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Mothers’ Challenges in Feeding their Children with Autism Spectrum Disorder—Managing More Than Just Picky Eating


Mothers’ perspectives of the processes involved in addressing the feeding challenges of children with autism spectrum disorder (ASD) were explored qualitatively. The research question was: What is the process of mothers’ feeding their children with an ASD who have feeding challenges, and specifically what is the nature of these challenges? Data were from semi-structured interviews with 11 mothers of 12 children with ASD ranging from 4–11 years. This grounded theory study used constant comparative analysis in developing categories to define the processes mothers used in understanding and then meeting the feeding needs of their children with ASD. Four feeding processes emerged from the analysis. 1) recognizing the feeding challenges, 2) defining the underlying nature of the feeding challenges, 3) seeking support for and validation of the feeding challenges, and 4) staging their approach. The feeding challenges had three different patterns of onset and went beyond typical picky eating behaviors.

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  1. Ahearn, W. H., Castine, T., Nault, K., & Green, G. (2001). An assessment of food acceptance in children with autism or pervasive developmental disorder—not otherwise specified. Journal of Autism and Developmental Disorders, 31(5), 505–511.

    PubMed  Article  Google Scholar 

  2. Bowen, G. A. (2008). Naturalistic inquiry and the saturation concept. Qualitative Research, 8(1), 137–152.

    Article  Google Scholar 

  3. Carruth, B. R., & Skinner, J. D. (2001). Mothers' sources of information about feeding their children ages 2 months to 54 months. Journal of Nutrition Education, 33(3), 143–147.

    PubMed  Article  Google Scholar 

  4. Carruth, B. R., Skinner, J. D., Houck, K. S., Moran, J. I., Coletta, F., & Ott, D. (1998). The phenomenon of "picky eater": a behavioral marker of eating patterns of toddlers. Journal of the American College of Nutrition, 17(2), 180–186.

    PubMed  Google Scholar 

  5. Centers for Disease Control and Prevention. (2010). Autism spectrum disorders (ASDs). Retrieved 02/17, 2011, from

  6. Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks: Sage.

    Google Scholar 

  7. Cornish, E. (1998). A balanced approach towards healthy eating in autism. Journal of Human Nutrition and Dietetics, 11, 501–509.

    Article  Google Scholar 

  8. Dovey, T. M., Isherwood, E., Aldridge, V., & Martin, C. (2010). Typology of feeding disorders based on a single assessment system: Case study evidence. Infant, Child and Adolescent Nutrition, 2(1), 52. doi:10.1177/1941406409360038.

    Article  Google Scholar 

  9. Evans-Morris, S., & Dunn-Klein, M. (2000). Pre-feeding skills (2nd ed.). USA: Therapy Skill Builders.

    Google Scholar 

  10. Field, D., Garland, M., & Williams, K. (2003). Correlates of specific childhood feeding problems. Journal of Pediatrics and Child Health, 39(4), 299–304.

    Article  Google Scholar 

  11. Fodstad, J. C., & Matson, J. L. (2008). A comparison of feeding and mealtime problems in adults with intellectual disabilities with and without autism. Journal of Developmental & Physical Disabilities, 20(6), 541–550.

    Article  Google Scholar 

  12. Glaser, B. G. (1992). Basics of grounded theory analysis. Mill Valley: Sociology.

    Google Scholar 

  13. Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough?: an experiment with data saturation and variability. Field Methods, 18(1), March 15, 2008.

    Google Scholar 

  14. Johnson, C. R., Handen, B. L., Mayer-Costa, M., & Sacco, K. (2008). Eating habits and dietary status in young children with autism. Journal of Developmental & Physical Disabilities, 20(5), 437–448.

    Article  Google Scholar 

  15. Keen, D. (2008). Childhood autism, feeding problems and failure to thrive in early infancy: seven case studies. European Child and Adolescent Psychiatry, 17(4), 209–216.

    PubMed  Article  Google Scholar 

  16. Kerwin, M. E., Eicher, P. S., & Gelsinger, J. (2005). Parental report of eating problems and gastrointestinal symptoms in children with pervasive developmental disorders. Children's Health Care, 34(3), 221–234.

    Article  Google Scholar 

  17. Kuschner, E. S., Bennetto, L., & Silverman, L. B. (2005). Gustatory function and food preferences in high-functioning autism. Boston: International Meeting for Autism Research.

    Google Scholar 

  18. Ledford, J. R., & Gast, D. L. (2006). Feeding problems in children with autism spectrum disorders: a review. Focus on Autism and Other Developmental Disabilities, 21(3), 153–166.

    Article  Google Scholar 

  19. Lewinsohn, P. M., Holm-Denoma, J. M., Gau, J. M., Joiner, T. M. J., Striegel-Moore, R. B. P., & Lamoureux, B. (2005). Problematic eating and feeding behaviors of 36-month-old children. International Journal of Eating Disorders, 38(3).

  20. Liamputtong, P., & Ezzy, D. (2006). Qualitative research methods (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  21. Linscheid, T. R. (2006). Behavioral treatments for pediatric feeding disorders. Behavior Modification, 30(1), 6–23.

    PubMed  Article  Google Scholar 

  22. Lukens, C. T., & Linscheid, T. R. (2008). Development and validation of an inventory to assess mealtime behavior problems in children with autism. Journal of Autism & Developmental Disorders, 38(2), 342–352.

    Article  Google Scholar 

  23. Matson, J. L., & Fodstad, J. C. (2009a). Issues in identifying the etiology of food refusal in young children. Journal of Pediatric Gastroenterology & Nutrition, 48(3), 274–275.

    Article  Google Scholar 

  24. Matson, J. L., & Fodstad, J. C. (2009b). The treatment of food selectivity and other feeding problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(2), 455–461. doi:10.1016/j.rasd.2008.09.005.

    Article  Google Scholar 

  25. Nadon, G., Feldman, D. E., Dunn, W., & Gisel, E. (2011). Mealtime problems in children with autism spectrum disorder and their typically developing siblings: a comparison study. Autism: The International Journal of Research and Practice, 15(1), 98–113. doi:10.1177/1362361309348943.

    Article  Google Scholar 

  26. Palmer, S., & Ekvall, S. (Eds.). (1978). Pediatric nutrition in developmental disorders. Springfield: Thomas.

    Google Scholar 

  27. QSR International Pty Ltd. (2008). NVivo 8. Australia

  28. Reynolds, J. (2011) Canadian family's ultimate picky eater survival guide. Canadian Family, 19(8).

  29. Richards, L., & Morse, J. M. (2007). Readme first for a user's guide to qualitative methods (2nd ed.). Thousand Oaks: Sage.

    Google Scholar 

  30. Satter, E. (1987). How to get your kid to eat…but not too much. Palo Alto CA: Bull.

    Google Scholar 

  31. Schreck, K. A., & Williams, K. (2006). Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research in Developmental Disabilities, 27, 353–363.

    PubMed  Article  Google Scholar 

  32. Schreck, K. A., Williams, K., & Smith, A. F. (2004). A comparison of eating behaviors between children with and without autism. Journal of Autism and Developmental Disorders, 34(4), 433–438.

    PubMed  Article  Google Scholar 

  33. Schreiber, R. S., & Stern, P. N. (Eds.). (2001). Using grounded theory in nursing. New York: Springer.

    Google Scholar 

  34. Schwarz, S., Corrender, J., Fisher-Medina, J., Cohen, J., & Rabinowitz, S. (2001). Diagnosis and treatment of feeding disorders in children with developmental disabilities. Pediatrics, 108(3), 671–676.

    PubMed  Article  Google Scholar 

  35. Seiverling, L., Williams, K., & Sturmey, P. (2010). Assessment of feeding problems in children with autism spectrum disorders. Journal of Developmental & Physical Disabilities, 22(4), 401–413. doi:10.1007/s10882-010-9206-0.

    Article  Google Scholar 

  36. Strong, J. (2003). Seeing beyond the clouds: Best practice occupational therapy. Canadian Journal of Occupational Therapy, 70(4), 197–202.

    Google Scholar 

  37. Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). Addressing feeding disorders in children on the autism spectrum in school-based settings: physiological and behavioral issues. Language, Speech and Hearing Services in Schools, 39, 261–272.

    Article  Google Scholar 

  38. Uyanik, O., Dogangun, B., Kayaalp, L., Korkmaz, B., & Dervent, A. (2006). Food fadism causing vision loss in an autistic child. Child: Care, Health & Development, 32(5), 601–602.

    Article  Google Scholar 

  39. Williams, K., Hendy, H., & Knecht, S. (2008). Parenting feeding practices and child variables associated with childhood feeding problems. Journal of Developmental and Physical Disabilities, 20, 231.

    Article  Google Scholar 

  40. World Health Organization. (2004). WHO guide to mental and neurological health in primary care: A guide to mental and neurological ill health in adults, adolescents and children (2nd ed.). London: Royal Society of Medicine.

    Google Scholar 

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Sincere thanks to the participants for their insight, enthusiasm and willingness to share their experiences. We acknowledge Dr. Lonnie Zwaigenbaum’s guidance as a member of the first author’s graduate committee and his dedication to children and families impacted by autism. Funding acknowledgments: Canadian Institutes of Health Research Autism Research Training Program, Margaret Brine Scholarship, Canadian Occupational Therapy Foundation Invacare Master’s Scholarship, Gauk-Westfield Award, and Alberta Advanced Education Award.

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Corresponding author

Correspondence to Laura G. Rogers.

Interview Guide

Interview Guide

  1. 1.

    Tell me about your child (age, influence of ASD).

  2. 2.

    Tell me a bit about your family (siblings, who lives in home).

  3. 3.

    Does your child have any particular medical concerns that affect feeding?

  4. 4.

    Do you have any concerns about your child’s weight?

  5. 5.

    Tell me about feeding your child right now.

    Specific feeding challenges; particular about specific food groups, brands of foods, food presentation;

    • Eating in certain environments (friends/ relatives’ homes, preschool/daycare, school)

    • Special occasions/ cultural celebrations

    • Meal and snack routine or graze throughout the day

    • Any supplements (vitamins, supplements, Pediasure )

    • Does meeting your child’s feeding needs and nutritional needs cause any significant financial challenges for your family?

  6. 6.

    When did these challenges start?

  7. 7.

    Tell me about your child’s feeding as an infant. Transitions from breast to bottle, bottle to cup, to purees, to lumpy solids, to finger foods, to utensils.

  8. 8.

    Tell me about your child at the following ages: 2, 3, 4, (and other ages if older).

    As issues arose asked:

    • What did you do to try to make things easier? What did you try first?

    • What strategies worked? Who suggested the strategies?

    • How did you make your choices?

    • Were the strategies offered by others helpful?

  9. 9.

    Was there an age when things got worse? What do you think contributed to this? What else was happening in your lives at the time?

  10. 10.

    Was there an age where things became easier?

  11. 11.

    What are the strategies you currently use to feed your child?

  12. 12.

    Do you feel that through these strategies your child has adequate nutrition?

  13. 13.

    Is there anything else that you would like to tell me about your child’s feeding?

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Rogers, L.G., Magill-Evans, J. & Rempel, G.R. Mothers’ Challenges in Feeding their Children with Autism Spectrum Disorder—Managing More Than Just Picky Eating. J Dev Phys Disabil 24, 19–33 (2012).

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  • Autism
  • Picky eating
  • Feeding
  • Eating behavior
  • Grounded theory