Parent Feeding Practices of Picky-Eating Children with and without Autism Spectrum Disorder

Background:  “Picky eating” children with and without autism spectrum disorders (ASD) often exhibit a variety of eating problems (e.g., sensory sensitivity to the taste, texture, smell, or temperature of food) as well as a variety of mealtime problem behaviors (e.g., food refusal, aggression, and self-injurious behaviors). The feeding practices and parenting stress of parents of children with ASD, feeding disorders, or with typical development are not commonly studied in relation to each other. Several studies have found that parents may vary how they feed their child based on certain characteristics or behaviors of their child. For example, parent feeding practices such as providing specially tailored meals (e.g., pureeing foods, serving semi-liquid foods), providing preferred snack foods, being more controlling and coercive, providing a large variety of fruits and vegetables, using verbal positive persuasion, limiting snacks, or reducing fats were found to vary in relation to certain behaviors or characteristics of the child (e.g., having a texture sensitivity to food, feeding problems, or a diagnosis of ASD). Parents of children with developmental disabilities report helping and supervising during mealtime to be the most stressful parenting task. Further, parents of children with a diagnosis of ASD in combination with a behavior disorder report greater parenting stress than parents of children only diagnosed with an ASD, a behavior disorder, or who are typically developing. 

Objectives:  There is little research available examining how parent feeding practices may differ based on the interaction between characteristics/behaviors of the child and parenting stress experienced. Therefore, the purpose of the current study was to investigate differences in parent feeding practices based on parenting stress and child characteristics. 

Methods:  Variables were split into two levels based on respective grand means or clinical significance. Two-way factorial ANOVA’s were used to analyze differences in 9 types of parent feeding practices based on interactions between different levels of parenting stress and characteristics of the child. 

Results:  Parents of children with and without an ASD with high sensory sensitivity to food were more likely to use verbal positive persuasion at mealtime (p<.05) compared to parents of children with low sensory sensitivity to food. Parents were more likely to provide many food choices and insist on eating if their child was typically developing compared to having a child with ASD (p’s<.05). Several interaction effects were significant.  For typically developing children, parents were more likely to limit snacks and reduce fats if their child had more mealtime problem behaviors. In contrast, parents of children with ASD were more likely to limit snacks or reduce fats if their child had less mealtime problem behavior (p’s<.05). 

Conclusions:  Overall, it appears that parent feeding practices do differ based on level of parenting stress and certain characteristics of their child.  Implications will be discussed.