Picky Eater or Selective Eater? Signs to Look For

Is your child just picky, or is something more going on? Ben Sarcia, BCBA, Director of Healthy Beginnings, explains the difference between picky eating and food selectivity and how understanding that distinction can help families know when to seek support.

When we talk about feeding challenges, I’m not a fan of the word “picky.” Picky makes it sound like everything is normal—when for many kids, there is a real clinical issue going on.

Yes, everyone has food preferences! And it’s completely typical for kids between ages two and ten to be unsure about new or unfamiliar foods. A picky eater might need a little encouragement or maybe the promise of a favorite treat, but they can try something new.

Kids (and adults!) can be picky, or they can have more serious struggles with eating. For this post, I’ll focus on children.

So, what’s the difference between pickiness and food selectivity?

Food selectivity is a clinical concern and may come with a diagnosis, such as avoidant restrictive food intake disorder (ARFID). It can look like cutting out whole food groups, insisting on a specific brand, or needing a drink in the exact same cup every time. Sometimes foods get dropped from a child’s diet over time for no clear reason. Other times, there is a reason—maybe an illness or a scary event like choking or an allergic reaction.

Selectivity is also common in autism because many children show a strong need for sameness. For example, a child might only eat McDonald’s french fries, and they must come in the red carton with the golden arches, not the white pouch from the kid’s meal.

A child doesn’t have to show all of these signs, but when mealtime patterns limit the amount or variety of food and drink a child can have, it becomes a real concern.

Another important term is “food refusal.” This is when a child refuses food (and sometimes drinks) completely. They may depend on nutrition shakes or even a feeding tube to stay healthy. Because of that, treating total refusal can sometimes be even more complex than helping a child expand foods when selectivity is present.

As behavior analysts, we work closely with medical providers and speech-language pathologists to create a plan. We look at behavioral barriers, the child’s eating and drinking skills, and whether a medical issue is getting in the way.

This teamwork matters! What looks like selectivity today might have started because of a past—or current—medical problem. With the right comprehensive support, children can make amazing progress. And the goal? To one day be able to call them “picky.” Because having preferences is something we can all relate to!