Why I Got It Wrong (And What It Taught Me About Autism and Eating)
Podcast Episode – April 7, 2025
Host: Christine Miroddi Yoder, Pediatric Feeding Therapist
________________
Hi, and welcome to today's episode. I'm Christine, a pediatric feeding therapist, and I help parents of picky and fearful eaters move from high-stress, stuck mealtimes to confident, curious foodies. We take a holistic approach that looks at the whole child — across the four pillars of feeding: gut, sensory, oral motor, and mindset — so that no root cause is overlooked.
In today’s episode, I’m sharing a story about a time I got it wrong — really wrong — with a client. It’s humbling, but it taught me so much about feeding struggles, especially in children with autism. And even if your child isn’t on the spectrum, I think you’ll walk away from this episode with new insight.
The Case That Changed Everything
Years ago, before I specialized exclusively in feeding therapy, I was handed a case involving a young girl with autism. At the time, I felt confident — I had worked at a private ABA-style school in Manhattan and had years of experience with autistic children. But I was still early in my feeding therapy journey and not fully trained in identifying the root causes of feeding struggles.
I assumed the feeding issue was behavioral. I leaned on what I knew: token boards, rewards, structured routines. She gagged at food? I treated it like a behavior. She refused to eat? I adjusted the reinforcer. We stuck to the plan and pressed forward — assuming that if we just found the right motivator, she’d eventually cooperate.
But I Was Wrong
What I didn’t realize then was that I had completely missed the real problem.
She wasn’t misbehaving. She was overwhelmed. And more importantly — she was physically struggling.
I ruled out oral motor issues too quickly. She had teeth, could speak, moved her tongue… but those superficial checks meant nothing without a real oral motor assessment. I also didn’t connect her feeding difficulties to sensory challenges — even though I knew children with autism often have sensory differences.
Back then, I didn’t have the lens to see that her body wasn’t capable of chewing certain textures — not because she wouldn’t, but because she couldn’t. Meats, veggies, mixed textures — they overwhelmed her. Her gagging wasn’t defiance. It was a clue I failed to decode.
When Behavior-Based Approaches Fall Short
Behavioral tools can sometimes work in the moment — and they did. She complied. She took bites. She earned rewards. But she didn’t learn to love food. She didn’t gain confidence or autonomy. And in hindsight, I may have unintentionally eroded her trust — in food, in herself, and in the therapy process.
And here’s the truth I’ve learned since: in nearly every feeding case involving autism, the root issue isn’t behavioral. It’s oral motor. It’s sensory. It’s fear. It’s overwhelm. And when those things are missed, kids suffer — even when they’re “complying.”
What I’d Do Differently Today
Now that I’ve trained extensively in feeding therapy, I see this case so differently. She likely had muscle atrophy from not chewing a variety of textures. She may have had low tone. Her gagging was her body’s warning sign, and I missed it.
Today, I never take a “within normal limits” report at face value unless I know the therapist conducted a proper oral motor assessment. I always ask:
* Is there tone?
* Are there retained reflexes?
* What are the sensory processing patterns?
* Is the gag reflex protective or oversensitive?
* Is this truly behavioral — or a survival response?
This is why I created the Unlocking Mealtimes Roadmap — because mislabeling a feeding issue can delay progress for months or even years. We need to dig deeper, not just aim for surface-level compliance.
For Parents — Especially Those Navigating Autism
If you’ve been told your child’s feeding issues are “just behavioral,” I encourage you to keep asking questions. You deserve to understand what’s really going on. And if something doesn’t sit right — trust your gut.
Children with autism often struggle with:
* Poor chewing coordination
* Low oral muscle tone
* Sensory sensitivity to textures, smells, and temperatures
* Food rigidity due to gut imbalance or anxiety
It’s rarely “just” picky eating. And it’s almost never “just” behavior.
For Therapists: Give Yourself Grace
To my fellow therapists: training gaps are real. If you’ve made mistakes, like I did, give yourself grace — and then get better. Keep learning. Take courses. Ask questions. The more you learn, the better outcomes your clients will have.
Today, I approach feeding with a holistic lens. And that one case I got wrong? It shaped everything I do now.
Let’s Find the Real Root Together
If you're curious whether your child’s feeding struggles are rooted in fear, sensory issues, oral motor delays, or something deeper, take our free quiz at thepickyeaterstest.com. You'll learn what kind of eater your child is and what to do next.
And if you’re ready for real answers and real progress, explore our resources at foodologyfeeding.com. You don’t have to figure this out alone — and you shouldn’t have to.
See you next week.
