Comparison of Parental Concerns Around Child’s Food Intake Between Children with ASD and Typically Developing Children

Background:  Background: Food selectivity is a common feeding problem in children with autism spectrum disorder (ASD). In previous reports from our Children’s Activity and Mealtimes Patterns (CHAMPS) study we found that children with ASD exhibit more food selectivity and mealtime behavior problems than typically developing (TD) children. Despite the high prevalence of feeding problems among children with ASD, there are few reports about the extent to which parents are concerned about the quality of their child’s diet.

Objectives:  To determine parental concern around eating and diet among children with ASD and TD children.

Methods:  53 children with ASD and 58 TD children between the ages of 3-11 years participated in the CHAMPS study. Parents completed several questionnaires including the Meals In Our Household Questionnaire, which we used to assess parental concern about their child’s nutritional intake. We focused on 8 questions related to diet quality. We dichotomized the 6-tiered response categories into 2 groups as follows: not concerned, a little concerned and somewhat concerned comprised one category (‘Not Concerned’) and the responses of quite concerned, very concerned and extremely concerned comprised the other category (‘Concerned’). Chi square analyses were used to compare the frequency of parental responses between children with ASD and TD children.

Results:  We found that parents of children with ASD were significantly more likely to be concerned than parents of TD children that their child was not eating enough (15% vs 2% p<0.013); eating too much junk food (26% vs 7% p<0.005); eating only a few types of food (57% vs 10% p<0.001); not eating enough vegetables (43% vs 10% p<0.001); and not eating enough fruit (32% vs 2% p<0.001). No significant differences were found in response to questions about eating too much (11%vs 3% p<0.15; eating too much fat (13% vs 7%, p<.27) and eating too much sugar (9% vs 5%, p<.48). We did not observe any significant changes in the findings when these analyses were repeated using logistic regression that adjusted for age and sex.

Conclusions:  These findings suggest that parents of children with ASD have elevated concerns compared to parents of TD children regarding their children’s nutritional status. The findings also support the need for professionals to include inquiries about these concerns when working with parents of children with ASD and to develop and test strategies for parents to promote their children’s healthy eating.