PCDA supports LEND fellows from the University of Washington LEND program and Children's Hospital Los Angeles UCEDD/LEND program

Interdisciplinary Feeding Therapy for Children with Autism and Other Developmental Challenges

December 18, 2014

Professional Child Development Associates (PCDA) is a non-profit agency in Pasadena, California that is recognized for expertise in the DIR/Floortime® Approach to interdisciplinary care for children with special health care needs and their families. This model takes into account the child's feelings, relationship with caregivers, developmental level, and individual differences in motor development, social-emotional development, cognitive function and a child's ability to process and respond to sensory information. Our unique approach to services includes training, individual and group therapy, and specialized feeding therapy for children with autism and other developmental challenges.

Eating challenges affect approximately 46-89% of children with autism.1, 2  When compared to typically developing peers, children with autism demonstrate greater selectivity, with approximately 60% eating less that 20 foods, and avoidance of novel foods.3, 4 Mealtime is often a stressful environment with greater disruption to family routines, different menus than others at the table, disruptive behaviors requiring frequent redirection, limited family interaction, and meals and snacks resembling or being used as "therapy sessions.2"   The prevalence of obesity in children is rising and children with developmental disabilities are no exception.1, 5   Generally, children with autism tend to grow similar to their typical peers, however, the tendency to have fewer foods in a child's repertoire puts them at risk of nutrient deficiencies and exposure to toxins.3, 6-7 Children with autism have also shown higher rates of gastrointestinal disturbances than their typically developing peers.8, 9

For over ten years, our feeding team has been successful in helping children to accomplish feeding goals, which make feeding safe, support growth and nutrition, and foster a positive experience with food and mealtime. Currently, LEND fellows are involved in our Food for Fit Families (F3), which is a 12 week weight management program for children with autism, and their families funded by The Doug Flutie, Jr. Foundation For Autism, Inc. F3 offers cooking activities, non-competitive sports to support motor skills, nutrition education games, strategies to address behavioral issues around eating, and parent-to-parent support. The fellows are also beginning to compile our feeding team data in order to share the effectiveness of the DIR/Floortime® Approach on feeding with other professionals. We hope to advance current knowledge around appropriate interventions for feeding difficulties seen in children with autism and other developmental challenges.

"The caring, devotion, knowledge and expertise of the staff at [PCDA] cannot be matched...they are the A-Team on all that is dietary and nutrition for special needs children." - Parent of child receiving feeding therapy at PCDA


1. Phillips KL, Schieve LA, Visser S, Boulet S, Sharma AJ, Kogan MD, Boyle CA, Yeargin-Allsopp M. (2014) Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Maternal and Child Health Journal 18 (8): 1964-1975.

2. Ausderau K, Juarez M. (2013) The impact of autism spectrum disorders and eating challenges on Family Mealtimes. Infant Child Adolesc Nut 5:315-323.

3. Sharp WG, Berry RC, McCracken C, Nuhu NN, Marvel E, Saulnier CA, Klin A, Jones W, Jaquess DL. (2013) Feeding Problems and Nutrient Intake in Children with Autism Spectrum Disorders: A meta-analysis and comprehensive review of the literature. J Autism Dev Disord. Published online 1 February 2013.

4. Marí-Bauset S1, Zazpe I, Mari-Sanchis A, Llopis-González A, Morales-Suárez-Varela M. (2013) Food Selectivity in Autism Spectrum Disorders: A Systematic Review. J Child Neurol. 2013 Oct 4. [Epub ahead of print]

5. Cermak SA, Curtin C, Bandini LG. (2010) Food selectivity and sensory selectivity in children with autism spectrum disorders. J Am Diet Assoc. 110:238-246.

6. Hyman SL, Stewart PA, Schmidt B, Cain U, Lemcke N, Foley JT, Peck R, Clemons T, Reynolds A, Johnson C, Handen B, James SJ, Courtney PM, Molloy C, Ng PK. (2012) Nutrient intake from food in children with autism. Pediatrics. 130 Suppl 2:S145-53.

7. Zimmer MH, Hart LC, Manning-Courtney P, Murray DS, Bing NM, Summer S. (2012) Food variety as a predictor of nutritional status among children with autism. J Autism Dev Disord. 42(4):549-56.

8. Buie T, Campbell DB, Fuchs GJ 3rd, Furuta GT, Levy J, Vandewater J, Whitaker AH, Atkins D, Bauman ML, Beaudet AL, Carr EG, Gershon MD, Hyman SL, Jirapinyo P, Jyonouchi H, Kooros K, Kushak R, Levitt P, Levy SE, Lewis JD, Murray KF, Natowicz MR, Sabra A, Wershil BK, Weston SC, Zeltzer L, Winter H. (2010) Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Ped. 125 Suppl 1:S1-18.

9. Chaidez V, Hanse RL, Hertz-Piccioto I. (2013) Gastrointestinal problems in children with autism, developmental delays or typical development. J Autism Dev Disord. epublished November 6, 2013.