Insights into Family Meals from the Perspective of Children on the Spectrum

Background: Although mealtimes and children’s eating patterns are often the focus of autism research, there have been few efforts to understand mealtimes from the child’s perspective. In general, the voices of children with autism remain largely absent from research regarding autism (Milton & Bracher, 2013).

Objectives: The first goal of this study was to have a better understanding of family meals by analyzing the perspectives of children on the autism spectrum. The second goal was to evaluate the qualitative interview procedures.

Methods: This study is part of a larger study of family meals and autism. Interviews were conducted with 16 children whose parents had identified as having autism. Parents were recruited for the larger study using opportunistic sampling (Miles & Huberman, 1994). Children ranged in age from 5 to 14. The interview consisted of four components: reaction to video recording from their family meal (recorded in the larger study); interview based on semi-structured questions; interview based on using art supplies and figurines; and child-directed interviewing. The data were analyzed using thematic (Braun, Clarke, & Terry, 2014). Although the analysis primarily relied on the child interviews, parent interviews and mealtime observations were used from the larger study to provide context for their statements.

Results: Three themes were identified: special relationships, the importance of conversation, and being challenged by new food. Children often identified a specific person in the family to whom they had a special connection or relied on for support. Although these special relationships were not mentioned as such during the interviews with mothers from the larger study, they could be observed (especially in terms of help-seeking behavior from the mealtime observations). Important conversations were described by the children as something that made them feel closer to their families and part of the family unit. This was regardless of the degree of participation in the conversation, for example, a child explained what he enjoyed about family meals as “Just talking to her [his mother]. I don’t do much but just talking to her.” The third theme, being challenged by new food, was the topic that elicited the most emotional language from the children. Words like nervous and anxious were used to describe how they felt about being exposed to new foods.

Conclusions: This research highlights the difficulty of qualitatively interpreting the interviews of children on the autism spectrum, but suggests that they can provide valuable insights into their experience of family life. Further research can explore how to incorporate their perspectives into research on families and autism. By in large, the interview techniques we used were successful in eliciting some mealtime oriented conversation; however, it would have been difficult to establish the trustworthiness of the findings based solely on the child interviews. This research can inform mealtime based interventions for children with autism as well as education programs for parents of children on the spectrum.