Parent’s perceptions of the challenges and barriers to implementing a parent-led intervention for food selectivity in children with Autism

Introduction
Food selectivity is more common in children with autism compared to children without. It encompasses food refusal, a limited repertoire of accepted foods, and high-frequency single food intake, and can lead to nutritional inadequacy and increased parental stress. Group-based, parent-led interventions designed to improve mealtime behaviour and the nutritional quality of diets of children with autism have shown limited improvements. Therefore, the present study aimed to explore parents’ experiences of such interventions in order to refine existing group programmes and develop further supporting resources.

Methodology
Qualitative, semi-structured interviews and open questionnaires were conducted with parents of children with food selectivity, who have an autism diagnoses or characteristics of autism (formal diagnoses pending). Parents’ views on the acceptability of a group-based intervention and their experiences of implementing specific elements within the home environment were explored. Interviews were audio-recorded and transcribed verbatim in preparation for thematic analysis of the full data corpus.

Results
A series of themes emerged from the data, most dominant was the need for more individualised and intensive group sessions due to the specific, varying needs of children with autism. This approach would ideally include group sessions tailored specifically for children with autism and opportunity for dietitians to personally meet and observing the children. The group sessions were successful at encouraging parents to attempt new mealtime strategies, yet major challenges continued to arise regarding implementation due to food refusal. Despite this, the group sessions provided a reassuring and useful environment for parents to share ideas and experiences with other parents of children with autism.

Conclusion
Food selectivity continues to occur in children with autism even after group-based, parent-led interventions due to recurrent food refusal. The present study highlights the need to offer more individualised support for parents attempting to improve the nutritional intake of their children with autism.