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Beyond Food Acceptance: A Longitudinal Case Report Introducing Feeding Development in Autism Spectrum Disorder

Rodrigues AC · 23 Jul 2026

Abstract

Abstract Background Feeding selectivity is one of the most prevalent and persistent challenges experienced by children with Autism Spectrum Disorder (ASD). Although intervention outcomes are traditionally evaluated by the number of accepted foods or nutritional indicators, these measures may underestimate broader developmental changes that occur throughout feeding intervention. This case report proposes a multidimensional perspective of feeding outcomes by introducing the concept of Feeding Development as a functional framework for understanding therapeutic change. Case Presentation: A preschool-aged child with ASD presenting with severe feeding selectivity, sensory processing differences, oral-motor difficulties, and significant functional limitations during mealtimes underwent a comprehensive interdisciplinary assessment followed by a longitudinal, family-centered intervention. Clinical reasoning integrated occupational therapy, Ayres Sensory Integration® principles, behavioral learning strategies, caregiver coaching, and environmental modifications. Standardized assessments, developmental history, sensory processing evaluation, and longitudinal clinical observations guided individualized intervention planning. Intervention: Treatment prioritized the progressive development of sensory regulation, food exploration, behavioral flexibility, occupational participation, and caregiver competence before targeting food acceptance. Intervention was organized into sequential therapeutic phases emphasizing graded sensory experiences, play-based food interaction, family participation, and generalization across natural environments. Outcomes: Longitudinal follow-up demonstrated clinically meaningful improvements across multiple domains, including sensory tolerance, food exploration, behavioral flexibility, mealtime participation, caregiver confidence, and occupational feeding performance. Expansion of the child's food repertoire occurred progressively as a consequence of these broader developmental changes rather than as an isolated therapeutic objective. Conclusions This report suggests that feeding intervention in ASD should be conceptualized as a developmental process rather than solely as an increase in accepted foods. We propose Feeding Development as a multidimensional functional construct integrating sensory, motor, behavioral, environmental, family, and occupational dimensions of pediatric feeding. This framework may contribute to more comprehensive outcome measurement, improved clinical reasoning, and future longitudinal research investigating functional trajectories of feeding intervention in children with ASD.