A Behavioral Parent-Training Intervention for a Child With Avoidant/Restrictive Food Intake Disorder
Abstract
Avoidant/restrictive food intake disorder (ARFID) is a feeding disorder classification in the Diagnostic and Statistical Manual of Mental Disorders , 5th ed. ( DSM–5 ; American Psychiatric Association, 2013 ) that describes a pervasive and disruptive pattern of food refusal and/or severe food selectivity. Currently, there is need for the development of evidence-based behavioral treatments for food selectivity that can be implemented in outpatient clinics, involve parents in treatment, and generalize to the child’s real-world environment. We have described in this study a behavioral feeding intervention that integrates components from intensive feeding programs with parent-training strategies in the treatment of a 6-year-old girl with ARFID. Treatment was primarily parent-mediated and included psychoeducation, in vivo parent coaching, parent modeling, differential reinforcement, gradual exposure to novel foods, and contingency management. The course of the intervention was divided into an initial differential reinforcement phase and subsequent directive strategies phase. Results indicate increased dietary repertoire, clinically significant decreases in problematic parent and child feeding behaviors, and acceptance of bites of 30 novel foods from pre to postintervention. Positive treatment outcomes were maintained at 6-week posttreatment follow-up.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Studies with non-autistic children and young people have evidenced ARFID presentations with multiple drivers of food avoidance and/or restriction.
“studies with non-autistic children and young people have evidenced ARFID presentations with multiple drivers of food avoidance and/or restriction.85,86”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [86]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,767 · see citing works
Manikam, R., & Perman, J. A. (2000) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-200001000-00007 · Cited by 495 · see citing works
Autism Diagnostic Observation Schedule
(2012) · SpringerReference · doi:10.1007/springerreference_184220 · Cited by 440 · see citing works
Mealtime Behaviors of Young Children: A Comparison of Normative and Clinical Data
Crist, W. B., & Napier‐Phillips, A. (2001) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200110000-00001 · Cited by 325 · see citing works
Mitchell, G. L., Farrow, C. V., Haycraft, E., & Meyer, C. (2012) · Appetite · doi:10.1016/j.appet.2012.09.014 · Cited by 259 · see citing works
Systematic Review of Psychological Interventions for Pediatric Feeding Problems
Lukens, C. T., & Silverman, A. H. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu040 · Cited by 171 · see citing works
Behavioral Treatments for Pediatric Feeding Disorders
Linscheid, T. R. (2005) · Behavior Modification · doi:10.1177/0145445505282165 · Cited by 152 · see citing works
EFFECTS OF BEHAVIORAL SKILLS TRAINING ON PARENTAL TREATMENT OF CHILDREN'S FOOD SELECTIVITY
Seiverling, L. J., Williams, K. E., Sturmey, P., & Hart, S. (2012) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.2012.45-197 · Cited by 143 · see citing works
PARENTAL ASSESSMENT AND TREATMENT OF FOOD SELECTIVITY IN NATURAL SETTINGS
Najdowski, A. C., Wallace, M. D., Doney, J. K., & Ghezzi, P. M. (2003) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.2003.36-383 · Cited by 129 · see citing works
Sharp, W. G., Burrell, T. L., & Jaquess, D. L. (2013) · Autism · doi:10.1177/1362361313489190 · Cited by 123 · see citing works
PARENTAL USE OF ESCAPE EXTINCTION AND DIFFERENTIAL REINFORCEMENT TO TREAT FOOD SELECTIVITY
Anderson, C. M., & McMillan, K. (2001) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.2001.34-511 · Cited by 106 · see citing works
Utilizing a home‐based parent training approach in the treatment of food selectivity
Najdowski, A. C., Wallace, M. D., Reagon, K. A., Penrod, B., Higbee, T. S., & Tarbox, J. (2010) · Behavioral Interventions · doi:10.1002/bin.298 · Cited by 80 · see citing works
Stark, L. J., Powers, S. W., Jelalian, E., Rape, R. N., & Miller, D. L. (1994) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/19.6.751 · Cited by 73 · see citing works
Tarbox, J., Schiff, A., & Najdowski, A. C. (2010) · Education and Treatment of Children · doi:10.1353/etc.0.0089 · Cited by 60 · see citing works
Fischer, A. J., Luiselli, J. K., & Dove, M. (2015) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000090 · Cited by 53 · see citing works
Pizzo, B., Williams, K. E., Paul, C., & Riegel, K. E. (2009) · Behavioral Interventions · doi:10.1002/bin.285 · Cited by 44 · see citing works
Puliafico, A. C., Comer, J. S., & Albano, A. M. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.05.002 · Cited by 39 · see citing works
Effect of Brief Clinic-Based Training on the Ability of Caregivers to Implement Escape Extinction
McCartney, E. J., Anderson, C. M., English, C. L., & Horner, R. H. (2005) · Journal of Positive Behavior Interventions · doi:10.1177/10983007050070010301 · Cited by 32 · see citing works
Clawson, E. P., & Elliott, C. A. (2014) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000076 · Cited by 14 · see citing works
Flagged first, then by citations
1 of the 21 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Canadian practice guidelines for the treatment of children and adolescents with eating disorders
Couturier, J., Isserlin, L., Norris, M., Spettigue, W., Brouwers, M., Kimber, M., McVey, G., Webb, C., Findlay, S., Bhatnagar, N., et al. (2020) · Journal of Eating Disorders · doi:10.1186/s40337-020-0277-8 · Cited by 215 · see citing works
Avoidant/restrictive food intake disorder: A systematic scoping review of the current literature
Bourne, L., Bryant‐Waugh, R., Cook, J. M., & Mandy, W. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112961 · Cited by 171 · see citing works
Ornstein, R. M., Essayli, J. H., Nicely, T. A., Masciulli, E., & Lane‐Loney, S. E. (2017) · International Journal of Eating Disorders · doi:10.1002/eat.22737 · Cited by 112 · see citing works
Bourne, L., Mandy, W., & Bryant‐Waugh, R. (2022) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.15139 · Cited by 110 · see citing works
Cognitive–behavioral treatment of avoidant/restrictive food intake disorder
Thomas, J. J., Wons, O. B., & Eddy, K. T. (2018) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000454 · Cited by 97 · see citing works
Willmott, E., Dickinson, R., Hall, C., Sadikovic, K., Wadhera, E., Micali, N., Trompeter, N., & Jewell, T. (2023) · International Journal of Eating Disorders · doi:10.1002/eat.24073 · Cited by 78 · see citing works
Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170 · Cited by 61 · see citing works
Mammel, K. A., & Ornstein, R. M. (2017) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000000507 · Cited by 56 · see citing works
Dahlsgaard, K. K., & Bodie, J. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.11.001 · Cited by 39 · see citing works
Bryant‐Waugh, R., Loomes, R., Munuve, A., & Rhind, C. (2021) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.11.001 · Cited by 29 · see citing works
Kennedy, H. L., Dinkler, L., Kennedy, M. A., Bulik, C. M., & Jordan, J. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00578-x · Cited by 29 · see citing works
Avoidant/restrictive food intake disorder: An adult case responding to cognitive behavioral therapy
Görmez, A., Kılıç, A., & Kırpınar, İ. (2018) · Clinical Case Studies · doi:10.1177/1534650118795286 · Cited by 22 · see citing works
Steen, E., & Wade, T. D. (2018) · International Journal of Eating Disorders · doi:10.1002/eat.22832 · Cited by 19 · see citing works
Rienecke, R. D., Drayton, A. K., Richmond, R. L., & Mammel, K. A. (2019) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104519864129 · Cited by 19 · see citing works
Shimshoni, Y., & Lebowitz, E. R. (2020) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-20-00009 · Cited by 16 · see citing works
Dumont, E. L. M., Jansen, A. T. M., Duker, P. C., Seys, D. M., Broers, N. J., & Mulkens, S. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2023.1108185 · Cited by 13 · see citing works
Lenz, K. R., Mitan, L. P., Kleinhenz, S. R., & Matthews, A. L. (2018) · Clinical Case Studies · doi:10.1177/1534650118796562 · Cited by 13 · see citing works
Technology and Telehealth Applications
Fischer, A. J., Clark, R. R., Askings, D. C., & Lehman, E. L. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-811122-2.00007-3 · Cited by 12 · see citing works
Blennerhassett, C., Richards, M., & Clayton, S. (2023) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-023-00378-2 · Cited by 11 · see citing works
Nocerino, R., Mercuri, C., Bosco, V., Giordano, V., Simeone, S., Guillari, A., & Rea, T. (2024) · Nutrients · doi:10.3390/nu16173034 · Cited by 10 · see citing works
LaMarre, A., McGuigan, K., & Lewthwaite, M. (2023) · Medical Humanities · doi:10.1136/medhum-2022-012553 · Cited by 9 · see citing works
Johansson, M., Hermansson, J., Linnsand, P., Gillberg, C., & Nygren, G. (2023) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2023.1179775 · Cited by 9 · see citing works
Prevalence of obesity and autism spectrum disorder.
Voulgarakis, H. M., Bendell, D., & Field, T. M. (2017) · Behavioral Development · doi:10.1037/bdb0000054 · Cited by 9 · see citing works
King, H. C., Howarth, R., Choi, S. R., & Fischer, A. J. (2022) · Child & Family Behavior Therapy · doi:10.1080/07317107.2021.2024716 · Cited by 8 · see citing works
Davis, E. C., & Stone, E. L. (2020) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2020.08.011 · Cited by 8 · see citing works
Avoidant/Restrictive Food Intake Disorder (ARFID): Review of Case Studies
Medina‐Tepal, K. A., Arévalo, R. V., Trujillo, E., & Díaz, J. M. M. (2023) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.22201/fesi.20071523e.2023.1.748 · Cited by 7 · see citing works
Karvay, Y. (2025) · European Eating Disorders Review · doi:10.1002/erv.3180 · Cited by 4 · see citing works
Hansen, S. G., DeMarco, J., & Etchison, H. M. (2021) · Autism and child psychopathology series · doi:10.1007/978-3-030-66441-1_8 · Cited by 3 · see citing works
Fernand, J. K., Saksena, K., Penrod, B., & Fryling, M. J. (2017) · Autism and child psychopathology series · doi:10.1007/978-3-319-71210-9_21 · Cited by 3 · see citing works
Avoidant/Restrictive Food Intake Disorder
Menzel, J. E., & Luo, T. J. (2021) · Springer eBooks · doi:10.1007/978-3-030-67127-3_6 · Cited by 1 · see citing works
Avoidant/Restrictive Food Intake Disorder in Children
Shimshoni, Y., & Lebowitz, E. R. (2022) · Springer eBooks · doi:10.1007/978-3-030-67929-3_74-1 · Cited by 1 · see citing works
Dara, N., Imanzadeh, F., Madani, S., Tajalli, S., Rohani, P., Hosseini, A., Ashtigoo, P., Hatefi, S., Farsani, Z. F., Hajipour, M., et al. (2020) · International Journal of Pediatrics · doi:10.22038/ijp.2020.44424.3680
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.003 · Cited by 1 · see citing works
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.005
Cognitive-Behavioral Model of ARFID
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.006
Stage 1: Psychoeducation and Early Change
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.008
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.007
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.009
Stage 3: Maintaining Mechanisms in Order of Priority
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.010
Overview of Existing Treatments for Feeding, Eating, and Anxiety Disorders
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.004
CBT-AR Adherence: Session-by-Session Ratings
Thomas, J. J., & Eddy, K. T. (2018) · doi:10.1017/9781108233170.015
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.012
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.011
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.016
Thomas, J. J., & Eddy, K. T. (2018) · doi:10.1017/9781108233170.002
Thomas, J. J., & Eddy, K. T. (2018) · doi:10.1017/9781108233170.014
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.017
Thomas, J. J., & Eddy, K. T. (2018) · doi:10.1017/9781108233170.001
Conclusion and Future Directions
Thomas, J. J., & Eddy, K. T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108233170.013
Avoidant/Restrictive Food Intake Disorder in Children
Shimshoni, Y., & Lebowitz, E. R. (2023) · Springer eBooks · doi:10.1007/978-3-031-16691-4_74
Kingsdorf, S., Pančocha, K., Moskalets, A., & Ivanova, K. (2024) · Child & Family Behavior Therapy · doi:10.1080/07317107.2024.2317131
A systematic review of mealtime training for caregivers: effectiveness and social validity
Tereshko, L., Magrauth, M., & Weiss, M. J. (2026) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2026.1758507
- Authors
- Murphy, J., & Zlomke, K. R.
- Affiliations
- University of South Alabama (US)
- Corresponding author
- Murphy, Jillian
- ORCID
- Zlomke, Kimberly R.
- Venue
- Clinical Practice in Pediatric Psychology
- Publisher
- SAGE Publications
- Published
- 2016-03
- Volume
- 4
- Issue
- 1
- Pages
- 23-34
- ISSN
- 2169-4826 (ISSN-L)
- 2169-4834
- OpenAlex
- W2326955845
- Cited by
- 52
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 1 · 2018: 23 · 2017: 5
- FWCI
- 8.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Practice in Pediatric Psychology (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- avoidant/restrictive food intake disorder, picky eating, food refusal, parent training, parent-mediated intervention, differential reinforcement, contingency management, parental role modeling, psychoeducation, novel food acceptance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review