Selective Eating and Autism

Research suggests that anywhere from 46% to 84% of autistic children experience selective eating.

And the downstream risks are substantial: selective eating is linked with nutritional deficiencies, psychosocial impairment, and increased risk of developmental and psychiatric comorbidities, with severity tied to how persistent and restrictive the eating patterns become.

In this OT Potential course, Britt St. John, PhD, MPH, OTR/L, joins us to break down what occupational therapy professionals need to understand—and do—when supporting autistic children with selective eating. We’ll begin with Britt’s story and key terminology (picky eating vs. selective eating vs. feeding disorders), then move into practical, evidence-based guidance for clinicians.

Together, we’ll focus on three core areas:

• Assessment: How to identify the nature and severity of selective eating, including available OT assessments and red flags that should guide clinical decision making.

• Caregiver collaboration: How to partner with families in ways that reduce stress, build shared understanding, and promote sustainable change at home.

• Evidence-backed treatment options: What the research supports, how OT interventions fit within interprofessional care, and when to refer on.

This course is designed for OTs and OTAs looking for clarity in a complex practice area—and for practical tools you can use immediately to support families navigating selective eating.

Here is the related clinical decision support treatment guide mentioned in the episode.

1. You will recognize assessments that OTs can utilize for selective eating in autistic children.

2. You will be able to identify evidence backed- treatment interventions that OTs can utilize for selective eating in autistic children.

• Intro

• Discussion

  1. Can you tell me the story of how you became interested in selective eating?

  2. Walk me through the language around selective eating. Is it different from being a picky eater? Is feeding problems the umbrella category you would use?

  3. What do we know currently about selective eating and autism?

  4. When does OT feel like the right fit for a selective eater?

  5. What made you participate in our clinical decisions support page project?

  6. What assessments are available to us?

  7. What consideration should we make in interacting with caregivers?

  8. What are the main evidence backed options for treatment?

  9. When should we refer on?

  10. What would you like to see from this practice area in the next 5 years?

• Live Q&A

• Closing

• Caregiver-Implemented Feeding Interventions for Autistic Children with Food Selectivity: A Systematic Review

• Benefits and Challenges of a Telehealth Eating and Mealtime Intervention for Autistic Children: Occupational Therapy Practitioners’ Perspectives

• The Role of Occupational Therapy in Managing Food Selectivity of Children with Autism Spectrum Disorder: A Scoping Review

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

OT Potential pays guest speakers an honorarium for their participation, either directly or to an institution of the speaker's choosing at their request. We invite guests whose expertise often comes from practices, programs, or building products in their field. Where a speaker has a financial interest in the subject of a course, we disclose it below so you can weigh it for yourself.

OT Potential's interest in this topic: We have no financial stake in this topic. Our speaker was paid by OT Potential to contribute to our treatment guide on selective eating.

Speaker interests: Britt St. John is an assistant professor at the University of Washington whose research focuses on selective eating in autistic children — the subject of this course. She has no other financial interest in this topic to disclose.