If you are considering occupational therapy as a treatment for feeding challenges for your autistic child, we want you to be as informed as possible—so we, as OTs, can truly partner to create the best course of treatment for your family and your child.
In occupational therapy, we tend to work from “menus” of evidence-based assessments and treatments. This gives us the flexibility to meet the specific needs of each family. Below, you’ll find the assessment and treatment options your therapist may use, along with the evidence supporting them.
At the bottom of this page, you’ll find occupational therapists near you who specialize in feeding therapy.
Please note that this page is for educational purposes and does not substitute advice from your medical provider.
A quick note on when to pursue occupational therapy for feeding difficulties
Occupational therapists view feeding as a foundational occupation that supports growth, development, and participation in daily life. And eating is not just about nutrition—it involves sensory processing, motor skills, family routines, and the meaningful experience of sharing meals with others.
“Feeding difficulties” is a broad term that includes everything from typical picky eating to diagnosed conditions such as Pediatric Feeding Disorder (PFD) or Avoidant/Restrictive Food Intake Disorder (ARFID). Feeding challenges are common in childhood and are especially prevalent among neurodiverse children, with research suggesting that anywhere from 46% to 84% of autistic children experience selective eating.
Early occupational therapy can help reduce mealtime stress, support nutrition and independence, and turn eating into a more positive experience for the whole family. If your child eats fewer than 25 different foods, is losing foods they once accepted, or if feeding challenges are affecting your child’s health or wellbeing, consider talking with your child’s doctor about whether feeding therapy might be helpful.
Therapist-recommended assessments for selective eating
Occupational therapists assess a broad range of underlying factors that affect feeding, such as mealtime routines, feeding behavior, sensory patterns, diet variety, and family goals as part of a comprehensive feeding assessment.
As you can see below, multiple different components can be involved in evaluating feeding difficulties. That’s partly because several areas of overall body function can be affected—especially within the context of everyday life.
Assessments also serve as a point of comparison for tracking an individual’s progress and response to treatment over time. An accurate and thorough baseline allows your therapist (and you/your child) to discern how much the interventions are helping. Your therapist may perform certain assessments at various intervals over the course of therapy.
Members of the OTPotential Club can log in to see these assessments broken down in more detail.
Family/Caregiver Interview
A feeding assessment typically starts with a family interview to understand your family’s specific feeding concerns, priorities, and experience with selective eating. A family interview may include questions about:
- Your family mealtime routines
- Foods your family typically eats and child preferences
- History and onset of your child’s feeding difficulties
- Family priorities for therapy
Caregiver-Reported Tools for Feeding Behavior:
- Feeding and Eating in AutiSm Together (FEAST) Assessment
- Behavioral Pediatrics Feeding Assessment Scale (BPFAS)1
- Pediatric Eating Assessment Tool (PediEAT)
- Feeding Flock Tools2
- Child Oral and Motor Proficiency Scale(ChOMPS)
- Feeding Impact Scales
Caregiver-Reported Diet Variety Questionnaires
Setting Goals for OT Feeding Therapy
Therapy works best when there is buy-in from the patient. It is important that you and your child work with your therapist to set treatment goals that truly reflect your family’s priorities and what’s important to you.
Occupational Therapy Treatment Interventions for Selective Eating
After a thorough evaluation and goal-setting process, it is time to start making progress. Below are treatment interventions that can be implemented as part of a holistic therapy program.
Occupational therapists take a unique approach, considering intervention at the person, environment, and occupational level. OTs focus on building skills, confidence, and positive mealtime experiences through play-based and family-centered interventions, with the goal to support children and families in creating calm, predictable routines that promote curiosity, increase comfort, and make mealtimes more successful and enjoyable.
Possible Treatment Interventions
Okay, here are some details on what treatment can look like:
Caregiver-mediated intervention
Feeding therapy is built around your family and everyday routines, with you, the caregiver, as an active partner in the process. Your therapist will model strategies, coach you through them, and help you use these tools at home so progress carries over into real life3—whether in person or through telehealth.4
Caregiver coaching and education5
Sometimes, the most helpful support is understanding why feeding feels hard for your child and learning how to respond in supportive ways. Your therapist can provide clear guidance and practical tips so you can feel confident making small changes at home that can lead to big improvements at mealtimes.
For some families, this guidance alone is enough to reduce stress and improve mealtime success!6
Multidisciplinary team-based intervention7
Because feeding challenges can be complex, therapy may also involve collaboration with other professionals such as doctors, speech therapists, or dietitians. Working together as a team helps ensure your child’s feeding needs are supported from every angle.
Choosing an occupational therapist
If you are looking for an occupational therapy professional near you to help address selective eating challenges for your autistic difficulties, you can use the OT Near Me Directory below. We’ve highlighted the professionals who have tagged “autism” as a focus area. For pediatric therapy, look for therapists who have also selected pediatrics as an interest.
Resources
Client Education
- Feeding Matters Resources
Conclusion
Hopefully this article helped you understand what occupational therapy for selective eating in autistic children entails.
This article is updated regularly based on newly released research. If you have any research you would like us to consider, please drop it in the comments.
Therapists who would like more detailed information on feeding therapy best practices can join us as members of the OT Potential Club.
Article by
Sarah Lyon, OTR/L, is the CEO of OT Potential and is on a mission to bridge the gap between research and real occupational therapy practice.
References
Here’s the science backing the assessments and treatment outlined above.
- Crist, W., & Napier-Phillips, A. (2001). Mealtime behaviors of young children: A comparison of normative and clinical data. Journal of Developmental and Behavioral Pediatrics: JDBP.
- Feeding Flock. (2025). The Feeding Flock Tools. Feeding Flock.
- Hladik, L., Ausderau, K., & St John, B. (2022). Experience and Perceptions of Mothers Participating in an In-Home, Parent-Mediated Feeding Intervention for Their Child With Autism. American Journal Of Occupational Therapy.
- Hladik, L., St. John, B. M., Carbery, M., Gray, M., Drew, J. R., & Ausderau, K. K. (2023). Benefits and Challenges of a Telehealth Eating and Mealtime Intervention for Autistic Children: Occupational Therapy Practitioners’ Perspectives. OTJR: Occupation, Participation and Health.
- Blennerhassett, C., Richards, M., & Clayton, S. (2025). Caregiver-Implemented Feeding Interventions for Autistic Children with Food Selectivity: A Systematic Review. Review Journal of Autism and Developmental Disorders.
- Johnson, C. R., Brown, K., Hyman, S. L., Brooks, M. M., Aponte, C., Levato, L., Schmidt, B., Evans, V., Huo, Z., Bendixen, R., Eng, H., Sax, T., & Smith, T. (2019). Parent Training for Feeding Problems in Children With Autism Spectrum Disorder: Initial Randomized Trial. Journal of Pediatric Psychology.
- McComish, C., Brackett, K., Kelly, M., Hall, C., Wallace, S., & Powell, V. (2016). Interdisciplinary Feeding Team: A Medical, Motor, Behavioral Approach to Complex Pediatric Feeding Problems. MCN: The American Journal of Maternal/Child Nursing.
OT Potential does not endorse any treatments, procedures, products, or therapists referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking medical advice should consult their medical provider.