OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT

• Published in: Infant mental health journal 2018-07, Vol.39 (4), p.410-422
• Main Authors: Aldridge, Victoria K., Dovey, Terence M., El Hawi, Nicole, Martiniuc, Antonie, Martin, Clarissa I., Meyer, Caroline
• Format: Article
• Language: English
• ISSN: 0163-9641; 1097-0355
• DOI: 10.1002/imhj.21722

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from “normal” to “abnormal,” with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape‐maintained behaviors will lead to underrecognition of families in need of clinical support. Objetivos : A pesar del ampliamente conocido uso de las observaciones de comportamiento para evaluar las conductas de alimentación del niño en la investigación y la práctica clínica, pocos estudios han caracterizado comprensivamente las horas de comidas o identificado características que marcan diferencias entre niños con y sin una alimentación desorganizada; estos fueron los propósitos del presente estudio. Métodos : Las observaciones al momento de la comida se llevaron a cabo con 18 niños con Trastorno de Evitar/Restringir el Ingerir Comida (ARFID) y 21 niños con un desarrollo típico. Las observaciones fueron codificadas inductivamente, y se examinaron asociaciones entre el trastorno y las acciones observadas al momento de la comida. Resultados : La mayoría de los comportamientos fueron observados a través de los momentos de comida tanto clínicos como no clínicos, y muchos no difirieron en cuanto a la frecuencia entre niños con o sin ARFID. Sin embargo, se observaron significativas diferencias de grupo en las frecuencias de comportamiento en