Susana R Patton1, Cathleen Odar Stough2, Teresa Y Pan3, Lauren O Holcomb4, Meredith L Dreyer Gillette5. 1. Nemours Children's Specialty Clinic, 807 Children's Way, Jacksonville, FL, 32207, United States. Electronic address: Susana.patton@nemours.org. 2. Department of Psychology, College of Arts and Sciences, University of Cincinnati, P.O. Box 210376, Cincinnati, OH, 45221-0376, United States. Electronic address: odarcc@ucmail.uc.edu. 3. VA San Diego Healthcare System/University of California, San Diego, 3350 La Jolla Village Dr (116B), San Diego, CA, 92161, United States. Electronic address: teresa.pan@va.gov. 4. Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, United States. Electronic address: Lholcomb@kumc.edu. 5. Developmental and Behavioral Health/Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Associate Professor of Pediatrics, University of Missouri Kansas City School of Medicine, 2401 Gillham Rd., Kansas City, MO, 64108, United States. Electronic address: mldreyer@cmh.edu.
Abstract
BACKGROUND: Feeding problems are common in children with Autism Spectrum Disorder (ASD), and there are associations between parent reports of child ASD symptom severity and feeding problems. The current study further explores this association between ASD severity and family mealtime behaviors using directly observed naturalistic mealtime interactions. METHODS AND PROCEDURES: Seventy-three children (Mage = 5.42 years) were presented an unfamiliar food during a videotaped but otherwise typical home meal. Mealtime behavior was assessed through coding of the videotaped meal using the Dyadic Interaction Nomenclature for Eating (DINE) and parent report (Brief ASD Mealtime Behavior Inventory; BAMBI). ASD severity was assessed with the clinician-completed Childhood Autism Rating Scale-Second Edition (CARS-2). OUTCOMES AND RESULTS: Greater ASD severity was associated with fewer bites of the unfamiliar food, greater disruptive behavior during meals, and greater parental commands to take bites during meals. We found negative associations between limited food variety and food refusal (BAMBI subscales) and child bites of the unfamiliar food, with higher levels of limited food variety and food refusal associated with fewer bites of the unfamiliar food. CONCLUSIONS AND IMPLICATIONS: Children with more severe ASD may eat less and be more disruptive during meals, despite parent redirection. We also found associations between the BAMBI and DINE which suggest the BAMBI may be a sensitive measure of mealtime behaviors such as food flexibility and food refusal.
BACKGROUND: Feeding problems are common in children with Autism Spectrum Disorder (ASD), and there are associations between parent reports of child ASD symptom severity and feeding problems. The current study further explores this association between ASD severity and family mealtime behaviors using directly observed naturalistic mealtime interactions. METHODS AND PROCEDURES: Seventy-three children (Mage = 5.42 years) were presented an unfamiliar food during a videotaped but otherwise typical home meal. Mealtime behavior was assessed through coding of the videotaped meal using the Dyadic Interaction Nomenclature for Eating (DINE) and parent report (Brief ASD Mealtime Behavior Inventory; BAMBI). ASD severity was assessed with the clinician-completed Childhood Autism Rating Scale-Second Edition (CARS-2). OUTCOMES AND RESULTS: Greater ASD severity was associated with fewer bites of the unfamiliar food, greater disruptive behavior during meals, and greater parental commands to take bites during meals. We found negative associations between limited food variety and food refusal (BAMBI subscales) and child bites of the unfamiliar food, with higher levels of limited food variety and food refusal associated with fewer bites of the unfamiliar food. CONCLUSIONS AND IMPLICATIONS: Children with more severe ASD may eat less and be more disruptive during meals, despite parent redirection. We also found associations between the BAMBI and DINE which suggest the BAMBI may be a sensitive measure of mealtime behaviors such as food flexibility and food refusal.
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