Associations between autism symptom severity and mealtime behaviors in young children presented with an unfamiliar food

BACKGROUND

Feeding problems are common in children with Autism Spectrum Disorder (ASD), and there are associations between parent reports of child ASD symptom severity and feeding problems. The current study further explores this association between ASD severity and family mealtime behaviors using directly observed naturalistic mealtime interactions.

METHODS AND PROCEDURES

Seventy-three children (M_age = 5.42 years) were presented an unfamiliar food during a videotaped but otherwise typical home meal. Mealtime behavior was assessed through coding of the videotaped meal using the Dyadic Interaction Nomenclature for Eating (DINE) and parent report (Brief ASD Mealtime Behavior Inventory; BAMBI). ASD severity was assessed with the clinician-completed Childhood Autism Rating Scale-Second Edition (CARS-2).

OUTCOMES AND RESULTS

Greater ASD severity was associated with fewer bites of the unfamiliar food, greater disruptive behavior during meals, and greater parental commands to take bites during meals. We found negative associations between limited food variety and food refusal (BAMBI subscales) and child bites of the unfamiliar food, with higher levels of limited food variety and food refusal associated with fewer bites of the unfamiliar food.

CONCLUSIONS AND IMPLICATIONS

Children with more severe ASD may eat less and be more disruptive during meals, despite parent redirection. We also found associations between the BAMBI and DINE which suggest the BAMBI may be a sensitive measure of mealtime behaviors such as food flexibility and food refusal.

A Delphi survey to identify activities of nurse practitioners in primary care

The practice activities of nurse practitioners (NPs) in primary care have not been well delineated. The purpose of this study is to identify the activities of NPs in the provision of primary care. Patient, practitioner, and healthcare system variables were collected to describe the sample and determine if these factors influenced the activities of NPs. Primary care NPs (n = 139) representing the practice areas of pediatrics (n = 12), family (n = 75), adult (n = 15), and women's health (n = 37) responded to serial questionnaires using Delphi technique asking them to identify activities they perform routinely in their practices. Using frequency analysis, activities common to the practice of all NPs were identified, and using Chi-square, activities of specialty NP practice were identified. Regression analysis was used to correlate NP, patient, and healthcare system variables with the activities performed as part of NP practice. Three lists of activities of NP practice were developed: core activities of all NP practice, specialty activities, and other activities. Initial analyses of variables that might influence NP practice were examined. These results can be useful to healthcare consumers choosing providers, as well as legislators, educators, employers of NPs, and other interested healthcare professionals.

Haitian Americans: implications for nursing care

Each year a number of Haitians enter the United States and may become part of the U.S. health care system. Nurses need to be sensitive to cultural differences and should assess clients for special needs that may arise because of cultural diversity. This article provides strategies for interacting with the Haitian American client in a clinical setting to ensure success in providing nursing care.