Date Presented 04/21/2023

This study examines the relationship among child independence, self-help skills, and family mealtime. Results have implications for OT in developing interventions to support increased independent feeding during mealtime.

Primary Author and Speaker: Gina Sylvester

Additional Authors and Speakers: Hannah Laufenberg, Karla Ausderau, Brittany St John

PURPOSE: Feeding challenges are a significant concern for autistic children with impacts on child health and family mealtime. Mealtime is an important routine for families to promote family cohesion and child independence. The purpose of this study is to characterize feeding self-help skills in autistic children and explore the relationship between child independence and family mealtime. Findings from this study could be used to inform occupational therapy practice including feeding intervention for autistic children.

DESIGN: A cross-sectional national survey (N = 427) of caregivers of autistic children (2-12 years) with feeding challenges. Participants were recruited through a national research registry, university list servs, and community flyers.

METHOD: Data from the Survey for Characterizing Feeding Challenges in Autistic Children was used. The Feeding and Eating in AutiSm Together (FEAST) assessment was used to assess feeding challenges. A composite score of child’s feeding independence was created using independence in four feeding self-help skills. Relationships between child independence and family mealtime were explored using Pearson’s r correlations.

RESULTS: 21.78% of autistic children needed assistance in at least three self-help skills, while 53.86% needed assistance in at least one area. Small significant correlations were identified between the self-help composite score and mealtime variables including caregiver preparing a separate meal for the child (r = −0.18, p < .001), child willingness to accept new foods when offered (r = 0.14, p<.001), and child’s feeding challenges disrupting family mealtime (r = −0.10, p = 0.04).

CONCLUSION: Challenges with independent feeding can significantly impact family mealtime and adult support required during eating. This research is an important step in developing self-help interventions to support increased independent feeding during mealtime could greatly benefit both child development and successful family mealtime.


Bandini, L. G., Curtin, C., Phillips, S., Anderson, S. E., Maslin, M., & Must, A. (2017). Changes in food selectivity in children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(2), 439–446.

Meredith P. Gronsk, M. P. (2021) Occupational therapy interventions to support feeding and toileting in children from birth to age 5 years. The American Journal of Occupational Therapy, 75(5),

Fiese, B. H. (2021). Family mealtimes: Promoting health and well-being. In L. A. Francis, S. M. McHale, V. King, & J. E. Glick (Eds.), Families, Food, and Parenting: Integrating Research, Practice and Policy. Springer.

Leader, G., Tuohy, E., Chen, J. L., Mannion, A., & Gilroy, S. P. (2020). Feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues in children and adolescents with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 50(4), 1401–1410.