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Selective eating is the little studied phenomenon of eating a highly limited range of foods, associated with an unwillingness to try new foods. Common in toddlers, it can persist into middle childhood and adolescence in a small number of children, most commonly boys. When this happens social avoidance, anxiety and conflict can result. This article describes a sample of 20 children with selective eating who presented for help to a specialist eating clinic. We outline the presenting features and associated phenomena for the group, suggest an approach to treatment, and explore from a theoretical point of view where this symptom, disorder or normal variant fits into the spectrum of childhood eating difficulties.