Food selectivity and other feeding problems are endemic in children with autism spectrum disorders (ASD). Additionally, many of the challenging behaviors which fall into this category are idiosyncratic to ASD. A technology is beginning to emerge regarding methods to lessen and effectively treat these issues which, if unchecked, can result in poor nutrition and difficulties in feeding. Specificity in foods consumed, choking, and aggression associated with food refusal can put the child and caregiver at risk. This paper provides a critical review of the current status of evidence-based clinical practices for this highly important set of challenging behaviors of ASD children.