Autism & Developmental

Treatment of Food Selectivity in an Adult With Autism Spectrum Disorder

Pubylski-Yanofchick et al. (2022) · Behavior Analysis in Practice 2022
★ The Verdict

Offer a preferred bite right after an adult with autism tastes a new fruit or veggie—positive reinforcement beats escape and the skill spreads.

✓ Read this if BCBAs helping food-selective adults with autism in day-hab or group-home settings.
✗ Skip if Clinicians working only with pediatric feeding or clients who already eat 20+ foods.

01Research in Context

01

What this study did

The team worked with one young learners man with autism who ate only five foods.

They used an alternating-treatments design. Each lunch offered one new fruit or veggie.

In one condition he got a bite of pizza (positive reinforcer) after tasting the new food. In the other condition he could remove the new food (negative reinforcer) after tasting it.

02

What they found

Both setups raised tasting from 0 % to about 80 % by the end.

The pizza condition won. The man chose it more often and tasted faster.

Skills spread. He later tried new foods and kept tasting in a different room and with new staff.

03

How this fits with other research

Rubio et al. (2021) reviewed kids and found finger prompts work best. This adult needed no physical prompt—just reinforcement—showing age changes the tool you pick.

McConnell et al. (2020) also helped autistic young men, but used escape extinction for dental work. Both studies show adults with autism can still gain new adaptive skills when you pick the right contingency.

Scotchie et al. (2023) ran a multielement probe first to cut expulsion in kids. The adult study skipped that step because acceptance, not expulsion, was the problem—same design family, different target.

04

Why it matters

You can expand an adult’s diet without escape extinction or physical prompts. Start with a simple DRA: first bite of the new food earns a bite of the favorite. Let the client vote with their choices—positive reinforcement usually wins and keeps the peace at mealtime.

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→ Action — try this Monday

Put one pea on the plate and deliver a pizza bite the moment it’s tasted—track acceptance for five lunches.

02At a glance

Intervention
differential reinforcement
Design
alternating treatments
Sample size
1
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original 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.

Behavior Analysis in Practice, 2022 · doi:10.1007/s40617-021-00650-z