Parent-Child Interaction in Families of Children with Autism: Analysis across Mealtime and Play Contexts

Background: Children with autism spectrum disorder (ASD) often display behaviors such as food selectivity, mealtime rigidity, food refusal, and disruptive mealtime behaviors that can significantly disrupt family mealtime. These behaviors and the ways in which caregivers respond to them have been shown to greatly influence the quality of the parent-child interaction and the overall mealtime experience for families. The playtime experience is also influenced by symptoms of ASD. Specifically, children with ASD are less likely to participate in pretend play and demonstrate decreased social engagement during play. As dyadic interaction is a central component to playtime and mealtime experiences for young children, it is important to examine the impact of these contexts on the dyad and on each individual.

Objectives: The purpose of this study was to compare the differences of parent-child interaction during the mealtime and playtime contexts.

Methods: A repeated measures design was used to identify and compare the characteristics of the parent-child interaction in parent-child dyads across two contexts: playtime and mealtime. Seventeen children with ASD ages 2-7 years participated in a playtime and mealtime observation using preferred food with their primary caregiver. The interactions were video recorded and coded using the Parent-Child Early Relational Assessment. The Parent-Child Early Relational Assessment is designed to measure quality of affect and behavior during a five-minute face-to-face parent-child interaction. The parent, child, dyad, and total scores were compared across playtime and mealtime contexts using related samples t-tests.

Results: Parent and dyad scores were significantly higher (p<.05) in the playtime context compared to mealtime with a large effect size, indicating more positive interactions during playtime and more negative interactions during mealtime. Child scores were not significantly different across contexts.

Conclusions: Children with ASD display consistent behaviors across the playtime and mealtime contexts. However, parents displayed significantly more positive affect and behavior during playtime as compared to more negative affect and behavior during the mealtime context. This difference in parent scores suggests that context influences parent affect and behavior, thereby impacting their overall interaction with their child. The majority of previous research and interventions has focused on the behavior of children with ASD during mealtime, however our results suggest that the parents’ behavior and affect also contributes to the difficult mealtime experience. Interventions focused on mealtime for children with ASD should include the parent as well as the child, as context influences this dyadic interaction and mealtime context. When designing interventions focusing on improving the mealtime experience for children with ASD, providing parent support and strategies are important methods to improve the overall family experience and potentially child eating behaviors.