Autism Mealtime Behavior Inventory Research Articles

Level of support/commitment and behavior during mealtime and dental care negatively impact the dental caries prevalence in autistic individuals: cross-sectional study.

To verify whether factors associated with Autism Spectrum Disorder (ASD) would have impact on the dental-caries prevalence. All ASD-individuals receiving care in a specialized center with minimum of 4y old were recruited. Demographic, socioeconomic and behavioral characteristics, level of support/commitment (Childhood Autism Rating Scale), mealtime behavior (Brief Autism Mealtime Behavior Inventory) and medication use were answered by ASD-individual's parents. Behavior during dental care was evaluated from Frankl scale. Dental-caries prevalence was the primary outcome. Three examiners calibrated/trained collected the data. Chi-square test was used to compare the variables impact on the dental-caries prevalence. 61 ASD-individuals were potentially eligible, and the all parents/guardians consent to participate. Dental-caries prevalence was 42.9%, which was statistically associated with lower toothbrushing frequency, higher level of support/commitment, and worse behavior at meals and during in dental care. Dental-caries prevalence was approximately higher twice in ASD-individuals: (i) uncooperative with dental care when compared those cooperative (62% versus 32%, respectively); (ii) with severe level of support when compared to those with mild/moderate level (58% versus 28%, respectively); and (iii) with worse mealtime behavior when compared to those with better behavior (59% versus 28%, respectively). A medium statistical correlation was observed between support level and mealtime behavior (rS=0.39). The BAMBI component statistically associated with dental-caries prevalence was the food refusal (capture problem when a child rejects a presented food, crying, spitting out food). higher required level of support, worse mealtime behavior and uncooperative profile in dental care negatively affect the dental-caries prevalence. our findings provide evidence of the need of specialized, preventive and individualized dental care among ASD-individuals.

Recruitment feasibility and dietary and behavioral patterns in toddlers with ASD: Preliminary results from the Autism Eats program

BackgroundProblematic mealtime behaviors and inadequate diet quality are pressing concerns for children with autism spectrum disorder (ASD). This study aimed to evaluate recruitment feasibility and baseline outcomes of the Autism Eats program for children under 3 years with ASD. MethodsRecruitment feasibility was assessed through reach and participation rates. The Healthy Eating Index (HEI-2015) scores were calculated from 3-day food records. Problematic mealtime behaviors were assessed with the Brief Autism Mealtime Behavior Inventory. Parental feeding practices were assessed using the Child Feeding Questionnaire. Anthropometric measurements of children and parents were taken. Weight-for-length percentiles were calculated based on the CDC growth charts. Descriptive statistics, one-sample t-tests, and Spearman's rho correlations were used for data analysis. ResultsOf the contacted dyads, 74 % agreed to participate. All 51 enrolled dyads completed baseline survey (100 %), and 98 % completed 3-day food records and anthropometric measurements. Significantly higher problematic mealtime behaviors were observed, compared to the reference (e.g., Total score 55.7 vs. 32.5; p < .001). Children with ASD exhibited lower HEI-2015 scores than national data (e.g., Total score 59 vs. 62). A large proportion of the children (29 %) had a weight-for-length ≥ 95th percentile. Several significant associations were found among mealtime behaviors, diet quality, parental feeding practices, and weight status. ConclusionRecruitment was highly feasible, and the findings suggest that early nutrition intervention may hold promise in addressing problematic mealtime behaviors and promoting healthier dietary habits in young children with ASD.Clinical Trial Registration: This trial has been registered at www.ClinicalTrials.gov (NCT05194345).

Clinical Correlates and Prevalence of Food Selectivity in Children with Autism Spectrum Disorder

ObjectiveTo examine clinical correlates and prevalence of food selectivity (FS) – i.e., self-restricted diet, reluctance to try new foods – in children with autism spectrum disorder (ASD) ascertained from a general outpatient autism clinic. Study designA multidisciplinary team (pediatric nurse practitioner, psychologist and dietitian) assessed medical and psychosocial histories and dietary habits in 103 children with ASD (mean age= 5.8 + 2.2 years; range 2-10). Parents rated child mealtime behavior on Brief Autism Mealtime Behavior Inventory (BAMBI) and disruptive behavior on Aberrant Behavior Checklist (ABC). Height and weight measurements were collected. Children were classified as FS or no FS based on parent reported intake and mealtime behavior. A 24-hour dietary recall was used to record intake percentages < 80%. Logistic regression and multivariable modeling were used to evaluate clinical correlates with FS. ResultsOf 103 children, 45.6% (n=47) were classified as FS; 54.4% (n=56) no FS. After adjusting for potential confounders, the odds of FS increased by 1.91 (95% CI: 1.38, 2.64, p<.001) for every half-SD increase in BAMBI total score and by 1.35 (95% CI: 1.05, 1.74, p=.020) for every half-SD increase in ABC Hyperactivity/Noncompliance. No group differences in anthropometrics or nutritional intake were identified. ConclusionsFS in children with ASD was strongly associated with greater severity of disruptive mealtime and hyperactivity/noncompliance behaviors. FS was not associated with anthropometrics or nutritional intake.

Food Selectivity in Children with Autism Spectrum Disorder: A Statistical Analysis in Southern Italy.

This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful rehabilitation treatments to draw on. This research included the parents or caregivers of pediatric patients diagnosed with autism spectrum disorder and placed within a therapeutic clinic. The sample is composed of 111 children, males and females, aged between 2 and 10 years, and includes 60 children diagnosed with autism and 51 children with normotypical development, similar in characteristics but without the disorder. The standardized questionnaire, "Brief Autism Mealtime Behavior Inventory", was developed to examine behavior during meals, especially in children with ASD. The "Brief Sensory Profile", and the "Child Oral and Motor Proficiency Scale", were also administered. The results obtained from the analysis lead to evidence of eating and food selectivity difficulty. Additionally, our study demonstrates that food selectivity can be caused by extreme sensory modulation and sensory problems related to the smell, texture, color, and temperature of food. In fact, the results obtained emphasize the correlation between food selectivity and the sensory domains of taste and smell. Furthermore, this research highlights a correlation between motor skills and eating skills, particularly regarding food selectivity, which is closely associated with atypical and disruptive behaviors during meals.

Weight Status, Dietary Intake, and Mealtime Behaviour Among Autism Spectrum Disorder Children in Klang Valley, Malaysia

Introduction: Nutrition is one of the important contributors to the well-being of children with disability. Given the various data on the nutritional status of autism spectrum disorder (ASD) children, it is imperative to conduct a detailed nutritional assessment of the local population. This study compares ASD with typical developing (TD) children to determine the weight status and association of mealtime behavior with dietary intake in Klang Valley, Malaysia. Methods: A total of 106 children aged five to nine years old participated in this cross-sectional study. Sociodemographic were assessed through self-administered questionnaires. The body weight and height were collected; the body mass index (BMI) was calculated. A three-day food record and a Brief Autism Mealtime Behavior Inventory (BAMBI) data were obtained from the caretakers. Results: More than one-third (39%) of the ASD children were overweight or obese compared to TD children (23%). However, there is a significant difference (X2=10.29, p=0.03) when TD children were categorized as stunted and severely stunted. Meanwhile, the total energy intake was statistically significant (X2=9.53, p=0.008). The majority (88.2%) of ASD children experience problems in mealtime behavior characteristically limited food acceptance with a mean score of (28.78±6.80). Mealtime behavior was not associated with energy, carbohydrate, protein, and fat when the p&gt;0.05. Conclusion: Even though there was no association of mealtime behavior with dietary intake, the BMI was significantly influenced by excessive daily calorie consumption. Because of growth parameters influence physical development, nutritional intervention program should be carried out in order to improve nutritional status of AS children.

The Efficacy of the Global Intensive Feeding Therapy on Feeding and Swallowing Abilities in Children with Autism Spectrum Disorder: A Pilot Study.

The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times a day. GIFT focused on (a) encouraging desensitization; (b) widening the food repertoire (in terms of both variety and quantity); (c) reducing inappropriate mealtime behaviors; and (d) encouraging the development of appropriate chewing and swallowing abilities. GIFT was preliminarily implemented among 11 children with a diagnosis of ASD. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the Brief Autism Mealtime Behavior Inventory (BAMBI), and food repertoire were investigated using Wilcoxon signed-rank test in three different times: baseline (T1), after treatment (T2), and one month after treatment (T3). Using Bonferroni correction, statistically significant differences were found between T1 and T2 for behavioral issues, as measured with BAMBI (p = 0.007), as well as for chewing abilities as measured with KCPS (p = 0.005) and for food acceptance (p = 0.005). These improvements were maintained after a month of follow-up, thanks to the collaboration of families and/or primary caregivers. In conclusion, GIFT seems to be an effective approach to improving behavioral issues, food acceptance, and chewing abilities in children with ASD.

Brief Autism Mealtime Behavior Inventory (BAMBI): Italian Translation and Validation.

Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following international guidelines, then we investigated internal consistency as measured by Cronbach's alpha and test-retest reliability, as measured by the Intraclass Correlation Coefficient (ICC) in a sample of both children with ASD and with typical development (TD). A total of 131 children were recruited in a clinical and community sample. Internal consistency revealed significant data for both TD and ASD children, with a Cronbach's Alpha of 0.86 and 0.71, respectively. Test-retest reliability showed excellent values for each item of the BAMBI (range 0.83-1.00). Furthermore, we investigated differences in gender and body max index; however, no significant differences were found among groups. In conclusion, the Italian version of the BAMBI showed good internal consistency and test-retest reliability and it can be used for clinical and research purposes.

Association between feeding/mealtime behavior problems and internalizing/externalizing problems in autism spectrum disorder, other neurodevelopmental disorders and typically developing children.

The aim of current study was to examine the nature and prevalence of feeding problems and mealtime behavior problems in children with autism spectrum disorder (ASD) comparing to children with other neurodevelopmental disorders (NNDs) and TD children. We also investigated the impact of intelligence quotient (IQ) and/or emotional and behavioral problems on feeding and mealtime behavior problems. Participants completed the following tests: Social Communication Questionnaire (SCQ), Child Behavior Checklist (CBCL), Brief Autism Mealtime Behavior Inventory (BAMBI) and Behavioral Pediatric Feeding Assessment Scale (BPFAS). Children with ASD showed more feeding and mealtime behavior problems including food refusal (P<0.001, P<0.001) and limited variety of foods (P=0.014; P=0.018) compared with NDDs and TD children. ASD group showed more problems in mealtime behavior (P=0.034) and parent behaviors (P=0.028) compared to TD group. Internalizing (P=0.003) and externalizing (P=0.008) problems were positively related to parent frustration during mealtime in ASD group. These results suggest that routine screening for feeding and mealtime behavior problems among children with ASD is necessary to prevent dietary inadequacies that may be associated with eating habits.

The Relationship Between Nutrition-Physical Activity Behaviors of Autistic Children with Their Families and Children's Obesity Levels During Covid Pandemic.

The family has a key role in the obesity management of children with autism. This study examines the relationship between the nutrition-physical activity behaviors of autistic children with their families and children's obesity levels during covid-19 pandemic. The descriptive and cross-sectional study involved 80 parents of autistic children. A positive correlation was found between children's mean BMI values before and during the pandemic(p = 0.000). Family Nutrition and Physical Activity Scale(FNPAS) and Brief Autism Mealtime Behavior Inventory(BAMBI) score were 55.18 ± 7.86 and 31.76 ± 8.79, respectively. In addition, it was found that 32.5% of the children ate more than before the pandemic, 50.0% engaged in less physical activity, and 16.3% didn't do any physical activity. The study results suggesting the risk of obesity.

Validation of brief autism mealtime behavior inventory (BAMBI) questionnaire in Vietnam in 2021

The purpose of this study was to translate the Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire into Vietnamese to develop and validate the evaluation of feeding behavior in patients with Autism Spectrum Disorder (ASD). This cross - sectional research was conducted at 18 centers raising children with ASD in Vietnam from May 2021 to December 2021. After testing by Cronbach’s alpha index, all 18 factors were kept (Cronbach’s alpha &gt; 0.7). Then, these 18 questions were included in exploratory factor analysis (EFA) resulting in 4 questions being eliminated (Loading factor &gt; 0.5). The remaining 14 sentences that were built into a model with 5 factors and CFA confirmatory factor analysis showed that this BAMBI’s model is considered to be quite close to the fit model (CFI &lt; 0.9), and divided them into 5 factors (according to EFA) with KMO = 0.757 and Barlett’s Test = 0.000, which was accepted. Therefore, the brief autism mealtime behavior Inventory may be a valid and accurate measuring instrument to evaluate mealtime and feeding difficulties in people with autism in Vietnam.

Eating and sleep problems, related factors, and effects on the mental health of the parents in children with autism spectrum disorder

This study aimed to evaluate the frequency of sleep and eating problems in children with autism spectrum disorder (ASD), the factors associated with these problems, and the relationship with the risk of developing depression and anxiety in their parents. In the study, 156 children with ASD and their parents were included. The Brief Autism Mealtime Behavior Inventory (BAMBI), the Children's Sleep Habits Questionnaire (CSHQ), the Hospital Anxiety Depression Scale (HADS) were completed by the parents. The Childhood Autism Rating Scale (CARS) was administered by the researchers to evaluate the severity of ASD in children. The mean age of children was 8.08 ± 2.84, and 87.2% of the children were male. The mean score of CARS was 41.25 ± 6.16, the mean score of BAMBI was 45.67 ± 11.87, and the mean score of CSHQ was 51.67 ± 10.17. According to the CSHQ, 83.3% of the children had sleep problems. The response rate above the cut-off point in the HAD-A subscale was 59.6%, whereas it was 67.3% in the HAD-D subscale. There was a positive correlation between CARS and BAMBI, CSHQ, HAD-A, and HAD-D subscales. There was a positive correlation between BAMBI and CHSQ, HAD-A, and HAD-D subscales. There was a positive correlation between the CSHQ, HAD-A, and HAD-D subscales. There was a negative correlation between the age of the child with ASD, food refusal, and resistance to bedtime. As sleeping and eating problems affect a large portion of children diagnosed with ASD and their caregivers, large population-based studies evaluating both these problems must be designed and carried out to understand factors affecting the prevalence, development, and persistence of sleeping and eating problems and to determine interventions to reduce these issues.

A nutrition education intervention to improve eating behaviors of children with autism spectrum disorder: Study protocol for a pilot randomized controlled trial

Autism spectrum disorder (ASD) is a developmental disorder that affects communication and social behaviors. Children with ASD often experience mealtime behavior challenges and selective eating behaviors. They also tend to consume fewer fruits and vegetables and more high-energy dense foods, compared to neurotypical peers. A nutrition intervention was designed to prevent the development of feeding disorders and the long-term negative health impacts associated with poor dietary intake. This randomized controlled trial will evaluate the feasibility and preliminary efficacy of the nutrition education intervention for children with ASD and their parents through the Early Intervention (EI) services. We will recruit EI providers and parent-child dyads (n = 48) from EI programs, and randomly assign them into Autism Eats intervention (n = 24) or enhance usual care (EUC) comparison group (n = 24). The Autism Eats is 10 weekly sessions delivered individually as part of EI, while the EUC group will receive only 1 nutrition education session and then weekly parent handouts. The Autism Eats integrates ASD-specific feeding strategies and behaviorally-focused intervention strategies such as goal setting. Feasibility indicators include reach/participation, attrition, completion, fidelity, compatibility, and qualitative participant feedback. Outcome measures include dietary intakes and mealtime behaviors of children with ASD using 3-day food records and a validated questionnaire, the Brief Autism Mealtime Behavior Inventory (BAMBI). We will examine whether there are differences in children's food intakes, variety, diet quality, and mealtime behaviors between Autism Eats and EUC groups at post-intervention and 5-month follow-up assessment. This study will provide critical data to inform a full-scale randomized controlled trial.

Characteristics of the autism spectrum disorder gastrointestinal and related behaviors inventory in children.

Gastrointestinal (GI) symptoms are one of the prevalent co‐occurring issues in autism spectrum disorder (ASD), though the range of symptom frequency estimates varies dramatically across studies, which can limit the further research of GI issues in ASD as well as potential treatment strategies. The wide range of prevalence estimates is partly due to the lack of standardized, validated measures of GI symptoms among people with ASD. The goal of this study was to (1) develop a measure, which included non‐verbal and mealtime behaviors, to assess for GI symptoms and (2) evaluate its psychometric characteristics. This was accomplished by drawing on two existing tools, Autism Treatment Network Gastrointestinal Inventory and the Brief Autism Mealtime Behavior Inventory, and deriving new items, to create the “ASD Gastrointestinal and Related Behaviors Inventory” (ASD‐GIRBI). The ASD‐GIRBI was piloted in an online registry of families with a child with ASD. A psychometric analysis was carried out in a sample of 334 children aged 6–17 years with ASD, resulting in a 36‐item tool. The Cronbach's alpha for the overall scale was 0.88. Exploratory factor analysis identified a seven‐factor model (1. Bowel movement pain; 2. Aggressive or disruptive during mealtimes; 3. Particular with foods; 4. Abdominal pain and upset stomach; 5. Refusing food; 6. Constipation and encopresis; 7. Motor or other behaviors). Following validation in an independent sample with clinical evaluation of GI symptoms, this tool will be helpful for both research and clinical purposes.

Feeding difficulties in Asian children with autism spectrum disorder

To characterize the nature and severity of feeding difficulties in Asian young children with Autism Spectrum Disorders (ASD) and identify potential predictors of poorer feeding outcomes. Cross sectional study of children aged 1-7 years with ASD. Parents completed the following: demographic information, brief autism mealtime behavior inventory, aberrant behavior checklist (ABC), behavioral pediatrics feeding assessment scale (BPFAS) and caregiver feeding style questionnaire. Additional information (medical data, cognitive and developmental assessment results, e.g., Autism Diagnostic Observation Schedule Second Edition, Autism Diagnostic Interview, Revised, Vineland Adaptive Behaviour Scales, etc.) were subsequently obtained from electronic medical records retrospectively by one of the study team members. Of the 67 children, 28.4% had feeding difficulties (high BPFAS total frequency score). Caregiver feeding styles were authoritarian (34.8%) or indulgent (39.4%). Child characteristics did not significantly predict for the severity of feeding difficulties. Univariate analysis revealed that authoritarian feeding style (p=0.001) and ABC hyperactivity score (p=0.006) were significantly associated with BPFAS severity score. Multivariate analysis revealed that ABC hyperactivity score remained significantly associated with BPFAS severity score after controlling for all other ABC subscale scores. A final regression model including all child characteristics and ABC scores did not reveal any significant predictors of BPFAS total frequency score (R2=0.557). Our findings suggest an association between hyperactivity, authoritarian feeding style and feeding difficulties. Children with ASD who have significant hyperactivity behaviors in the context of parents with an authoritarian feeding style should be actively screened for problematic feeding behaviors.

Impact of eating habits and nutritional status on children with autism spectrum disorder

ObjectivesObesity is common among children with Autism Spectrum Disorder (ASD). They suffer more feeding problems than children with normal developmental milestones. Several kinds of diet are recommended for children with ASD. This study determines the frequency of eating disorders and obesity among such children. We investigate the predisposing factors of eating disorders and examine the effects of consumed food on autism scores. MethodsIn this single-centre, cross-sectional study, 46 children with ASD aged between 2 and 10 years were included. Anthropometric measurements were recorded and Brief Autism Mealtime Behavior Inventory (BAMBI), Autism Behavior Checklist (ABC), and Food Frequency Questionnaire (FFQ) forms were filled in by their parents. ResultsThe rates of being overweight and obese were 10.9% and 28.3%, respectively. Food selectivity was observed in 84.8% of the children, and BAMBI food refusal scores were significantly higher for those aged between 2 and 5 years (p = 0.03). Autism scores and consumption of milk, yoghurt, oily seeds, rice/pasta, and fruits (p < 0.05) were significantly correlated. There were also significant differences between these scores and the frequency of consuming eggs, legumes, and other cereals (p < 0.05). ConclusionObesity was more common in children with ASD than typically developed children. Despite the high rate of food selectivity, our findings confirmed that food selectivity could be considered independent of obesity. Further, the diet of patients with ASD must include more fruits, yogurt, eggs, legumes, other cereals, less milk, and less rice/pasta.

Evaluation of sleep disturbances, gastrointestinal problems and eating behaviors in Turkish children with autistic disorder and PDD-NOS

PurposeThe purpose of this study is to evaluate the relationship between sleep disturbances, gastrointestinal (GI) problems and eating behaviors in children who are diagnosed with autistic disorder (AD) and pervasive developmental disorder not otherwise specified (PDD-NOS).Design/methodology/approachThis study was conducted with 102 children who were diagnosed with autism spectrum disorder (ASD). Sleeping and GI (abdominal pain, constipation, diarrhea, vomiting, difficulty swallowing) problems in children were obtained by asking their parents using a questionnaire. The feeding assessment survey (FAS), brief autism mealtime behavior inventory (BAMBI) and food consumption frequency were used to obtain information about the children’s eating habits.FindingsThe BAMBI total score, food refusal and features of autism subscale scores of those with AD were higher than those in the PDD-NOS group (p < 0.05). Sleeping, GI and eating problems are seen in those with AD more commonly than in those diagnosed with PDD-NOS.Originality/valueTo the knowledge, this is the first study that compares GI, sleeping and eating problems in children with AD and PDD-NOS. Sleeping, GI and eating problems may be more frequent in children with AD than in those with PDD-NOS. The GI problem rate is higher in children with autism with sleeping problems than without sleeping problems.

The association between maternal features and nutritional problems in children with autism spectrum disorder

ABSTRACT Objective In the literature, there is almost no data on the relationship between autistic children’s nutritional problems and their mothers’ demographic and nutritional characteristics. Therefore, this study aimed to evaluate whether there was a relationship between maternal features and nutritional problems in autistic children. Methods This study was conducted with the participation of 58 autistic children (6-19 years) and their mothers. Descriptive data were obtained with a general questionnaire. For the evaluation of children’s nutritional status, anthropometric measurements and 24-hour dietary recall were used. Also, the Brief Autism Mealtime Behavior Inventory and ORTO-15 questionnaires were used to evaluate the meal behavior of children and orthorexia tendency of mothers, respectively. Results No significant correlation was found between the Brief Autism Mealtime Behavior Inventory scores in children of mothers with high and low orthorexia tendency. There were also no statistically significant differences between the children of mothers with high and low educational level in terms of Brief Autism Mealtime Behavior Inventory scores. Only the dietary vitamin B6 intake was significantly higher in the children of mothers with high educational level. Maternal age was associated with the dietary energy and protein intake, unlike, maternal orthorexia tendency was not associated with the nutritional status and meal behavior of children. The abdominal pain experience in the last one month was found to be significantly higher in the children of employed mothers than children of unemployed mothers. Conclusion It is thought that the maternal characteristics are not effective on meal behavior in children and also maternal age and educational status have a very limited effect on the nutritional status of children.

Brief Report: Mealtime Behaviors of Chinese American Children with Autism Spectrum Disorder.

This study investigated mealtime behaviors of Chinese-American children with autism spectrum disorder (ASD). Thirty-one parents of Chinese-American children with ASD participated in this study and the Brief Autism Mealtime Behavior Inventory (BAMBI) was used. The top problematic mealtime behaviors reported by parents were prefers "crunchy" food (54.2%); not willing to try new foods (48%); and does not remain seated at the table until the meal is finished (46%). This study found that the majority of the Chinese-American children with ASD seldom or never were aggressive (96%) or disruptive during mealtimes (92.3%). Compared to their white counterparts, Chinese-American children with ASD showed slightly lower scores on problematic mealtime behaviors. These findings may provide significant information to practitioners.

FEEDING PROBLEMS OF CHILDREN WITH AUTISM

Children with autism generally have feeding problems especially in their mealtime behavior. The purpose of this study is to identify the feeding problems of children with autism. To be able to determine the problems of children with autism BAMBI (Brief Autism Mealtime Behavior Inventory), (Demand, Johnson and Fokles, 2015; Meral and Fidan, 2014) is used. Twenty-one families of children with autism were participated in the study. The results of our study showed that according to the parental reports children with autism have feeding problems in terms of mealtime behavioral problems such as crying and yelling throughout meals. Other results of the study and recommendations are discussed in discussion. Keywords Feeding behaviors Feeding behaviors, autism, eating problems, family’s perception

Mealtime Behavioral Problems in Hong Kong Chinese Preschoolers with Autism Spectrum Disorder

The relationship between Autism Spectrum Disorder (ASD) and mealtime behavioural problems has been discussed in the United States recently, but there is limited research data on this matter in Chinese children. This study aims to evaluate the prevalence of feeding and mealtime behavioural problems in Hong Kong Chinese preschoolers with ASD using the Brief Autism Mealtime Behavior Inventory (BAMBI). Parents with children aged between 2 to 6 years old diagnosed with ASD were asked to complete a Chinese version of BAMBI, which is a validated 18-item questionnaire designed to measure mealtime behavioural problems in children with ASD. A total of 177 children were enrolled: 78.0% were boys and 22.0% were girls; the mean age was 5.0 (2.9-6.3). The survey revealed that the “limited variety” of food was the most prevalent feeding problem. Close to half of caregivers found limited food variety being problematic and affecting their daily functioning. The perception of problems by caregivers was positively correlated with the frequency of problematic feeding behaviours. These feeding behavioural problems are not alleviated by current training. We suggest concentrating specifically on addressing the feeding behaviour through a multidisciplinary approach and by incorporating dietary advice, which will be beneficial to children with ASD and their families.