A Stepwise Evaluation of Pairing and Shaping for Children With Autism and Feeding Difficulties

ABSTRACT Feeding difficulties are pervasive for children with autism. The present study investigated the effects of a pairing intervention on cooperation with instructions/acceptance of new foods, inappropriate behaviors, proximity to therapist, and indices of happiness for two children with autism and avoidant restrictive food intake disorder. The researchers sought to examine the effects of an intervention package that did not require restrictive seating or nonremoval of the spoon while assessing caregiver acceptability throughout the procedures. When the pairing intervention alone was not effective to decrease inappropriate behaviors and increase acceptance of new foods, we implemented pairing with shaping procedures. Pairing with shaping was effective to increase acceptance of four new foods for one participant. For the other participant, we ultimately implemented nonremoval of the spoon procedures to increase acceptance of new foods and decrease inappropriate mealtime behaviors. Results have implications for the conditions under which interventions other than nonremoval of the spoon may increase acceptance of new foods for children with autism and feeding difficulties, and how efficacy and efficiency may impact caregiver acceptability.