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Picky Eating or ARFID

Watch the video below to learn more about the difference between

picky eating and ARFID. Use this page to find more resources and references. Please feel free to visit www.edtfi.org for even more resources.

References

Allen SL, Smith IM, Duku E, Vaillancourt T, Szatmari P, Bryson S, Fombonne E, Volden J, Waddell C, Zwaigenbaum L, Roberts W, Mirenda P, Bennett T, Elsabbagh M, Georgiades S. Behavioral Pediatrics Feeding Assessment Scale in Young Children With Autism Spectrum Disorder: Psychometrics and Associations With Child and Parent Variables. J Pediatr Psychol. 2015 Jul;40(6):581-90. doi: 10.1093/jpepsy/jsv006. Epub 2015 Feb 27. PMID: 25725217; PMCID: PMC4469918.

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Archibald, T., & Bryant-Waugh, R. (2023). Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions. JCPP Advances, e12160.

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Brigham KS, Manzo LD, Eddy KT, Thomas JJ. Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents. Curr Pediatr Rep. 2018 Jun;6(2):107-113. doi: 10.1007/s40124-018-0162-y. Epub 2018 Apr 16. PMID: 31134139; PMCID: PMC6534269.

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Bryant-Waugh R. Avoidant restrictive food intake disorder: an illustrative case example. Int J Eat Disord. 2013 Jul;46(5):420-3. doi: 10.1002/eat.22093. PMID: 23658083.

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Bryant-Waugh, R. Thomas, Micali, Cooke, Eddy (June, 2017) Assessment of Avoidant/Restrictive Food Intake Disorder across the Lifespan: Join the PARDI! Paper presented at the meeting of the Academy for Eating Disorders, Prague, Czech Republic.

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Burton Murray H, Becker KR, Harshman S, Breithaupt L, Kuhnle M, Dreier MJ, Hauser K, Freizinger M, Eddy KT, Misra M, Kuo B, Micali N, Thomas JJ, Lawson EA. Elevated Fasting Satiety-Promoting Cholecystokinin (CCK) in Avoidant/Restrictive Food Intake Disorder Compared to Healthy Controls. J Clin Psychiatry. 2022 Jul 11;83(5):21m14111. doi: 10.4088/JCP.21m14111. PMID: 35830620; PMCID: PMC9801687.

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Burton Murray H, Dreier MJ, Zickgraf HF, Becker KR, Breithaupt L, Eddy KT, Thomas JJ. Validation of the nine item ARFID screen (NIAS) subscales for distinguishing ARFID presentations and screening for ARFID. Int J Eat Disord. 2021 Oct;54(10):1782-1792. doi: 10.1002/eat.23520. Epub 2021 Apr 22. PMID: 33884646; PMCID: PMC8492485.

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Cardona Cano S, Hoek HW, Bryant-Waugh R. Picky eating: the current state of research. Curr Opin Psychiatry. 2015 Nov;28(6):448-54. doi: 10.1097/YCO.0000000000000194. PMID: 26382157.

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Crist W, Napier-Phillips A. Mealtime behaviors of young children: a comparison of normative and clinical data. J Dev Behav Pediatr. 2001 Oct;22(5):279-86. doi: 10.1097/00004703-200110000-00001. PMID: 11718230.

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Eddy, K.T., Thomas, J.J., Hastings, E., Edkins, K., Lamont, E., Nevins, C.M., Patterson, R.M., Murray, H.B., Bryant-Waugh, R., & Becker, A.E. (2015). Prevalence of DSM-5 Avoidant/Restrictive Food Intake Disorder in a Pediatric Gastroenterology Healthcare Network. International Journal of Eating Disorders 48(5), 464-470.

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Fishbein M, Cox S, Swenny C, Mogren C, Walbert L, Fraker C. Food chaining: a systematic approach for the treatment of children with feeding aversion. Nutr Clin Pract. 2006 Apr;21(2):182-4. doi: 10.1177/0115426506021002182. PMID: 16556929.

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Fitzpatrick, K.K., Forsberg, S.E. & Colborn, D. (2015). Family-Based Therapy for Avoidant Restrictive Food Intake Disorder. Loeb, LeGrange &Lock (Ed.), Family Therapy for Adolescent Eating and Weight Disorders (pp. 256-276). New York, NY: Routledge.

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Lesser, J., Eckhardt, S., Ehrenreich-May, J. & Le Grange, D. (June, 2017) Integrating Family Based Treatment with the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A novel treatment for Avoidant Restrictive Food Intake Disorder. Paper presented at the meeting of the Academy for Eating Disorders, Prague, Czech Republic.

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Esposito M, Mirizzi P, Fadda R, Pirollo C, Ricciardi O, Mazza M, Valenti M. Food Selectivity in Children with Autism: Guidelines for Assessment and Clinical Interventions. Int J Environ Res Public Health. 2023 Mar 14;20(6):5092. doi: 10.3390/ijerph20065092. PMID: 36982001; PMCID: PMC10048794.

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Lock, J.D. (2021). Family-Based Treatment for Avoidant/Restrictive Food Intake Disorder (1st ed.). Routledge. https://doi.org/10.4324/9781003042020

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Murphy, J., & Zlomke, K. R. (2016). A behavioral parent-training intervention for a child with avoidant/restrictive food intake disorder. Clinical Practice in Pediatric Psychology, 4(1), 23–34. https://doi.org/10.1037/cpp0000128

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Nicely TA, Lane-Loney S, Masciulli E, Hollenbeak CS, Ornstein RM. Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day treatment for eating disorders. J Eat Disord. 2014 Aug 2;2(1):21. doi: 10.1186/s40337-014-0021-3. PMID: 25165558; PMCID: PMC4145233.

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Norris ML, Spettigue WJ, Katzman DK. Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatr Dis Treat. 2016 Jan 19;12:213-8. doi: 10.2147/NDT.S82538. PMID: 26855577; PMCID: PMC4725687.

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Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395. http://dx.doi.org/10.1037/0022-006X.51.3.390

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Remington, A., Añez, E., Croker, H., Wardle, J., & Cooke, L. (2012). Increasing food acceptance in the home setting: A randomized controlled trial of parent-administered taste exposure with incentives. American Journal of Clinical Nutrition, 95(1), 72–77. https://doi.org/10.3945/ajcn.111.024596

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Sharp WG, Burrell TL, Jaquess DL. The Autism MEAL Plan: a parent-training curriculum to manage eating aversions and low intake among children with autism. Autism. 2014 Aug;18(6):712-22. doi: 10.1177/1362361313489190. Epub 2013 Oct 7. PMID: 24101716.

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Sharp WG, Stubbs KH, Adams H, Wells BM, Lesack RS, Criado KK, Simon EL, McCracken CE, West LL, Scahill LD. Intensive, Manual-based Intervention for Pediatric Feeding Disorders: Results From a Randomized Pilot Trial. J Pediatr Gastroenterol Nutr. 2016 Apr;62(4):658-63. doi: 10.1097/MPG.0000000000001043. PMID: 26628445.

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Tanner AB, Richmond TK. Assessing growth in children and adolescents with Avoidant/Restrictive Food Intake Disorder. J Eat Disord. 2024 Jun 14;12(1):82. doi: 10.1186/s40337-024-01034-8. PMID: 38877582; PMCID: PMC11177361.

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Thomas, J., & Eddy, K. (2018). Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder. In Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults (p.I). Cambridge: Cambridge University Press.

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Thomas, J. J., Eddy, K. T. & Becker, K. R. Presentation at ICED 2017. Cognitive-Behavioral Therapy for Avoidant Restrictive Food Intake Disorder: CBT-AR, Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Department of Psychology (Psychiatry), Harvard Medical School.

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Thomas, J.J., Wons OB, Eddy KT. Cognitive-behavioral treatment of avoidant/restrictive food intake disorder. Curr Opin Psychiatry. 2018 Nov;31(6):425-430. doi: 10.1097/YCO.0000000000000454. PMID: 30102641; PMCID: PMC6235623.

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Zucker N, Copeland W, Franz L, Carpenter K, Keeling L, Angold A, Egger H. Psychological and Psychosocial Impairment in Preschoolers with Selective Eating. Pediatrics. 2015 Sep;136(3):e582-90. doi: 10.1542/peds.2014-2386. Epub 2015 Aug 3. PMID: 26240213; PMCID: PMC4552088.

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 What is new in ARFID Treatment (2025)

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James RM, O'Shea J, Micali N, Russell SJ, Hudson LD. Physical health complications in children and young people with avoidant restrictive food intake disorder (ARFID): a systematic review and meta-analysis. BMJ Paediatr Open. 2024;8(1):e002595. Published 2024 Jul 8. doi:10.1136/bmjpo-2024-002595 https://pmc.ncbi.nlm.nih.gov/articles/PMC11261741/

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Jhe GB, Chad-Friedman E, Eldredge O, et al. Weight/Shape concerns in youth with Avoidant/Restrictive Food Intake Disorder (ARFID). Eat Disord. 2025;33(5):651-665. doi:10.1080/10640266.2024.2404788

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Karvay Y. Considering a Functional Conceptualisation of Avoidant/Restrictive Food Intake Disorder (ARFID): A Systematic Scoping Review of Emerging Evidence on ARFID. Eur Eat Disord Rev. 2025;33(4):730-750. doi:10.1002/erv.3180

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Kambanis PE, Thomas JJ. Advancing the Science of Avoidant/Restrictive Food Intake Disorder (ARFID): Six Key Questions. Int J Eat Disord. 2025;58(6):1001-1007. doi:10.1002/eat.24418 https://pmc.ncbi.nlm.nih.gov/articles/PMC12264816/

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Mikhael-Moussa H, Bertrand V, Lejeune E, et al. The Association of Avoidant/Restrictive Food Intake Disorder (ARFID) and Neurogastroenterology Disorders (Including Disorders of Gut-Brain Interaction [DGBI]): A Scoping Review. Neurogastroenterol Motil. 2025;37(9):e70039. doi:10.1111/nmo.70039 https://pmc.ncbi.nlm.nih.gov/articles/PMC12351358/

 

​​Thomas JJ, Holsen L, Van De Water AL, et al. Neural Response to Food Cues in Avoidant/Restrictive Food Intake Disorder. JAMA Netw Open. 2025;8(2):e2460101. Published 2025 Feb 3. doi:10.1001/jamanetworkopen.2024.60101 https://pmc.ncbi.nlm.nih.gov/articles/PMC11836757/

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Trujillo-ChiVacuán E. Beyond Western Frameworks: Rethinking ARFID Diagnosis and Treatment-Lessons From Latin America. Int J Eat Disord. 2025;58(6):1036-1038. doi:10.1002/eat.24422

 

Willmott E, Dickinson R, Hall C, et al. A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder (ARFID). Int J Eat Disord. 2024;57(1):27-61. doi:10.1002/eat.24073

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ARFID treatment for people with Autism/ADHD

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Bourne L, Mandy W, Bryant-Waugh R. Avoidant/restrictive food intake disorder and severe food selectivity in children and young people with autism: A scoping review. Dev Med Child Neurol. 2022;64(6):691-700. doi:10.1111/dmcn.15139 https://onlinelibrary.wiley.com/doi/10.1111/dmcn.15139

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Burrell TL, Scahill L, Nuhu N, Gillespie S, Sharp W. Exploration of Treatment Response in Parent Training for Children with Autism Spectrum Disorder and Moderate Food Selectivity. J Autism Dev Disord. 2023;53(1):229-235. doi:10.1007/s10803-021-05406-w

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Cobbaert L, Millichamp AR, Elwyn R, et al. Neurodivergence, intersectionality, and eating disorders: a lived experience-led narrative review. J Eat Disord. 2024;12(1):187. Published 2024 Nov 20. doi:10.1186/s40337-024-01126-5 https://pubmed.ncbi.nlm.nih.gov/39568093/

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Farag F, Sims A, Strudwick K, et al. Avoidant/restrictive food intake disorder and autism spectrum disorder: clinical implications for assessment and management. Dev Med Child Neurol. 2022;64(2):176-182. doi:10.1111/dmcn.14977 https://onlinelibrary.wiley.com/doi/10.1111/dmcn.14977

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Keski-Rahkonen A, Ruusunen A. Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome. Curr Opin Psychiatry. 2023;36(6):438-442. doi:10.1097/YCO.0000000000000896

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Sader M, Weston A, Buchan K, et al. The Co-Occurrence of Autism and Avoidant/Restrictive Food Intake Disorder (ARFID): A Prevalence-Based Meta-Analysis. Int J Eat Disord. 2025;58(3):473-488. doi:10.1002/eat.24369 https://pmc.ncbi.nlm.nih.gov/articles/PMC11891632/

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Schimansky S, Jasim H, Pope L, et al. Nutritional blindness from avoidant-restrictive food intake disorder - recommendations for the early diagnosis and multidisciplinary management of children at risk from restrictive eating. Arch Dis Child. 2024;109(3):181-187. Published 2024 Feb 19. doi:10.1136/archdischild-2022-325189

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Sharp WG, Burrell TL, Berry RC, et al. The Autism Managing Eating Aversions and Limited Variety Plan vs Parent Education: A Randomized Clinical Trial. J Pediatr. 2019;211:185-192.e1. doi:10.1016/j.jpeds.2019.03.046 https://pmc.ncbi.nlm.nih.gov/articles/PMC6661002/

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ARFID vs specific phobia diagnosis (ex. fear of throwing up - Emetophobia)

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Dosanjh S, Fleisher W, Sam D. I think I'm Going to be Sick: An Eight-Year-Old Boy with Emetophobia and Secondary Food Restriction. J Can Acad Child Adolesc Psychiatry. 2017;26(2):104-109. https://pmc.ncbi.nlm.nih.gov/articles/PMC5510939/

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Gianneschi JR, Washington KA, Nicholas J, et al. Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder. Int J Eat Disord. 2024;57(12):2329-2340. doi:10.1002/eat.24303 https://pmc.ncbi.nlm.nih.gov/articles/PMC12208279/

 

Maertens C, Couturier J, Grant C, Johnson N. Fear of Vomiting and Low Body Weight in Two Pediatric Patients: Diagnostic Challenges. J Can Acad Child Adolesc Psychiatry. 2017;26(1):59-61. https://pmc.ncbi.nlm.nih.gov/articles/PMC5349284/

 

Veale D, Costa A, Murphy P, Ellison N. Abnormal eating behaviour in people with a specific phobia of vomiting (emetophobia). Eur Eat Disord Rev. 2012;20(5):414-418. doi:10.1002/erv.1159

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Zickgraf HF, Loftus P, Gibbons B, Cohen LC, Hunt MG. "If I could survive without eating, it would be a huge relief": Development and initial validation of the Fear of Food Questionnaire. Appetite. 2022;169:105808. doi:10.1016/j.appet.2021.105808

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Zickgraf HF, Murray HB, Rigby A. Avoidant/Restrictive Food Intake Disorder Symptoms are Common and Impairing in Adults With Specific Phobia of Vomiting: An Exploratory Study in an Understudied Population. Psychol Rep. Published online April 21, 2025. doi:10.1177/00332941251330531

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