The #1 Reason ABA Falls Short
Christine Miroddi Yoder, Pediatric Feeding Therapist
Episode originally aired: July 14, 2025
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What if I told you that using rewards and reinforcers to get your child to eat might work in the moment—but in the long run, it doesn’t build trust, it doesn’t build skills, and it definitely doesn’t build a love of food?
Let me tell you a story.
When I first started doing feeding therapy, I worked at a specialized school for children with severe autism in New York City. The approach to feeding there? Token boards. Reinforcement schedules. “Take one bite, then you get bubbles.”
And honestly, that’s what I was taught. Everyone around me was doing it. I hadn’t learned about feeding in grad school. Whether you're an OT or an SLP, we don’t really get that training. We learn about swallowing—aspiration, coughing, dysphagia. We learn how to recommend thickened liquids or diet modifications. But not how to teach a child to eat.
So, I thought using reinforcement meant I was “doing feeding therapy.” I didn’t realize how much I didn’t know.
I didn’t assess oral motor skills.
I didn’t think about sensory processing.
I didn’t consider gut health.
I didn’t ask about emotional safety or past trauma with food.
That’s not how I practice anymore—because when you know better, you do better.
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Why ABA Seems to Work (At First)
ABA stands for Applied Behavior Analysis. It’s built entirely on reinforcement: reward the behavior you want, ignore or extinguish the behaviors you don’t.
In feeding, that looks like:
* “Take a bite, get a token.”
* “Eat this, and you get the iPad.”
* “No preferred food until you comply.”
And yes, this sometimes “works”—if the reward is strong enough.
But what happens when the reward stops working?
Many kids who receive ABA support already have limited interests. Once those reinforcers lose their power, you're stuck in a cycle of external control with no internal motivation. The child isn’t learning to enjoy food—they're just complying.
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The Real Problem: Compliance Over Connection
Here’s the #1 reason ABA fails in feeding therapy:
It focuses on compliance instead of connection.
The entire goal becomes:
“How do I get this child to do what I want?”
Instead of asking:
“Why is this hard for them, and how can I support them?”
You’re not treating the root cause—you’re outsmarting the symptom.
But food refusal is never just a behavior. It’s the end result of something deeper. And ABA often skips over those deeper layers entirely.
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What ABA Is Overlooking
1. Oral Motor Skills
ABA therapists aren’t trained to evaluate chewing, tongue coordination, or texture management. Even many speech therapists don’t assess this thoroughly.
I’ve seen countless reports that say “oral motor structures are intact.” That tells me nothing about function—how they chew, what muscles are weak, or whether they can actually manage a piece of chicken or a crunchy vegetable.
2. Sensory Processing
ABA therapists don’t have training in sensory integration. They might carry out a sensory protocol written by an OT, but they’re not trained to assess how texture, smell, or visual appearance is impacting that child’s nervous system.
3. Gut Discomfort
There’s no medical training in ABA. They’re not asking about reflux, constipation, inflammation, or food intolerances—all of which could make eating painful or distressing.
4. Mindset & Emotional Safety
Perhaps most importantly, ABA often ignores how the child feels about food. Is there anxiety? Past trauma? Pressure-induced fear? These matter deeply, and they’re usually left unaddressed.
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So What Can We Do Instead?
We take a holistic approach. It’s why I founded Unlocking Mealtimes and why I call myself a holistic feeding therapist.
That means:
* We start with connection, not compliance.
* We build routines, not power struggles.
* We explore food through the senses, not through force.
* We support oral motor skills before expecting consistent success.
* We regulate the nervous system instead of fighting against it.
Because here’s the truth: If your child doesn’t feel safe, no amount of stickers, bubbles, or bribery will make broccoli feel okay.
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You’re Allowed to Want More
If you’ve been told ABA is your only option for feeding therapy—
If you’ve been told rewards are the only way to get your child to eat—
I want you to know:
You’re allowed to want more than one bite.
You’re allowed to want your child to enjoy food.
You’re allowed to expect support that looks beneath the surface.
If you're ready to get to the root of what’s driving your child’s eating challenges, our Unlocking Mealtimes program is here to help.
Start by taking our quiz at ThePickyEatersTest.com — it will guide you to the support that fits your child’s unique feeding level.
Feeding therapy shouldn't be about obedience.
It should be about understanding, safety, and progress that lasts.
Thanks for being here. We’ll see you next week.
