Research Summary: The relationship between mealtime behaviour problems and family stress

Research Summary: The relationship between mealtime behaviour problems and family stress

by Victoria Stables

What you need to know: Behaviour problems around mealtime occur more often and produce more stress in families with children with ASD. Selective, picky eaters did not add to stress, but influenced the food choices that the entire family would eat.

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What is the research about?

Children with Autism Spectrum Disorder (ASD) are known to be pickier or more selective eaters than children without ASD. They will often eat only certain foods and refuse to eat other foods. In addition, parents report that children with ASD display many problematic behaviours at mealtimes such as crying, throwing food, refusing to sit, and refusing to eat. This may have consequences to the child’s nutritional health. This study investigated whether the families of children with ASD had more mealtime problems than families with typically-developing (TD) children. Further, this study compared mealtime parental stress levels and if food selectivity contributed to their stress.What did the researchers do?

Fifty-three children with ASD and fifty-eight TD peers from 3 to 11 years old were recruited via community programs, online postings, existing databases, and numerous autism support organizations. The researchers used parent self-report questionnaires from a modified version of the Youth/Adolescent Food Frequency Questionnaire (YAQ). Researchers first asked whether parents felt particularly stressed during family meals and if their child had more behaviour problems at those times. Second, the researchers measured how much children ate, what they liked to eat, if they refused food, and parental stress to see whether selective or ‘picky’ eaters also had more behaviour challenges and increased parental stress.

What did the researchers find?

The researchers found that parents of children with ASD did indeed report more mealtime stress and behavior problems compared to parents of their TD peers. Also, children with ASD who are selective or ‘picky’ eaters tended to display the most problematic behaviors at meals. Surprisingly, however, ‘picky’ eaters did not increase parent’s stress levels beyond the frustration and stress ASD parents already feel at mealtimes. The study also found that children with ASD have a strong impact on what food other family members ate. Food served at mealtimes is often dictated by what the child with ASD in the family would eat.

How can you use this research?

The results of the study show that meals are stressful times for families with children with and without ASD. What is important now is to find ways to reduce the frustration and stress parents feel at mealtime through parent or family based interventions or good treatment options. More research, however, is needed to figure out better ways to help ‘picky’ eaters to eat different types of foods.

About the Researchers

Carol Curtin (PhD) is an associate director of the UMMS University of Massachusetts Eunice Kennedy Shriver Center. Linda Bandini (PhD) is a professor and Director of the Nutrition Program at UMMS. Sarah E. Anderson (PhD) is an associate professor at Ohio State University in the Department of Epidemiology. Eric Mick (ScD) is an associate professor at UMMS in the Department of Quantitative Health Sciences. Aviva Must (PhD) is the Dean of Public Health and Professional Degree Programs at Tufts University. Kristie Hubbard (PhD, MPH, RD) is a dietitian and Instructor in the Department of Public Health and Community Medicine at Tufts University.

Citation: Curtin, C., Hubbard, K., Anderson, S., Mick, E., Must, A., & Bandini, L. (2015). Food Selectivity, Mealtime Behavior Problems, Spousal Stress and Family Food Choices in Children with and without Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45 (10), 3308-3315.

About the Chair

The Chair in Autism Spectrum Disorders Treatment and Care Research is dedicated to studying ways to improve the mental health and well-being of people with Autism Spectrum Disorders (ASD) and their families in Canada.

The Chair is funded by the Canadian Institutes of Health Research in partnership with Autism Speaks Canada, the Canadian Autism Spectrum Disorders Alliance, Health Canada, NeuroDevNet and the Sinneave Family Foundation. Additional support is provided by York University.

For more information, visit the Chair in Autism Spectrum Disorders Treatment and Care Research website at