Parental Attitudes and Behaviors Associated with Selective Eating in Children with Autism Spectrum Disorders

Although sometimes it appears as a natural behavior in children, selective eating can become problematic and severe, implying aliments rejection, a low range of eaten foods, the predominance of some foods in the child’s repertoire, aversion and avoidance of various food based on look, taste, texture, or smell. Consequences of selective eating can be noticed on health and development, interactions and inclusion in social settings, emotional and behavioral problems, low self-esteem, distress, and other family problems. In children with autism spectrum disorders (ASD), it can be associated with sensory processing disorder, mood disorders, and health problems, and can become severe (eg., avoidant restrictive food intake disorder). Parental attitudes and behaviors, family dynamics during mealtimes, the emotional climate of the family, social support, and cultural and social factors have a significant impact on the problem. A case example of a 13-year-old child, diagnosed with severe autism spectrum disorder and intellectual disability, with selective eating (a low variety of foods in his menu, food refusal, and behavioral interference during mealtimes) and a tendency towards overweight will show the co-occurrence of selective eating and parental problematic behaviors. The child’s sensory profile (reported by the parent) revealed no differences from the norms. Parental tendency to overly gratify the child’s behavior, excessive worrying, and excessive assistance were associated with the child’s tendency to eat selectively, as well as to his preference for unhealthy foods and refusal of healthy ones. The attachment between mother and child seems to be anxious and there is a high degree of fusion in the relationship. Intervention for the eating problems can include attachment-based therapies, systemic family therapy, cognitive-behavioral therapies, and training of parenting skills.