Parental Mealtime Practices in Children with Autism Spectrum Disorder: A Comparative Study

Importance Feeding difficulties are highly prevalent among children diagnosed with autism and can significantly affect family well-being. Parental mealtime practices play a critical role in shaping children's eating behaviors, yet their interaction in children diagnosed with autism remains insufficiently understood. Objective To examine the associations between children's feeding behaviors and parental mealtime practices in children diagnosed with autism and to compare these practices with those of typically developing (TD) children. Design Cross-sectional comparative study. Setting Pediatric clinic. Participants A total of 187 parents of children aged 2–7 years participated (97 children diagnosed with autism, 90 TD). Outcomes and Measures Autism traits were assessed using the Childhood Autism Rating Scale, feeding behaviors using the Brief Autism Mealtime Behavior Inventory, and parental mealtime practices using the Parent Mealtime Action Scale (PMAS). Results Caregivers of children diagnosed with autism reported significantly different mealtime practices compared with caregivers of TD children. After controlling for child age and BMI, significant group differences were observed for the PMAS subscales Positive Persuasion ( p < .001), Daily Fruit and Vegetable Availability ( p < .001), and Special Meals ( p < .001). Higher levels of autistic traits were associated with greater food refusal ( r = 0.42, p < .001), autism-related mealtime behaviors ( r = 0.30, p = .003), and greater caregiver use of Special Meals ( r = 0.38, p < .001). Conclusions and Relevance Autism traits are associated with feeding difficulties, and parental practices differ between children diagnosed with autism and TD groups. Understanding these relationships is essential for developing family-centered, occupation-based interventions to improve mealtime participation.