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Food Chaining for Picky Eaters

A photo of various foods with text that says "Food Chaining for Picky Eaters"

“Food Chaining for Picky Eaters” was written by Kaitlyn Wilson, BScFN, BA, and edited/reviewed by Jackie Silver, MHSc, RD and Gabi Abreu, BSc.

Medical Disclaimer: The information in this article is meant for educational purposes only. It is not intended to be personalized medical or nutrition advice. For a plan tailored to your needs, please consult with a Registered Dietitian or qualified healthcare professional.
Disclosure: This post may contain affiliate links with which I may earn a small commission but at no additional cost to you. Affiliate links help bloggers like me to provide you with free content. All opinions expressed here are genuine. 

Last updated: May 15, 2024

Expanding Food Acceptance with Food Chaining

Are your meal times stressful due to your child’s food refusals? Are you often worried about your child’s nutrition status due to their selective eating habits? If this sounds like your experiences, you are not alone. 

In this blog post, we will uncover the science behind food selectivity & sensory sensitivity, and dive into a game-changing strategy for expanding food repertoire. Food chaining is the gradual process of introducing new foods that share similar characteristics with accepted foods. In other words, you can build off of your child’s safe foods to introduce something new. 

A graphic showing the definition of food chaining

Who Can Benefit From Food Chaining?

Food chaining can be used for anyone who has food selectivity or sensory sensitivities. We will be focusing on food selectivity in children, but please note that food chaining can be helpful for any age with a limited food repertoire. 

  • Food selectivity is when someone only consumes a narrow range of foods. For example, someone may feel more comfortable eating only 5-8 specific foods. Food selectivity can be specific to food texture, color, shape, presentation, type, brand or packaging.
  • Sensory sensitivity is a higher awareness of information from the five senses (touch, taste, smell, sound, and sight). These heightened sensory sensitivities can contribute to the development of food selectivity. 
A graphic with definitions of Food Selectivity and Food Sensitivity

Food chaining is often used in the treatment of Avoidant/Restrictive Food Intake Disorder (ARFID). On average, people recently diagnosed with ARFID only meet 20-30% of their recommended nutrition intake due to food selectivity.

Notably, food selectivity and sensory sensitivities are common in neurodivergent individuals. Keep following along as we go over some of the feeding challenges specifically for autism and ADHD.

A graphic listing feeding challenges with autism and ADHD

Food Challenges in Autism

In one research study, over 90% of autistic children were found to have sensory sensitivities, ranging in severity. Furthermore, ARFID and autism often co-occur: it is estimated that 8.2%-54.8% of children with ARFID are autistic

So, what causes food sensitivity and selectivity in autistic individuals?

The exact reasons behind this are unclear. It’s likely that sensory sensitivities are caused by the brain processing sensory information differently. Additionally, challenges with oral motor skills, such as chewing, swallowing, and gastrointestinal disorders may contribute to these sensitivities.

Furthermore, the inclination towards prioritizing rigid routines or repetitive behaviors might lead individuals to consistently choose certain foods.

Autistic individuals may often rely on specific foods that provide them with a feeling of safety. Safe foods refer to specific foods that have passed the sensory sensitivity test and are deemed tolerable and comforting by individuals with sensory sensitivities. If you’d like to dive deeper into this topic, check out our blog post on Autism Safe Foods: Foods for Sensory Sensitivity

Letter blocks that spell out "SAFE FOOD"

Food Challenges in ADHD 

Is there a connection between picky eating and ADHD? Some research has found that children with ADHD are more likely to be picky eaters than neurotypical kids. We actually have a full blog post exploring this topic! If you are interested, please check out Exploring the Link Between ADHD and Picky Eating

So, what causes food selectivity in ADHD? Below are some possible contributors. 

Dopamine Levels. Children with ADHD may have low levels of dopamine (the “happy” hormone), making them more likely to crave high-carb/sugary foods. This is because sugar raises dopamine levels.

Sensory Sensitivity. Some children with ADHD have sensory sensitivities, causing them to feel overstimulated by certain taste, smell, or texture of the food. Sensory sensitivities might make trying a new food uncomfortable. 

Notably, some kids with ADHD have lower sensitivity to sensory information, which means they have the opposite of a sensory sensitivity. Research shows a range of sensory profiles for people with ADHD. 

Medication Side Effects. Individuals living with ADHD may rely on stimulant medication to improve focus and attention. However, these medications can cause appetite suppression, which can further contribute to picky eating tendencies.

What is Food Chaining?

Food chaining was developed by two Speech Language Pathologists (SLP) named Cheri Fraker & Laura Walber (they wrote a wonderful book called Food Chaining). It is a tool that considers your child’s favorite foods, and builds off of them to gradually introduce new foods or “fear foods” with similar characteristics. 

Fear foods are those foods your child avoids due to a sensory aspect or because of a negative memory of the food. 

Below is a food chaining example that highlights the transition from french fries (a safe food) to chicken pot pie (a fear food). Later in this article, we will teach you all you need to know to plan your own food chains.

Food chaining from french fries to chicken pot pie

Research shows that food chaining can effectively broaden the diets of extremely selective eaters. In one study involving 10 children aged 1 to 14, participants underwent a 3-month food chaining program, during which researchers tracked the expansion of their food repertoires.

Initially, the number of accepted foods ranged from 1 to 8. After the 3-month study, this range significantly increased to 8 – 129. Food chaining was found to be a successful tool to increase food acceptance in all participants: a big win for those looking to expand their food interests!

Implementing the Food Hierarchy With Food Chaining 

When trying new foods with the food chaining tool, it is important to keep in mind the principles of the food hierarchy. The food hierarchy refers to a series of exposures that can gradually make your child more comfortable in trying a new food. 

Think of all the sensory characteristics of food: smell, taste, texture, sight, and even sound (like a crunch when you bite into chips!). This means there is a lot of sensory information our brains receive when we eat food. For those with sensory sensitivities, it can be extremely overwhelming and uncomfortable to try new foods. 

That’s where the food hierarchy comes in. Every little step in becoming more exposed to the food is seen as a win! From tolerating the food in the same room all the way to having a bite. It is not realistic to expect a child to start eating a new food right away. We have to work through the different steps of the hierarchy gradually until we get to the last step of taking a bite!

In the food hierarchy, there are 6 steps to trying a new food, developed by Dr. Kay A. Toomey, a renowned pediatric psychologist:

A graphic showing the 6-step food exposure hierarchy

In one study using a food hierarchy tool, food repertoire increased from 4 food items to over 50 items in autistic children. Parents also reported less food refusals and decreases in mealtime behavior at home. 

Benefits of Food Chaining for Neurodivergent Kids

By now we can see that food chaining can unlock new food acceptances. Let’s explore why food chaining is particularly beneficial for neurodivergent children (or adults):

  1. Food aversions and sensory sensitivities are intentionally addressed with food chaining. Food chains are unique to each child’s sensory preferences and goal foods. 
  1. Non-threatening. Since food chaining builds off of the food your child already enjoys, food chaining is a non-threatening and gentle way to expand their food choices. 
  1. Improved nutrition and well-being. Once food repertoire increases with food chaining, your child can increase the variety of nutrients their body receives. In addition, mealtimes can become less overwhelming.
A graphic showing the benefits of food chaining for neurodivergent kids

Implementing Food Chaining at Home: A Guide for Parents and Caregivers

So how can we implement food chaining at home to increase food acceptance? The good news is that there is a set of practical steps you can use to build your own food chain. 

Step One. With your child, make a list of foods they already enjoy eating. This list will mark their current food repertoire and be used as a starting point for food chains. 

If possible, try to list foods from a variety of groups. For example, grains (crackers, bread, pasta), proteins (eggs, chicken, fish, beans), dairy (milk, yogurt, cheese), fruits (apples, strawberries), vegetables (carrots, cauliflower), fats (avocado, peanut butter, butter), and other (cookies, cakes, candy, chocolate). 

Step 3 of how to implement food chaining at home: make a list of foods they'd like to eat

Step Two. Based on your child’s accepted food list, figure out their preferred food profile. This is a list of characteristics your child is comfortable with in food. For example:

  • What flavors do they like? (Salty | Sweet | Spicy | Tart | Sour)
  • What textures do they like? (Crunchy | Soft | Hard | Chewy | Lumpy | Smooth)
  • What do they like to pair with their favorite foods? (Examples: butter, cheese, mustard, ketchup, mayo, barbeque sauce, hot sauce, soy sauce, ranch, hummus, peanut butter, Nutella, honey, jam)
Step 2 of how to implement food chaining at home: list out favorite flavor profile

Step Three. Make a list of the foods your child would like to eventually eat. The list can be composed of foods their friends/family eat, or simply foods they are interested in. These will serve as the goal foods to work towards!

Step 1 of how to implement food chaining at home: make a list of favorite foods

Step Four. Make your food chain based on your child’s preferred food profile. Build off of the textures, flavors, and condiments they already enjoy to introduce a new food.

Favorite Food →_____→_____→_____→ Goal Food

To help you along the way, food chains can follow 4 stages. However, they don’t necessarily need to be in the same order, and you can also do the food chains in more than 4 stages! These general stages allow for gradual and gentle exposure to help make trying new foods less overwhelming:

  • Stage 1) Maintain and expand taste and texture. For example, you can try offering new shapes and new brands of the same food item.
  • Stage 2) Vary taste and maintain texture. For example, you can offer a new flavor of the same item. 
  • Stage 3) Maintain taste and vary texture. For example, you can offer new types of items that still have a similar taste. 
  • Stage 4) Vary taste and texture. This is where you introduce the goal food! 
An infographic explaining the 4 stages of food chains

Tips When Implementing Food Chaining

Here are some extra strategies to keep in mind when food chaining to help you along the way:

  1. Only introduce one or two new foods at a time: It can be overwhelming to try a bunch of new foods at once. Breaking it down to one or two new items can help make the experience more comfortable for your child with food selectivity.
  1. Rate how motivated your child is to try the goal food on a scale of 1 to 10 (1 = really not feeling motivated to try it yet, 5 = feeling ready to try the new food, 10 = feeling really motivated to try the food). If your child is really motivated about trying a certain food over others on the list, it may be a good idea to start with that one!
  1. Gradually deviate from preferences. If you make a sudden jump between types of food, they may find the transition really overwhelming. For example, if your child really likes crunchy foods and you make the quick jump to soft foods, they may find it really uncomfortable. 
  1. Try new foods at the time of day your child is most hungry: When their appetite is peaked, they may be more willing to try new food.
A girl is sitting at the table eating food
  1. Always include foods your child likes along with the new food. This can help them feel more comfortable. 
  1. Rate the taste of new foods on a scale of 1 to 10 (1 = Don’t like it yet, 5 = Okay, 10 = Delicious!). Keeping track of the taste can help with timing when to introduce new foods. You can also track how the food was prepared.
  1. Try and try again: It may require 10 to 20 (or more!) attempts for someone to determine whether they enjoy a particular food. Taste buds may need time to get used to new flavors. Be patient with your child and don’t give up!
  1. Be okay if the food chain doesn’t lead completely to the goal food. Every new exposure is a win. If you don’t get all the way to the goal food, that’s okay too! 

Food Chaining Examples

Sometimes it’s helpful to build new ideas off of examples. In this section, we will provide some food chain examples using some popular food items kids like. Feel free to use one of these examples if it fits with your child’s baseline preferences or use them to create your own.

Food chaining from chicken nuggets to shredded chicken
Food chaining from cheese pizza to cheese sandwich
food chaining from french fries to carrots
Food chaining from chocolate to cherries

Food Acceptance is Supported by Having a Multidisciplinary Team

Food selectivity and sensory sensitivities make you more prone to deficiencies and malnutrition. Therefore, it is important to seek the support of a multidisciplinary team to monitor your child’s health and nutrition status. Professionals can also help you implement coping strategies to get you through overwhelming situations. Please note that there is some overlap between the roles of these professionals.

Typically, people experiencing food selectivity and sensory sensitivities can benefit from working with: 

  • A Registered Dietitian (RD). A dietitian can monitor your nutritional status and work to correct deficiencies and malnutrition. They can help you build food chains tailored to your child’s preferences and track changes over time and work towards expanding your child’s food repertoire. Working with a dietitian can improve your relationship with food. 
  • A Speech Language Pathologist (SLP). Speech Language Pathologists will look at oral structures, oral reflexes, non-nutritive suck, gross motor skills and respiratory skills to determine if there is an underlying reason for food selectivity. 
  • An Occupational Therapist (OT). Occupational Therapists can work with your child on sensory issues relating to food by engaging in hands-on sensory feeding therapy and food play. They can also teach your child emotion regulation skills if there is anxiety around trying new foods.
A dietitian is writing on a clipboard

Summary of Food Chaining

Food chaining is a powerful strategy to increase food repertoire for anyone who experiences food selectivity or sensory sensitivities. Working with a team of professionals can support your family’s journey into food chaining, and monitor your child’s health and nutrition status for overall well being. 

For neurodivergent kids, food chaining can help address food aversions, promote gradual exposure to foods in a non-threatening way, and has the potential to increase nutrition status. 

You can build your own food chains by following practical steps:

  1. Make a list of your child’s favorite foods
  2. Determine what tastes/textures/shapes your child is drawn to 
  3. Make a list of your child’s goal foods
  4. Design a food chain building off of your child’s preferences

Check out these other helpful resources

References

Archibald, T., Bryant-Waugh, R. (2023). Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions. Journal of child psychology and psychiatry advances. 3(2).  https://pubmed.ncbi.nlm.nih.gov/37753149/ 

Avena, N., Rada, P., Hoebel, B.G. (2008). Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews. 32(1). https://pubmed.ncbi.nlm.nih.gov/17617461/ 

Bialek-Dratwa, A., Szymańska, D., Grajek, M., Krupta-Kotara, K.,Szczepańska, E., Kowalski, O. (2022). ARFID-Strategies for Dietary Management in Children. Nutrients. 14(9). https://pubmed.ncbi.nlm.nih.gov/35565707/ 

Blum, K., Chen, A.L., Braverman, E.R., Comings, D.E, Chen, T., Arcuri, V., Blum, S., Downs, B., Waite, R.L., Notaro, A., Lubar, J., Williams, L., Prihoda, T.J., Palomo, T., Oscar-Berman, M. (2008). Attention-deficit-hyperactivity disorder and reward deficiency syndrome. Neuropsychiatric disease and treatment. 4(5). 893-918. https://pubmed.ncbi.nlm.nih.gov/19183781/ 

Cascade, E., Kalali, A.H., Wigal, S.B. (2010). Real-World Data on Attention Deficit Hyperactivity Disorder Medication Side Effects. Psychiatry. 7(4). 13-15. https://pubmed.ncbi.nlm.nih.gov/20508803/ 

Cermak, S.A., Curtin, C., Bandini, L.C. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association. 110(2) https://pubmed.ncbi.nlm.nih.gov/20102851/ 

Fishbein, M., Cox, S., Swenny, C., Mogren, C., Walbert, F. (2006). Food chaining: a systematic approach for the treatment of children with feeding aversion. Nutrition in Clinical Practice. 21(2). https://pubmed.ncbi.nlm.nih.gov/16556929/ 

Harris, H.A., Bowling, A., Santos, S., Greaves-Lord, K., Jansen, P.W. (2022). Child ADHD and autistic traits, eating behaviours and weight: A population-based study. Pediatric Obesity. 17(11). https://pubmed.ncbi.nlm.nih.gov/35751176/ 

Kamath, M.S., Dahm, C.R., Tucker, J.R., Huang-Pollock, C.L., Etter, N.M., Neely, K.A. (2020). Sensory profiles in adults with and without ADHD. Research in developmental disabilities. https://pubmed.ncbi.nlm.nih.gov/32526674/ 

Kessi-Rahkonen, A., Ruusunen, A. (2023). Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome. Current opinion in psychiatry. 36(6). https://pubmed.ncbi.nlm.nih.gov/37781978/ 

Leekam, S.R., Nieto, C., Libby, S.J., Wing, L., Gould, J. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of autism and developmental disorders. 37(5) https://pubmed.ncbi.nlm.nih.gov/17016677/ 

Marí-Bauset, S. M., Zazpe, I., Mari-Sanchis, A., Llopis-González, A., Morales-Suárez-Varela, M. (2014). Food Selectivity in Autism Spectrum Disorders: A Systematic Review. Journal of Child Neurology, 29(11), 1554-1561. https://doi.org/10.1177/0883073813498821 

Tanner, A., Andreone, B.E. (2015). Using Graduated Exposure and Differential Reinforcement to Increase Food Repertoire in a Child with Autism. Behavior analysis in practice. 8(2). https://pubmed.ncbi.nlm.nih.gov/27703925/ 

About Kaitlyn

Kaitlyn is a recent graduate of an Honors Specialization in Nutrition & Dietetics (BScFN) and Kinesiology (BA) at Brescia University College, affiliated with Western University. In the fall she will be continuing her education to obtain a Master’s in Nutritional Sciences (MScFN) at Western University. Kaitlyn has a strong dedication to staying up-to-date with evidence-based nutrition practices. She loves cooking, reading, crocheting, and going for walks outdoors!

About Jackie

Jackie is a Registered Dietitian whose mission is to empower and support the neurodivergent and physically disabled communities through nutrition. Jackie runs a virtual private practice and blog which has simple recipes and health information tailored to these communities. She loves cooking, exercising, traveling, journaling, and spending time with family and friends.

Check out her full bio here →

A headshot of Gabi Abreu

About Gabi

Gabi Abreu, BSc, is a Nutrition & Dietetics graduate from Toronto Metropolitan University and the Blog & Social Media Manager at Jackie Silver Nutrition. She is also the founder of the Working Woman’s Health Collection. WWHC was created with the purpose of inspiring women to achieve a healthy relationship with food, while taking into consideration the busy lifestyles that we live today. Beyond her professional pursuits, she loves experimenting with new recipes, trying new workout classes, and indulging her love for adventure through travel!