Mealtime Behaviours of Young Children with Sensory Food Aversions: An Observational Study

Introduction: Children with sensory food aversions (SFAs) are at risk for nutritional problems and occupational dysfunction during daily meals. To facilitate optimal occupational performance for children with SFAs, it is critical that clinicians understand child behaviour and caregiver strategy use to manage child behaviour during meals. The purpose of this paper is to examine the reliability of a novel coding scheme, the Behavioural Mealtime Coding System (BMCS) and identify associations among child acceptance of preferred and targeted foods, child food exploration and caregiver use of strategies to manage child behaviour.

Methods: Twenty-one children (aged 18-60 months) with SFAs and their caregivers were recruited using a convenience sample. An observational video coding system was developed to code mealtime behaviour in 63 typical mealtime videos recorded by caregivers in the home environment. Inter-rater reliability, descriptive statistics and bivariate correlations were calculated.

Results: The BMCS demonstrated excellent inter-rater reliability (ICC = .95). Child bites of targeted foods were associated with mealtime duration (r  = .51, p = .02) and events of the child licking food (r  = .57, p = .007). Caregiver use of threats was positively associated with child age (r  = .48, p = .03) and negatively associated with caregiver education level (r  = -.49, p = .03).

Conclusion: For children with SFAs, increasing mealtime duration by embedding positive activities to encourage food exploration may improve acceptance of healthy targeted foods. Future research is needed to better understand the complex relationships among caregiver strategy use, mealtime duration and child mealtime behaviour.