Treating Food Selectivity in Adolescents and Adults with Autism: A Systematic Replication

Vanderzell et al. (2025) worked with three autistic teens and adults living in group homes.

The team let each person pick a favorite reward. They earned that reward for tiny food steps: looking, touching, smelling, tasting, then swallowing healthy foods.

Sessions happened at lunch and dinner. No one was forced to eat. Staff only gave the prize when the person did the next small step.

All three participants ended up eating 60–100% of the target healthy foods.

Challenging behavior stayed at zero during meals. Gains held weeks later.

Pubylski-Yanofchick et al. (2022) got the same result with one autistic adult using fruit and veggies. Vanderzell’s study is a direct replication with more people and a wider age range.

Crowley et al. (2020) used a similar step-by-step idea with preschoolers. The new paper extends the logic upward to teens and adults.

Silbaugh et al. (2018) first tried reinforcement alone and it failed; they had to add physical guidance. Vanderzell shows that rich, participant-chosen rewards can still work without any physical prompting, updating the earlier finding.

If you run meals for older autistic clients, let them pick the prize and break the bite into tiny steps. You may not need physical prompts or escape extinction. Start tonight: ask the client what they want to work for, then reinforce the smallest food interaction.