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Updated: Mar 15, 2026
A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Co-occurring behavioral difficulties in children with severe feeding problems: A descriptive study
Melissa L González1, Karin Stern2
1Department of Behavioral Psychology, Kennedy Krieger Institute and Johns Hopkins School of Medicine, 707 North Broadway, Baltimore, MD 21205, United States.
Insights
Children with severe feeding problems often experience behavioral difficulties outside mealtimes, a challenge not exclusive to those with Autism Spectrum Disorder (ASD). This highlights the need for broader behavioral support strategies.
Area of Science:
- Pediatric Psychology
- Developmental Pediatrics
- Behavioral Science
Background:
- Feeding problems in children with Autism Spectrum Disorder (ASD) are linked to behavioral difficulties.
- The extent of behavioral issues outside mealtimes in children with feeding problems but without ASD is less understood.
Purpose of the Study:
- To describe behavioral difficulties co-occurring with severe food refusal/selectivity in children.
- To identify predictors of behavioral difficulties outside the meal context.
Main Methods:
- Retrospective chart review of 54 patients with severe feeding problems.
- Data collected on caregiver coaching and behavioral interventions outside mealtimes.
- Examined age, developmental delay/ASD, and feeding problem type as predictors.
Main Results:
- About half of the children received caregiver coaching or behavioral intervention.
- Younger age at admission predicted individual caregiver coaching.
- Developmental delay/ASD, age, and feeding problem type did not predict individualized treatment.
Conclusions:
- Difficult caregiver-child interactions outside mealtimes occur in some children with severe feeding difficulties.
- These behavioral associations may extend beyond children diagnosed with ASD.
Background:
Recent literature highlights the association between behavioral difficulties and the presence of feeding problems in children with an Autism Spectrum Disorder (ASD) relative to children with ASD without feeding problems. However, it is not clear to what extent behavior problems (outside of the meal setting) occur in children with feeding problems without comorbid ASD.
Aims:
The purpose is to describe co-occurring behavioral difficulties of a sample of children with severe food refusal/selectivity and examine potential predictors of behavioral difficulties outside of the meal context.
Method And Procedures:
The medical charts of fifty-four patients were reviewed and data were collected on the frequency of caregiver coaching and/or behavioral intervention outside of the meal context. Age, presence of developmental delay/autism, and type of feeding problem were examined as potential predictors of behavioral support.
Outcome And Results:
Approximately half of the sample received coaching or individualized intervention. The percentage of caregivers who received individualize coaching were similar across groups. Younger age at admission was a predictor of individual caregiver coaching. Presence of delay/ASD, age, and type of feeding problems were not significant predictors for individualized treatment programing.
Conclusion And Implications:
These data provide evidence of difficult caregiver-child interactions that occurs outside of the meal context for some children with severe feeding difficulties and suggest that this association may not be exclusive to children with ASD.
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