EXAMINING RELATIONSHIPS BETWEEN FAMILY MEALTIME ROUTINES AND FEEDING OUTCOMES IN YOUNG CHILDREN WITH SENSORY FOOD AVERSIONS

Picky eating is a common behavior of early childhood. Young children with Sensory Food Aversions (SFA) are at increased risk for picky eating behaviors that persist throughout childhood and into adulthood. Interventions that support increased dietary variety in the home are needed to prevent nutritional deficiency and related health issues later in life. The focus of this dissertation was to develop and test the feasibility and preliminary effects of an intervention, embedded within daily family meals, to improve feeding outcomes in young children with SFA. First, we conducted a hierarchical logistic regression to determine if frequency of family meals predicted low fruit and vegetable consumption in a large sample of preschool-age children. Next, we evaluated the feasibility and preliminary effects of the Mealtime PREP intervention for eleven children with SFA and their parents. Our findings support that the established protective benefits of family meals for school-age children and adolescents generalize to young children as well. We learned that low frequency of family meals is predictive of low fruit and vegetable intake among preschoolers. Additionally, we determined that the Mealtime PREP intervention package is feasible to deliver in the home and acceptable to parents of children with SFA. Preliminary analyses of effects suggest that statistically significant changes in food acceptance and clinically relevant shifts in mealtime behavior and risk of nutritional deficiency were observed in 9 of 11 child participants after parents were trained to deliver intervention strategies during scheduled, daily family meals. Valuable insights gained from this project will be incorporated into future studies examining the effects of the Mealtime PREP intervention. Future studies should focus on the development of an effective, yet parsimonious, protocol to promote healthy dietary variety in young children. Larger scale studies are required to make inferences about the effects of this type of intervention in the population of young children who are picky eaters. Future work is also needed to parse out the effects of parent-mediated interventions using a behavioral activation approach to parent-training. This method shows promise to bridge the gap of intervention delivery between the clinic and the home environment