Outcomes
We have helped over 50 families return to balance and healthy eating.
Meals like this have been achieved in just weeks!
These are plate examples from children in the programme (ate everything on the plate/empty plate).
For additional plate picture examples go to:
Outcomes/Results
(Taylor, Blampied, & Roglic’ 2020 n=26; Taylor & Taylor 2022 n=32)
On average, children meet 100% of their individualised admission goals.
Children consumed 100% of bites within an average of 46 minutes on the first day of treatment.
Children learned to take medication, chew, feed themselves with utensils, drink water from a cup, and sit for meals without distractions.
Volume increased to an average of 158 grams, and variety to >100 foods in all food groups. Dependence on supplements, formulas, and laxatives decreased.
Refusal, spitting out, and crying significantly decreased by >97%.
Research has shown that successful feeding treatment can improve child emotional/behavioural functioning and happiness, as well as caregiver stress. Caregivers report life-changing rippling positive impacts extending beyond eating for the child and family not only in health, but independence and social/behavioural areas (see review by Taylor, Phipps, Peterson, & Taylor 2024*; Taylor & Taylor, 2022 n=32*):
*Note: In addition to controlled data (e.g., % consumed, latency to acceptance, inappropriate mealtime behaviour), permanent product (e.g., grams, meal photos), and objective measures (e.g., direct observation of child indices of happiness), we have started asking caregivers for their perspectives for social validity, which in contrast is qualitative and subjective.
Increase in Foods Consumed
On average, children went from eating 6 foods to eating 94 foods from all food groups (protein, starch, vegetable, fruit).
High Caregiver Satisfaction Ratings (Taylor & Taylor, 2022, n=32)
- On average, caregivers report high satisfaction with the programme (4.87 out of 5) and high social acceptability of the treatment (4.83 out of 5).
Previous Failed Treatments (Taylor & Taylor, 2021; Taylor, Blampied, & Roglic’, 2020)
Children had previously received up to 11 years of prior failed interventions by up to 12 different disciplines/treatment types.
Case Outcome Summary Examples
These are only cases from Australia and only selected feeding relevant diagnoses and conditions are listed for each case. We focus on the specific individualised feeding needs/goals rather than diagnosis. In the hospital at Johns Hopkins/Kennedy Krieger, many diverse, severe, and complex feeding cases and issues were supported. In Australia, we have helped children with autism, developmental delay, intellectual disability, chromosomal abnormalities, coeliac disease, William’s syndrome, prematurity, constipation, anemia, nasogastric and gastrostomy tubes, failure to thrive, reflux, and dyspraxia, as well as children with typical development and no diagnoses at all.
- For parents/caregivers, please let me know if you would like to be connected to talk to other parents who have been through the process to hear about it from their perspective and ask questions. Note: Each child and family are unique and the programme is individualised. Outcomes experienced by one person do not necessarily reflect the processes and results that other people may experience or guarantee the same outcomes.
As the first case example from Australia, a 6-year-old child with autism only ate 2 specific foods and 2 brand-specific snacks, and drank 1 specific milk from 1 specific bottle. He received over 4 years of attempted treatments including an intensive multidisciplinary hospital admission. He consumed 8 new foods (2 from each food group) on the first day of treatment. Within a couple weeks, he was consuming 100% of any food presented to him (over 50 foods from all 4 food groups) at regular texture and drinking water from an open cup with little to no inappropriate mealtime behaviour. Both parents and the school were trained to implement the protocol and report high acceptability of the treatment (4.94/5) and satisfaction (4.91/5) on objective measures. He met 100% of measurable goals set by the family within a couple weeks. Parents reported continued success and maintenance for a year post-treatment, and the impact was multi-faceted and life changing for the family.
A 9-year-old boy with autism and history of NG tube at birth ate no fruits, vegetables, or meat and did not drink water, and was dependent on laxatives and formula. He had years of attempted treatments with multiple disciplines and therapists, including medications and participation in an intensive research study at a hospital. Within a few days, he was consuming 100% of any food presented to him (over 50 foods from all 4 food groups) at regular texture and drinking water from an open cup with high independence. Parents were trained and reported high acceptability of the treatment (4.89/5) and satisfaction (4.87/5). He met 100% of measurable goals set by the family in less than 2 weeks with continued success reported for over a year. Taylor (2018).
A nearly 4-year-old male with autism had a history of significant weight loss and highly inconsistent food intake. He might go for weeks only eating one food (e.g., Nutella). At the time of admission, he had just started eating 3 specific starches (1 restaurant specific), 1 protein combo, and occasionally might eat a few bites of 1 raw fruit and veg. He did not eat meat, vegetables, or fruits. Previous treatment attempts included multiple consultations with a dietitian, speech therapist, general practitioner, developmental paediatrician, sensory treatment (SOS) and purchase of specialised equipment by an occupational therapist on and off for a year, interdisciplinary hospital feeding clinic consultation, a psychologist, and supplements from a chiropractor. On the first day of treatment, he consumed 8 new foods from all the food groups at regular texture. His variety post-treatment was at over 83 foods and he quickly met 100% of his goals. His parents were trained to implement the protocol and reported high satisfaction (4.96/5) and social acceptability of the treatment (4.76/5). At 3-year follow-up gains were maintained. A 2-year-old male upon admission had inappropriate mealtime behaviour and was eating 1 protein starch combo, 2 proteins (1 restaurant specific), 3 starches (1 restaurant specific), 1 fruit, 1 veg, and smoothies/milkshakes. Post-treatment, he was consuming over 65 foods from all food groups at regular texture. His mom was trained to implement the protocol and he met 100% of his goals. Caregivers reported high satisfaction (4.96/5) and social acceptability of the treatment (4.76/5). At 3-year follow-up, parents reported that feeding problems were resolved and that he still ate 95% of foods. Taylor & Haberlin (2020).
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A 5-year-old male with autism, history of iron deficiency requiring supplementation, low weight, and history of constipation had never chewed or eaten regular texture food in his life, even baby rusks/puffs or mashed food. He was dependent on blended “baby” food and would not swallow any lumps or texture due to gagging and refusal. He would only eat certain blends/brands and regressed to drinking only milk if his food was unavailable. For most of his life (>4 years), parents consulted with a wide variety of professionals (e.g., paediatrician, headstart feeding specialist), and he had over a year of outpatient treatment and a week of inpatient hospitalisation treatment from an interdisciplinary feeding programme, and years of previous failed treatment attempts including speech, occupational, and behavioural therapy. If he got food in his mouth, he would try to swallow before it was chewed, gag, spit out, etc. After 3 weeks of treatment, he was eating (chewing and swallowing) a full plate of regular texture portions of a variety of 109 foods from all 4 food groups. He learned to bite off, chew, lateralise, masticate, judge, and swallow a wide variety of regular texture foods, including meats and raw fruit/veg. He met all (100%) 12 of his goals. His parents were trained and reported high acceptability of the treatment (5/5) and satisfaction (5/5). At 1-year follow-up, his mother reported that he was doing excellent. She rated his progress at a “4 to 5” out of 5 (much better to resolved). She stated that he ate a variety of different foods, but still had favourites. She stated that he would generally eat anything put in front of him. Taylor (2020).
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A 2.5-year-old male consumed a few specific starches, specific homemade omelette, 1 fruit, and certain pureed/ground mixtures (if fed as a nonself-feeder with iPad). He expelled foods, would not self-feed most foods, and did not consume foods from the food groups separately or at an age-appropriate texture. He met 100% of his goals and variety was at over 70 foods at regular texture from all food groups and using utensils with high independence in less than a week. His therapist and mum were trained to implement the protocol. At 3-year follow-up, his mum reported that his feeding problem was resolved and that he ate everything and loved to try new things too. Taylor & Haberlin (2020).
A 4-year-old male with a gastrostomy tube, autism, prematurity (24 weeks), history of ventilator, CPAP, oxygen, and nasogastric tube dependence and failure to thrive ate custard and soup as a nonself-feeder at a certain temperature. If a minuscule lump was in the soup, he would gag and vomit. He had never chewed or used his teeth or swallowed any texture. He might accept 2 other specific foods, but would pack for hours or expel. He consumed chocolate milk mix via spoon feeding as a nonself-feeder. He used an adaptive water bottle that squirted water into his mouth with prompting and assistance. He did not take medications orally (taken via G-tube). Previous treatment attempts included multiple years since birth with a hospital feeding team, various therapies, and a 10-day hospitalisation for tube weaning (this resulted in some small oral intake of custard, liquid soup, and chocolate milk mix). His parent’s persisted in oral feeding and volume and decreased tube nutrition dependence on their own. On the first day of treatment, he consumed 8 new foods from all the food groups at a junior texture. His variety is now at over 124 foods at any temperature, 28 crunchy foods, and 26 combination foods with crunchy foods. He is now self-feeding and scooping, including holding the container, and can use a fork. He is now drinking independently from a regular full cup including sipping, and drinking from a regular water bottle, and can drink from a regular straw. Liquid variety was increased to multiple flavours of nutritious formula and water in a regular open cup. He learned to eat independently from pouch. He can also now take medications orally rather than via tube. He learned to bite off, chew with his molars, lateralize, masticate, and swallow a wide variety of regular texture foods, including difficult foods in bite sizes such as meats and raw fruit/veg. He also learned to swallow fork-mashed texture foods. He ate all of his food in 2 free access snack practice social meals at a child’s table/chair. Refusal, expulsion, packing (not swallowing), emesis (vomit), and gagging/coughing all decreased to low/zero levels, and independence, chewing, and swallowing have increased significantly. He transitioned from a highchair to a booster at the family dinner table. His parents were trained to implement the protocol. He met all 22 of his goals in 15 days. Taylor (2021).
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A 13-year-old girl with typical development and growth consumed no vegetables or fruits. Her diet was limited to 5 specific starches, 1 protein, 1 protein starch combo, and snack foods. She was motivated to change her diet because of social and health (never feeling full, low energy, spikes/crashes) impact. Socially, this posed a significant problem at school, with friends and family, during parties and events, at restaurants, and during travel. Previous treatment attempts since the age of 2 years included multiple consultations with psychologists, eating disorders specialists, dietitians, speech/occupational therapists, gastroenterologist, and anxiety medications, hypnosis, sensory treatment (SOS), play therapy, rewards, removal of privileges, withholding food, etc. Side effects of medication included carb cravings, weight gain, and lethargy. On the first day of treatment, she consumed 13 new foods at regular texture 100% independently including 6 raw plain vegetables. Variety reached 48 foods and she quickly met 100% of goals. She ate multiple new foods at restaurants and ate family dinners independently. Caregivers reported high satisfaction (4.82/5) and social acceptability of the treatment (4.88/5). At 9-month follow-up, she still consumed at least 46 of the foods introduced. Some of the foods not being consumed was due to the family not cooking them or having them available rather than refusal. She was eating the family dinner including a raw salad daily and also was eating at school, at restaurants, and while traveling. Taylor, Haberlin, & Haberlin (2019).
A 5-year-old male with autism (level 2), severe constipation, laxative dependence, recent history of baby bottle and current formula dependence, liquid refusal, medication refusal, viral asthma, and eczema did not eat any fruit or vegetables. He ate only 2 proteins and 5 starches and 1 combo. He did not drink enough fluid or eat enough volume consistently and did not drink at all at school. He did not sit for meals or eat at the table. He required laxatives daily and saw a physio for his stomach. He has a physio eval every 6 weeks for his stomach. He had impactions and bowel stretching with decreased sensation that impacted toilet training attempts. He had therapy attempts since 18 months of age (ST, OT, multidisciplinary autism feeding team, behavioural therapy/psychology, sensory book, wide variety of approaches and strategies, multiple programs in an autism specific program). After less than 2 weeks of treatment, he was eating 67 foods from all food groups. He increased his liquid volume and eliminated formula dependence. He ate with his parents and sister. His mum and dad were trained to implement the protocol with high integrity. He met all (100%) 9 of his goals. His parents reported high acceptability of the treatment (4.87/5) and satisfaction (4.81/5). At 1-year follow-up, parents reported the feeding problem was much better overall (4 out of 5) and he was still eating all food groups. They reported that the intervention was extremely successful and that he had grown taller, was better able to concentrate at school, and constipation had improved. A 5-year-old female with autism (level 3), constipation, low height/weight, mild eczema, dyspraxia, toothbrushing/medication refusal, and recent history of formula dependence did not eat any vegetables. She mostly only ate plain starches. She would inconsistently and infrequently eat very small amounts of a few proteins and fruits as a nonself-feeder with rewards and significant effort, but also packed and expelled them. She did not eat enough volume of food and her growth was impacted. She did not drink enough water (wanted juice) and did not drink at all at school. She would go all day at school without drinking water. She would put too much food in her mouth and expel or have emesis (vomit). She would cry and refuse medication; it required slow administration, both parents with force, syringe, and an edible reward. She gagged and wouldn’t open for toothbrushing. She received nearly 2 years of behavioural feeding treatment attempts and early intervention, speech, OT, and physio. After less than 2 weeks of treatment, she was eating 116 foods from all food groups. She independently drank water and self-fed. Her mum and dad were trained to implement the protocol with high integrity. She ate at a family meal at a café. She met all (100%) 10 of her goals. Her mother and father reported high acceptability of the treatment (4.81 & 5 out of 5) and satisfaction (4.68 & 5 out of 5). Taylor & Lanovaz (2021).
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A 5-year-old male with autism (level 3), moderate intellectual disability, constipation (sometimes requiring laxatives), supplement dependency, lactose intolerance, toothbrushing refusal, and history of reflux in infancy ate mostly 1 specific cracker and thin hot chips. He did not eat any protein, vegetables, or fruits. He had vomiting and gagging and gagged around others eating. He was not eating any foods that required chewing or utensils so he was not using feeding skills. He didn’t know how to scoop and flipped his spoon so that the food fell off. He did not eat at school or away from home or during mealtimes (grazed). He had feeding treatment attempts for years including ST, OT, and behavioural therapy and sensory based treatment and “desensitisation”; he had early behavioural intervention. He was taught to pack food on his tongue resulting in gagging and vomiting and not chewing or moving food to his teeth. He had problem behaviour and was on psychotropics. After 1 week, he was eating 90 foods from all food groups and graduated early in less than half the time (6 days). He learned to scoop and use a spoon upright and gagging/vomiting and packing decreased. He met all (100%) 8 of his goals. His parents were trained and reported high acceptability of the treatment (5/5) and satisfaction (4.91/5). At 6-month follow-up, parents reported that he has always had 100% consumption, typically finished his plate in under 10 minutes, ate more from his second/free plate after, and ate more variety and volume of foods free access. They reported improvement in his mood and development. Taylor (2022).
A nearly 4.5-year-old male had autism, pica, and food stealing. Pica was significantly impacting his life and restricting his location, daily activities, independence, and adaptive functioning. He couldn’t go outside freely because he ate dirt, bark, grass, rocks, rubbish, etc. He also ate academic materials such as glue, crayons, plastic, paper, paint, etc. He also mouthed and bit many dangerous household objects (e.g., extension cord, cleaning products) which had visible teeth marks and bits missing and toys. Pica limited his academic, therapeutic, and leisure activities and materials. Food stealing also significantly impacted his daily life and social engagement. Others had to hide to eat around him. These behaviours significantly restricted him in community and social settings. The cupboards and outdoors had to be locked up. He has previously tested low on iron via blood test. He did not consume any vegetables separately (they had to be mashed into other foods) and only ate 3 fruits, and food stealing for unhealthy foods was a huge daily issue. In 9 days, he met all his short-term goals and learned how to independently throw away pica material and rubbish he previously ate, independently put away objects he previously chewed on and ate pieces off, use items appropriately (academic, leisure, therapy materials) that he previously would chew and eat, and to refrain from touching materials that he previously would chew/mouth/eat that are dangerous, inappropriate, or belong to others (e.g., food, electronics, household items), and independently accepted, chewed, and swallowed 25 new foods (including 12 vegetables, 8 fruits). His mum implemented the protocols with high integrity and his current treatment team and family continued/maintained, expanded, and simplified the pica treatment for everyday life. Caregivers reported high satisfaction (4.04/5) and social acceptability of the treatment (4.44/5). At over 2-year follow-up, his mother reported that his pica and eating were much better (4 out of 5) than before treatment. Taylor (2020).
A 5-year-old boy with autism consumed only 2 starches (one restaurant specific), 1 brand and container specific protein, and a high ground texture mixture. He did not consume any fruits or raw or separate vegetables, or other foods from the food groups separately or at an age-appropriate texture. On the first day, he consumed 8 novel foods from all food groups. In less than a week, he met 100% of his goals and his food list was at over 80 foods at regular texture (including steak and salad) on a full plate with regular cutlery/crockery. His mum conducted meals in the community and sibling meals and a therapist was trained to conduct morning tea at childcare. At 3-years follow-up, his mother reported that he still ate all of the foods from his food list and ate different varieties of combination foods. He would try new foods if a friend was eating it. She rated his eating as a 4 (much better than pretreatment) because he still showed some rigidity such as not eating boiled vegetables at a restaurant (wanted them boiled his mother’s way). Taylor & Haberlin (2020).
A 4-year-old male with autism was dependent on liquids and formula to meet his nutritional needs via baby bottle. He did not eat any foods from the food groups (protein, starch, vegetable, fruit) and ate only specific biscuits. He would eat a homemade fruit smoothie as a nonself-feeder, so would not feed himself. He did not drink out of an open cup. His parents reported that he did not have much of an appetite or seek out food. He refused some liquid medications (e.g., antibiotics) and gummy multivitamins. He was not able to stay a full day at school and would not eat anything in his lunchbox (even preferred foods) if a nonpreferred food was in it even if it was in a divided section. He has previously had low iron on blood tests and was on supplement. He had had over 2 years of failed treatment attempts from multiple disciplines. On the first day of treatment, he consumed 8 foods from the food groups at regular texture. His variety is at over 120 foods and he is independently scooping and biting off, improved his chewing and swallowing to eat regular texture, self-drinking from a regular open cup, can take medication from a regular open medicine cup, and is transitioning independently to the table. He ate at a restaurant with his family and ate at school and during therapy, and his nanny, mum, dad, and school shadow were trained to implement the protocol with high integrity. He met all (100%) 15 of his goals. At 1-year follow-up, his mother reported that he continued to eat at home well, but not free access at school (without a feeder/protocol). Taylor (2020).
An 11-year-old male with autism ate no fruits or vegetables, rarely used utensils, did not drink out of a cup, and had constipation and laxative dependence. He engaged in inappropriate mealtime behaviour if foods were near him (other’s eating), gagged at the smell, and requested his mum to wash her hands before touching his water bottle if she cut veggies. Previous treatment attempts include 18 months with an OT from a multidisciplinary feeding team and speech therapy. On the first day of treatment, he consumed 7 new foods at regular texture 100% independently. His variety is now at over 80 foods and he quickly met 100% of goals (including utensils and cup drinking). He ate at a restaurant and with his sibling. Parents were trained and reported high satisfaction (4.91/5) and social acceptability (5/5) of the treatment. At over 2-year follow-up, parents reported the problem as “definitely” at an “emphatic” 5 (resolved) and he had maintained all but 1 food. Taylor (2020).
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A 4-year, 3-month old female with autism (level 2) did not eat any vegetables or fruits and still drank from a baby bottle. She had never chewed raw vegetables, raw hard fruits, or tough meats/harder foods. The feeding disorder had gotten worse over time. She expelled (spit out) food, gagged, overstuffed her mouth, turned her head, left the table, and pushed the food/feeder away and threw. She had to have the iPad to eat less preferred foods and had to have large dessert rewards to eat. She did not eat at daycare but just had a baby bottle of milk. She ate only 3 combinations and no separate proteins, vegetables, or fruits from the food groups. The feeding problem had impacted her teeth (has had fillings, caps, and toothbrushing refusal), significant sleep disorder (on melatonin; has to have baby bottle and iPad at nap and bedtime; won’t nap at daycare so has to be picked up early), behaviour (has tantrums when denied preferred foods), toilet training for bowel movements (goes every other day), health (illnesses last longer and she will not take medication; e.g., during the intake she had the flu and would not take antibiotics), and progress with speech therapy (jaw weakness from not chewing). On a recent trip overseas, she still reverted to mostly only drinking milk and not eating. She would not take medication and spat it out. After less than 2 weeks of treatment, she was eating 122 foods from all food groups at regular texture and self-feeding/scooping and using a fork. She ate at a restaurant. She met all (100%) 8 of her goals. Her parents were trained and reported high acceptability of the treatment (4.81/5) and satisfaction (4.77/5). At 6-month follow-up, parents reported that they were very happy with her eating and that she ate everything from her discharge food list except 6 foods. They also reported that she had not had constipation for 3 months and that they decreased her laxative. Taylor (2022).
Here are some examples of food lists from children who completed the program.
These are foods they actually ate (consumed) multiple bites/portions of.
For additional food list examples go to:
