Child Eating Behaviors and Caregiver Feeding Practices in Children with Autism Spectrum Disorders.

OBJECTIVE: This pilot study compared children with autism spectrum disorders (ASD) and typically developing children (TDC) on weight-related outcomes and caregiver-reported child eating behaviors and feeding practices. DESIGN AND SAMPLE: Cross-sectional study. Caregivers of 25 children with ASD and 30 TDC, ages 4-6. METHODS: Caregivers completed validated questionnaires that assessed child eating behaviors and feeding practices. Children's height, weight, and waist circumference were measured. RESULTS: Children with ASD, when compared to TDC, showed significantly greater abdominal waist circumferences (p = .01) and waist-to-height ratios (p < .001). Children with ASD with atypical oral sensory sensitivity exhibited greater food avoidance behaviors, including reluctance to eat novel foods (p = .004), being selective about the range of foods they accept (p = .03), and undereating due to negative emotions (p = .02), than children with ASD with typical oral sensory sensitivity. Caregivers of children with ASD with atypical oral sensory sensitivity reported using food to regulate negative child emotions to a greater extent than caregivers of children with typical oral sensory sensitivity (p = .02). DISCUSSION: Children with ASD, especially those with atypical oral sensory sensitivity, are at increased risk for food avoidance behaviors and may require additional support in several feeding domains.

Role of child weight status and the relative reinforcing value of food in children's response to portion size increases.

OBJECTIVE: Food portion size is an important determinant of intake in children. It remains unknown if children's weight status and relative reinforcing value of food (RRVF) interact with portion size to affect intake. METHODS: In a randomized crossover design, 25 normal-weight and 25 obese children, ages 8-10 years, consumed dinner once a week for 3 weeks. At each dinner, the same meal was served, but the portion size of all foods (chicken nuggets, hash browns, ketchup, green beans, brownies) and a sugar-sweetened beverage (fruit punch) varied across conditions (100, 150, and 200%). Children's RRVF was assessed using a behavioral choice task. RESULTS: There was a significant main effect of portion size condition (P = 0.003) and weight status (P = 0.0005) and a nonsignificant trend for a portion size-by-weight status interaction (P = 0.108) on intake. Mean intakes across conditions (100, 150, and 200%) were 801 ± 57, 964 ± 58, and 873 ± 57 kcal for normal-weight children and 1041 ± 57, 1129 ± 57, and 1210 ± 57 kcal for obese children, respectively. Neither the main effect of RRVF status nor the condition-by-RRVF status interaction was significant (P > 0.48). CONCLUSIONS: Environments that offer large portions of palatable foods affect all children's intake irrespective of their weight status or how reinforcing they find food to be.