Your child could be eating this in weeks!
On average, children meet 100% of their individualised admission goals. 98% of cases meet 100% of their individualised admission goals.
Children consumed 100% of bites within an average of 46 minutes on the first day of treatment.
Children learned to take medication, chew, feed themselves with utensils, drink water from a cup, and sit for meals without distractions.
Volume increased to an average of 158 grams, and variety to all food groups.
Anecdotally, families report improvements in other areas following the programme: bloodwork, height/weight/BMI, hair quality and growth, haircuts, skin colour, toothbrushing, sleep, toileting, behaviour (e.g., transitions, following instructions, waiting), learning, energy, sports participation, decreased illnesses, and decreased dependence on supplements, formulas, and laxatives.
Increase in Foods Consumed
On average, cases go from eating 6 foods to eating 94 foods from all food groups (protein, starch, vegetable, fruit).
High Caregiver Satisfaction Ratings
- On average, caregivers report high satisfaction with the programme (4.87 out of 5) and high social acceptability of the treatment (4.83 out of 5).
Previous Failed Treatments
Children had previously received up to 11 years of prior failed treatment attempts by up to 12 different disciplines/treatment types.
Case Outcome Summary Examples
These are only cases from Australia thus far and only selected feeding relevant diagnoses and conditions are listed for each case. In the hospital at Johns Hopkins/Kennedy Krieger, many diverse, severe, and complex feeding cases and issues were treated. In Australia, we have helped children with autism, developmental delay, intellectual disability, chromosomal abnormalities, coeliac disease, William’s syndrome, prematurity, constipation, anemia, nasogastric and gastrostomy tubes, failure to thrive, reflux, and dyspraxia, as well as children with typical development.
- For parents/caregivers, please let me know if you would like to be connected to talk to other parents who have been through the process to hear about it from their perspective and ask questions.
As the first case example from Australia, a 6-year-old child with autism only ate 2 specific foods and 2 brand-specific snacks, and drank 1 specific milk from 1 specific bottle. He received over 4 years of attempted treatments including an intensive multidisciplinary hospital admission. He consumed 8 new foods (2 from each food group) on the first day of treatment. Within a couple weeks, he was consuming 100% of any food presented to him (over 50 foods from all 4 food groups) at regular texture and drinking water from an open cup with little to no inappropriate mealtime behaviour. Both parents and the school were trained to implement the protocol and report high acceptability of the treatment (4.94/5) and satisfaction (4.91/5) on objective measures. He met 100% of measurable goals set by the family within a couple weeks. Parents reported continued success and maintenance for a year post-treatment, and the impact was multi-faceted and life changing for the family.
A 9-year-old boy with autism and history of NG tube at birth ate no fruits, vegetables, or meat and did not drink water, and was dependent on laxatives and formula. He had years of attempted treatments with multiple disciplines and therapists, including medications and participation in an intensive research study at a hospital. Within a few days, he was consuming 100% of any food presented to him (over 50 foods from all 4 food groups) at regular texture and drinking water from an open cup with high independence. Parents were trained and reported high acceptability of the treatment (4.89/5) and satisfaction (4.87/5). He met 100% of measurable goals set by the family in less than 2 weeks with continued success reported for over a year.
A 9-year-old male with an autism spectrum disorder ate only 1 starch, 1 brand-specific protein starch combo, and 2 vegetables inconsistently. He did not eat a consistent volume of food and skipped meals and grazed. He did not eat when away from home and was highly selective about brand, preparer, cooking method, presentation method, appearance, and packaging. He did not eat at the table or use utensils. He had significant issues with constipation, and would not drink adequate fluids or use the toilet at school. He had had several years of attempted therapy by multiple professionals/disciplines with various orientations/approaches without success. In less than a week, he met his feeding goals. His variety was over 85 foods from all foods groups at regular texture, and he consumed 100% of meals. His parents and support worker were trained. His parents reported high acceptability of the treatment (4.6/5) and satisfaction (4.91/5).
An 11-year-old male with autism (level 3), developmental delay, multiple (18) abnormalities and nutritional deficiencies via bloodwork, formula/supplement dependence, height deficiency (stunted growth), overweight, and medication/supplement and toothbrushing refusal and a history of constipation ate zero foods from the food groups and did not drink water or milk. He only ate one brand specific snack chip and drank one type of juice. If either of these 2 items were unavailable or if there was any change to his setup for eating/drinking, he was at significant risk for dehydration, hospitalisation, IV placement, and tube placement and formula dependence. They tried removing the chips and he stopped drinking too and did not eat or drink for 2 entire days. He did not drink out of a regular open cup or use any utensils. He did not eat or drink away from home. He grazed all day and in the night which impacted his sleep. He had sores around his mouth due to repeated licking from the salt. The family had sought help since he was 2 years old with no results. They had multiple physician/paediatrician and dietitian consults and recommendations, occupational therapy for almost 4 years, and speech therapy. After a few weeks of intensive treatment, his food variety was at 164 foods from all 4 food groups at regular texture including raw veggies. He was independently scooping and using a spoon and fork appropriately, and self-drinking water from an open cup. He could take medication more independently from a medicine spoon. He ate at a restaurant and at school with the other kids and started to eat in free choice meals. His mum and dad were trained to implement the protocol with high integrity. He met all (100%) 20 of his goals. His parents reported high acceptability of the treatment (4.8/5) and satisfaction (4.9/5). At over 1-year follow-up, parents reported the feeding problem was much better (4 out of 5), he was still eating all food groups and drinking water, and he had had significant growth especially in height and had slimmed in weight.
A 5-year-old male with autism, history of iron deficiency requiring supplementation, low weight, and history of constipation had never chewed or eaten regular texture food in his life, even baby rusks/puffs or mashed food. He was dependent on blended “baby” food and would not swallow (expels) any lumps or texture due to gagging and refusal. He would only eat certain blends/brands and on regressed to drinking only milk if his food was unavailable. For most of his life (over 4 years), his parents consulted with a wide variety of professionals (e.g., paediatrician, headstart feeding specialist), and he had over a year of outpatient treatment and a week of inpatient hospitalisation treatment from an interdisciplinary feeding programme, and years of previous failed treatment attempts including speech, occupational, and behavioural therapy. If he got food in his mouth, he would try to swallow before it is chewed, gag, spit out, etc. After 3 weeks of treatment, he was eating (chewing and swallowing) a full plate of regular texture portions of a variety of 109 foods from all 4 food groups. He learned to bite off, chew, lateralise, masticate, judge, and swallow a wide variety of regular texture foods, including meats and raw fruit/veg. His mum and dad were trained to implement the protocol with high integrity. He met all (100%) 12 of his goals. His parents reported high acceptability of the treatment (5/5) and satisfaction (5/5). At 1-year follow-up, his mother reported that he was doing excellent. She rated his progress at a “4 to 5” out of 5 (much better to resolved). She stated that he ate a variety of different foods, but still had favourites. She stated that he would generally eat anything put in front of him.
A 7.5-year-old male with autism and developmental delay engaged in significant inappropriate mealtime behaviour including aggression, head banging, head hitting, and emesis (vomiting). His caregivers went to significant lengths to maintain his intake of food and fluids, including extremely long meal durations requiring 2+ people to feed meals. He did not eat or drink at school. For dinner, he consumed only one blended low-texture food. He did not chew his food adequately. He did not drink independently or consume an adequate volume of fluids. Constipation and dry, bleeding, cracked lips were a problem, and liquid refusal impacted adaptive toileting skills. On the first day of treatment, he consumed 22 new foods from all the food groups at regular texture and drank from an open cup. His variety reached over 90 foods (including meat) and he quickly met 100% of his goals. His parents and 3 grandparents were being trained to implement the protocol, and school was trained to do a drink protocol and free access recess protocol. Caregivers reported high satisfaction (4.48/5) and social acceptability of the treatment (4.65/5). Gains were maintained at 6-month follow-up and he was eating over 80 foods and completing 100% of meals.
A 2.5-year-old male consumed a few specific starches, specific homemade omelette, 1 fruit, and certain pureed/ground mixtures (if fed as a nonself-feeder with iPad). He expelled foods, would not self-feed most foods, and did not consume foods from the food groups separately or at an age-appropriate texture. He met 100% of his goals and variety was at over 70 foods at regular texture from all food groups and using utensils with high independence in less than a week. His therapist and mum were trained to implement the protocol. At 3-year follow-up, his mum reported that his feeding problem was resolved and that he ate everything and loved to try new things too.
A 4-year-old male with a gastrostomy tube, autism, prematurity (24 weeks), history of ventilator, CPAP, oxygen, and nasogastric tube dependence and failure to thrive ate custard and soup as a nonself-feeder at a certain temperature. If a minuscule lump was in the soup, he would gag and vomit. He had never chewed or used his teeth or swallowed any texture. He might accept 2 other specific foods, but would pack for hours or expel. He consumed chocolate milk mix via spoon feeding as a nonself-feeder. He used an adaptive water bottle that squirted water into his mouth with prompting and assistance. He did not take medications orally (taken via G-tube). He required tangible items during meals. Previous treatment attempts included multiple years since birth with a hospital feeding team, various therapies, and a 10-day hospitalisation for tube weaning (this resulted in some small oral intake of custard, liquid soup, and chocolate milk mix). His parent’s persisted in oral feeding and volume and decreased tube nutrition dependence on their own. On the first day of treatment, he consumed 8 new foods from all the food groups at a junior texture. His variety is now at over 124 foods at any temperature, 28 crunchy foods, and 26 combination foods with crunchy foods. He is now self-feeding and scooping, including holding the container, and can use a fork. He is now drinking independently from a regular full cup including sipping, and drinking from a regular water bottle, and can drink from a regular straw. Liquid variety was increased to multiple flavours of nutritious formula and water in a regular open cup. He learned to eat independently from pouch. He can also now take medications orally rather than via tube. He learned to bite off, chew with his molars, lateralize, masticate, and swallow a wide variety of regular texture foods, including difficult foods in bite sizes such as meats and raw fruit/veg. He also learned to swallow fork-mashed texture foods. He ate all of his food in 2 free access snack practice social meals at a child’s table/chair and stayed seated the entire time. Refusal, expulsion, packing (not swallowing), emesis (vomit), and gagging/coughing all decreased to low/zero levels, and independence, chewing, and swallowing have increased significantly. He transitioned from a highchair to a booster at the family dinner table. His parents were trained to implement the protocol. He met all 22 of his goals in 15 days.
A 5-year-old male with dyspraxia and low muscle tone upon admission consumed only a few specific foods of a specific brand, restaurant, and container. He ate no vegetables and mostly no fruits, and would not eat adequately at school. He would not cry and run away in the presence of certain snacks which posed a problem at school and in the community. He required the iPad to stay at the table to eat. He was also overweight. Previous treatment attempts included years with multiple speech therapists, interdisciplinary hospital feeding clinic consultation, ENT consultation, play therapy, and a psychologist. On the first day of treatment, he consumed 8 new foods from all the food groups at regular texture. His variety is now at over 120 foods. His parents and school personnel were trained to implement the protocol. He quickly met 100% of his goals. Caregivers reported high satisfaction (4.96/5) and social acceptability of the treatment (4.94/5).
A 13-year-old girl with typical development and growth consumed no vegetables or fruits. Her diet was limited to 5 specific starches, 1 protein, 1 protein starch combo, and snack foods. She was motivated to change her diet because of social and health (never feeling full, low energy, spikes/crashes) impact. Socially, this posed a significant problem at school, with friends and family, during parties and events, at restaurants, and during travel. Previous treatment attempts since the age of 2 years included multiple consultations with psychologists, eating disorders specialists, dietitians, speech/occupational therapists, gastroenterologist, and anxiety medications, hypnosis, sensory treatment (SOS), play therapy, rewards, removal of privileges, withholding food, etc. Side effects of medication included carb cravings, weight gain, and lethargy. On the first day of treatment, she consumed 13 new foods at regular texture 100% independently including 6 raw plain vegetables. Variety reached 48 foods and she quickly met 100% of goals. She ate multiple new foods at restaurants and ate family dinners independently with no inappropriate mealtime behaviour. Caregivers reported high satisfaction (4.82/5) and social acceptability of the treatment (4.88/5). At 9-month follow-up, she still consumed at least 46 of the foods introduced. Some of the foods not being consumed was due to the family not cooking them or having them available rather than refusal. She was eating the family dinner including a raw salad daily and also was eating at school, at restaurants, and while traveling.
A 7-year-old girl with autism and a history of anemia was eating 3 starches and certain snack foods, but no fruits, vegetables, or other meats. She would engage in significant problem behaviour in multiple settings if certain foods were around (e.g., on plane, at crunch & sip at school). She had just stopped the baby bottle this past year and would not accept medication. She had never drank from an open cup and would not drink water at room temperature. On the first day of treatment, she consumed 8 new foods from all the food groups at regular texture. Her variety is now at 85 foods and she is independently scooping, biting off, taking medication, and drinking from an open cup without inappropriate mealtime behaviour. She ate with her family at the dinner table and at a cafe. Her parents were trained to implement the protocol. She met all 11 of her goals less than 7 days (graduated early in half the time). Caregivers reported high satisfaction (5/5) and social acceptability of the treatment (5/5) via questionnaires. At 2.5 year follow-up the parents reported gains maintained and was still much better (4/5) than before treatment. She was eating across all food groups and would eat any foods presented with the rules.
A 3.5-year-old female with William’s syndrome, reflux, and dyspraxia and a history of constipation and failure to thrive was primarily dependent on formula in a baby bottle. Upon admission, she would inconsistently eat egg puree as a nonself-feeder for her mother only and a couple specific fruit puree baby pouches (on a spoon as a nonself-feeder). She had a history of gagging and vomiting just in the presence of other’s eating or a spoon. She did not consume any meats or vegetables or any increased texture foods. She had just recently in the past few months began swallowing some 2 specific snack foods; however, she expelled (spit out) the majority of it. She did not know how to feed herself with a spoon or drink from a cup. She did not drink any water (drank formula only) or drink out of anything (e.g., cup, straw, water bottle) but the baby bottle. Previous treatment attempts included multiple years with a speech therapist for feeding and a consultation with a hospital feeding team. On the first day of treatment, she consumed 8 new foods from all the food groups at a junior texture. Her variety is now at over 70 foods at a fork-mashed texture. She learned to accept, bite off, chew, and swallow various regular texture crackers and breads with various spreads and combination solid bites on top. She learned to self-feed and scoop and eat pouches independently. She learned to drink water independently from a regular full cup including sipping and drink from a regular water bottle. She also accepted medication in a cup. She ate and drank in free access snack practice social meals at a child’s table/chair and stayed seated. Expulsion (spitting out) and emesis (vomit) decreased to zero, inappropriate mealtime behaviour and gagging/coughing decreased to low levels, and age-appropriate independence with self-feeding/drinking, chewing, and swallowing have increased significantly. Her parents and grandmother were trained to implement the protocol. She met all 21 of her goals in 15 days. Caregivers reported high satisfaction (4.78/5) and social acceptability of the treatment (4.94/5) via questionnaires.
A 5-year-old male with autism (level 3), moderate intellectual disability, constipation (sometimes requiring laxatives), supplement dependency, lactose intolerance, toothbrushing refusal, and history of reflux in infancy ate mostly 1 specific cracker and thin hot chips. He did not eat any protein, vegetables, or fruits. He had vomiting and gagging and gagged around others eating. He was not eating any foods that required chewing or utensils so he was not using feeding skills. He didn’t know how to scoop and flipped his spoon so that the food fell off. He did not eat at school or away from home or during mealtimes (grazed). He had feeding treatment attempts for years including ST, OT, and behavioural therapy and sensory based treatment and “desensitisation”; he had early behavioural intervention. He was taught to pack food on his tongue resulting in gagging and vomiting and not chewing or moving food to his teeth. He had problem behaviour and was on psychotropics. After 1 week of treatment, he was eating 90 foods from all food groups and graduated early in less than half the time (6 days). He learned to scoop and use a spoon upright and gagging/vomiting and packing decreased. His mum and dad were trained to implement the protocol with high integrity. He met all (100%) 8 of his goals. His parents reported high acceptability of the treatment (5/5) and satisfaction (4.91/5). At 6-month follow-up, parents reported that he has always had 100% consumption, typically finished his plate in under 10 minutes, ate more from his second/free plate after, and ate more variety and volume of foods free access. They reported improvement in his mood and development.
A nearly 4.5-year-old male had autism, pica, and food stealing. Pica was significantly impacting his life and restricting his location, daily activities, independence, and adaptive functioning. He couldn’t go outside freely because he ate dirt, bark, grass, rocks, rubbish, etc. He also ate academic materials such as glue, crayons, plastic, paper, paint, etc. He also mouthed and bit many dangerous household objects (e.g., extension cord, cleaning products) which had visible teeth marks and bits missing and toys. Pica limited his academic, therapeutic, and leisure activities and materials. Food stealing also significantly impacted his daily life and social engagement. Others had to hide to eat around him. These behaviours significantly restricted him in community and social settings. The cupboards and outdoors had to be locked up at home. He has previously tested low on iron via blood test. He did not consume any vegetables separately (they had to be mashed into other foods) and only ate 3 fruits, and food stealing for unhealthy foods was a huge daily issue. In 9 days, he met all his short-term goals and learned how to independently throw away pica material and rubbish he previously ate, independently put away objects he previously chewed on and ate pieces off, use items appropriately (academic, leisure, therapy materials) that he previously would chew and eat, and to refrain from touching materials that he previously would chew/mouth/eat that are dangerous, inappropriate, or belong to others (e.g., food, electronics, household items), and independently accepted, chewed, and swallowed 25 new foods (including 12 vegetables, 8 fruits). His mum implemented the protocols with high integrity and his current treatment team and family continued/maintained, expanded, and simplified the pica treatment for everyday life. Caregivers reported high satisfaction (4.04/5) and social acceptability of the treatment (4.44/5). At over 2-year follow-up, his mother reported that his pica and eating were much better (4 out of 5) than before treatment.
A 5-year-old boy with autism consumed only 2 starches (one restaurant specific), 1 brand and container specific protein, and a high ground texture mixture. He did not consume any fruits or raw or separate vegetables, or other foods from the food groups separately or at an age-appropriate texture. On the first day, he consumed 8 novel foods from all food groups. In less than a week, he met 100% of his goals and his food list was at over 80 foods at regular texture (including steak and salad) on a full plate with regular cutlery/crockery. His mum conducted meals in the community and sibling meals and a therapist was trained to conduct morning tea at childcare. At 3-years follow-up, his mother reported that he still ate all of the foods from his food list and ate different varieties of combination foods. He would try new foods if a friend was eating it. She rated his eating as a 4 (much better than pretreatment) because he still showed some rigidity such as not eating boiled vegetables at a restaurant (wanted them boiled his mother’s way).
A 4-year-old male with autism was dependent on liquids and formula to meet his nutritional needs via baby bottle. He did not eat any foods from the food groups (protein, starch, vegetable, fruit) and ate only specific biscuits. He would eat a homemade fruit smoothie as a nonself-feeder, so would not feed himself. He did not drink out of an open cup. His parents reported that he did not have much of an appetite or seek out food. He refused some liquid medications (e.g., antibiotics) and would not accept a gummy multivitamin. He was not able to stay a full day at school and would not eat anything in his lunchbox (even preferred foods) if a nonpreferred food was in it even if it was in a divided section. He has previously had low iron on blood tests and was on supplement. He had had over 2 years of failed treatment attempts from multiple disciplines. On the first day of treatment, he consumed 8 foods from the food groups at regular texture. His variety is at over 120 foods and he is independently scooping and biting off, improved his chewing and swallowing to eat regular texture, self-drinking from a regular open cup, can take medication from a regular open medicine cup, and is transitioning independently to the table. He ate at a restaurant with his family and ate at school and during therapy, and his nanny, mum, dad, and school shadow were trained to implement the protocol with high integrity. He met all (100%) 15 of his goals. At 1-year follow-up, his mother reported that he continued to eat at home well, but not free access at school (without a feeder/protocol).
An 11-year-old male with autism ate no fruits or vegetables, rarely used utensils, did not drink out of a cup, and had constipation and laxative dependence. He engaged in inappropriate mealtime behaviour if foods were near him (other’s eating), gagged at the smell, and requested his mum to wash her hands before touching his water bottle if she cut veggies. Previous treatment attempts include 18 months with an occupational therapist from a multidisciplinary feeding team and speech therapy. On the first day of treatment, he consumed 7 new foods at regular texture 100% independently. His variety is now at over 80 foods and he quickly met 100% of goals (including utensils and cup drinking). His parents were trained and he ate at a restaurant and with his sibling. Parents reported high satisfaction (4.91/5) and social acceptability (5/5) of the treatment. At over 2-year follow-up, parents reported the problem as “definitely” at an “emphatic” 5 (resolved) and he had maintained all but 1 food.
A 4-year-old male twin with autism and a history of nasogastric (NG) tube in infancy had a diet mostly consisting of some specific snack foods. He did not eat an adequate or consistent volume of food. He did not eat any vegetables or fruits (except 2 specific fruit pouch purees). He only ate 2 proteins (1 inconsistently) and 1 starch. He did not consistently eat complete portions of foods (e.g., would eat the edges or specific pieces off). He did not drink water or drink out of a cup. He had significant issues with constipation which had required laxatives. He would not use utensils. He had a couple months of some treatment attempts by a therapist. After a couple weeks of intensive treatment, his food variety is now at over 96 foods from all 4 food groups at regular texture. He is independently scooping and using a spoon, biting off from regular portions of foods, and self-drinking water and milk from an open cup. He also can drink water from various water bottles and straws and can take medication from a medicine spoon. He ate at a restaurant with his family and ate freely at a child’s table/chair set with his siblings. His dad was trained to implement the protocol with high integrity. He met all (100%) 14 of his goals. His parents reported high acceptability of the treatment (5/5) and satisfaction (5/5) via questionnaire. At nearly 2-year follow-up his dad reported he was doing great and would pretty much eat on his own.
A 5-year-old male with developmental delays, a chromosomal abnormality, autism, and eczema did not eat any vegetables or fruits. He refused and expelled some medications. He would not eat at the table with his parents. He ate 3 proteins and 6 starches. On the first day of treatment, he consumed all 8 new foods. After a couple weeks of intensive treatment, his food variety was at 109 foods from all food groups at regular texture. He was taking mostly all of his bites independently and meals were quick (under 10 minutes). He also independently took medication from a medicine spoon. An outside of meal behaviour protocol was implemented and parents were trained as well (his team will continue follow-up). His mum was trained to implement the meal protocol with high integrity. He met all (100%) 8 of his goals.
An 8.5-year-old male with coeliac disease, history of significant constipation requiring laxatives and bowel issues, nutritional deficiencies (iron, zinc) requiring supplementation, eczema, and other developmental difficulties and delays (e.g., fine motor, anxiety) ate zero vegetables or fruits (except one specific pouch fruit). All foods were brand, flavour, and presentation specific (2 meat, 2 dairy, 4 starch). He also would swallow food without chewing and require blending and to be fed for certain foods. He had significant gagging and vomiting and rules about the way foods were prepared and presented and how and when he ate them (e.g., ate 4 pieces of toast even if he was too full and it made him vomit). He would only use a teaspoon (would gag on adult size spoon and refuse to use it) and required fresh spoons and wiping the spoon repeatedly during a meal. He refused to hold/touch certain foods and would engage in inappropriate mealtime behaviour if food got on his face or hands. He could not eat with other people due to the smells and sight and left the area/hid during social events. He could not travel or sleep over anywhere or participate in playdates that went over a mealtime. He also would pick the skin between his fingers at the webbing and this caused scars and bleeding. He had years of previous failed treatment attempts for most of his life including multiple consultations with various disciplines including dietitians, psychologists, psychiatrists, occupational therapists, and over a year of sensory treatment (SOS). On the first day of treatment, he consumed 9 new foods 100% independently. His variety was at 122 foods and he met 100% (all 7) of goals. Caregivers reported high satisfaction (4.87/5) and social acceptability (5/5) of the treatment, and mum was trained to implement the protocol with high integrity. At nearly 2-year follow-up his mum reported he was doing great (4 out of 5), still eating all food groups, and was able to eat with others and away from home now. His BMI moved into the healthy range and his energy and sports participation improved.
A nearly 10-year-old male with autism did not eat any vegetables or fruits (except 1 occasionally). He ate only some carbs, one meat, and one other protein. His growth was impaired and he had little appetite. He did not eat at school, couldn’t stay the night away from home or participate in social eating, and would go to bed hungry at home. He had occupational therapy and speech therapy for over 5 years with no consistent results and continued inappropriate mealtime behaviour. He was on medications for ADHD and sleep problems. On the first day of treatment, he consumed 6 new foods. His variety is now at over 110 foods from all the food groups and he met 100% (all 7) of goals with high independence. Caregivers reported high satisfaction and social acceptability of the treatment, and mum was trained to implement the protocol with high integrity.
A 7-year-old male had autism, intellectual disability, significant weight deficiency/impaired growth/failure to thrive, iron deficiency requiring supplementation, supplement refusal, formula dependence and refusal, medication refusal, toothbrushing refusal, constipation, and ear infections. He ate zero fruits or vegetables, 1 meat, 3 starches, and 3 combos, so 7 foods; however, these had dropped off and were selective by restaurant and the volume was not enough. He did not eat or drink all day at school. He had never fed himself with a spoon. He had just started sitting at the table without the iPad to eat and saying words last year with behavioural treatment. He had aggression and headbanging and was on medication. After a week of treatment (graduated early in less than half the time), he was self-feeding/scooping with utensils and eating a full plate of regular texture portions of a variety of nearly 80 foods from all 4 food groups. Variety reached 93 foods in 2 weeks. He learned to drink from a regular cup. He ate at a café with his family and started eating at school. His mum and dad were trained to implement the protocol with high integrity. He met all (100%) 12 of his goals. His parents reported high acceptability of the treatment (5/5) and satisfaction (4.86/5).
A 4-year, 3-month old female with autism (level 2) did not eat any vegetables or fruits and still drank from a baby bottle. She had never chewed raw vegetables, raw hard fruits, or tough meats/harder foods. The feeding disorder had gotten worse over time. She expelled (spit out) food, gagged, overstuffed her mouth, turned her head, left the table, and pushed the food/feeder away and threw. She had to have the iPad to eat less preferred foods and had to have large dessert rewards to eat. She did not eat at daycare but just had a baby bottle of milk. She ate only 3 combinations and no separate proteins, vegetables, or fruits from the food groups. The feeding problem had impacted her teeth (has had fillings, caps, and toothbrushing refusal), significant sleep disorder (on melatonin; has to have baby bottle and iPad at nap and bedtime; won’t nap at daycare so has to be picked up early), behaviour (has tantrums when denied preferred foods), toilet training for bowel movements (goes every other day), health (illnesses last longer and she will not take medication; e.g., during the intake she had the flu and would not take antibiotics), and progress with speech therapy (jaw weakness from not chewing). On a recent trip overseas, the family had to get a place with a kitchen but she still reverted to mostly only drinking milk and not eating. She would not take medication and spat it out. After less than 2 weeks of treatment, she was eating 122 foods from all food groups at regular texture and self-feeding/scooping and using a fork. Her mum and dad were trained to implement the protocol with high integrity and she ate at a restaurant. She met all (100%) 8 of her goals. Her parents reported high acceptability of the treatment (4.81/5) and satisfaction (4.77/5). At 6-month follow-up, parents reported that they were very happy with her eating and that she ate everything from her discharge food list except 6 foods. They also reported that she had not had constipation for 3 months and that they decreased her laxative.
Here are some examples of food lists from children who completed the program.
These are foods they actually ate (consumed) multiple bites/portions of.
For additional food list examples go to: