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Clin Child Fam Psychol Rev. 2017 Dec;20(4):403-421. doi: 10.1007/s10567-017-0236-3.

The BUFFET Program: Development of a Cognitive Behavioral Treatment for Selective Eating in Youth with Autism Spectrum Disorder.

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Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, USA.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA.
Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC, USA.
JFK Partners, Department of Psychiatry, University of Colorado, Anschutz Medical Campus, School of Medicine, Denver, CO, USA.


Selective eating (often referred to as "picky" eating) is common in individuals with autism spectrum disorder (ASD) across the lifespan. Behavioral interventions are widely used to treat selective eating; however, most of these programs are time intensive, have not been evaluated for use in outpatient settings, and do not typically include youth beyond early childhood. Despite the functional impact and risk for negative outcomes associated with selective eating, there are no empirically supported treatments available for older children, adolescents, or adults, either with or without ASD. To address this treatment gap, we developed BUFFET: the Building Up Food Flexibility and Exposure Treatment program. BUFFET is a 14-week, multi-family group cognitive behavioral treatment for selective eating in children (8-12 years) with ASD. In this paper, we will (1) discuss the theoretical conceptualization of BUFFET, (2) describe the treatment content and structure, (3) present feasibility data from the initial pilot trial, and (4) consider next steps in treatment development.


Autism spectrum disorder; Cognitive behavior therapy; Feeding; Intervention; Picky eating; Sensory

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