
You can now lead with pairing and shaping instead of jumping straight to nonremoval of the spoon. This keeps therapy fun, cuts escape battles, and still works for many kids. Track acceptance daily; if little change shows after a week, add the spoon procedure. Parents see quick wins without feeling like force-feeding, so buy-in stays high.
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02At a glance
03Original abstract
ABSTRACT Feeding difficulties are pervasive for children with autism. The present study investigated the effects of a pairing intervention on cooperation with instructions/acceptance of new foods, inappropriate behaviors, proximity to therapist, and indices of happiness for two children with autism and avoidant restrictive food intake disorder. The researchers sought to examine the effects of an intervention package that did not require restrictive seating or nonremoval of the spoon while assessing caregiver acceptability throughout the procedures. When the pairing intervention alone was not effective to decrease inappropriate behaviors and increase acceptance of new foods, we implemented pairing with shaping procedures. Pairing with shaping was effective to increase acceptance of four new foods for one participant. For the other participant, we ultimately implemented nonremoval of the spoon procedures to increase acceptance of new foods and decrease inappropriate mealtime behaviors. Results have implications for the conditions under which interventions other than nonremoval of the spoon may increase acceptance of new foods for children with autism and feeding difficulties, and how efficacy and efficiency may impact caregiver acceptability.
Behavioral Interventions, 2026 · doi:10.1002/bin.70064