OTSLPSurveyAutism : the international journal of research and practice2025

Comparing eating and mealtime experiences in families of children with autism, attention deficit hyperactivity disorder and dual diagnosis.

Zoe Matthews, Donna Pigden-Bennett, Teresa Tavassoli and 1 others

PMID 39264029

WHAT IT FOUND

Families of children with autism, ADHD, or both reported more chaotic mealtimes, higher food fussiness, and greater caregiver stress than families of neurotypical children.

The dual diagnosis group faced the most intense combination of these difficulties, suggesting a need for family-wide support rather than just feeding therapy.

Key findings

01Children in all neurodivergent groups showed significantly higher food fussiness and emotional undereating compared to neurotypical children.

02Families of children with ADHD and dual ASC+ADHD diagnoses reported significantly higher problematic mealtime behaviours and spousal stress than families of children with autism alone.

03Caregivers of neurodivergent children reported lower structure in family meals and higher global and mealtime-specific stress compared to caregivers of neurotypical children.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs

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What it does not show

The sample was predominantly white and female, limiting generalisability to other ethnicities and to fathers' perspectives. Data relied entirely on caregiver report without direct observation, which may introduce bias in how behaviours are perceived and rated. The cross-sectional design prevents determining whether mealtime difficulties cause caregiver stress or vice versa.

Declared interests

The authors declared no conflicts of interest and received no financial support for this research.

The easy way to misread this

Do not interpret the higher scores in the dual diagnosis group as proof that ADHD and autism simply add up linearly. The study shows a profile of greater difficulty, but it does not establish that the dual diagnosis causes these specific outcomes, only that they are reported more frequently in this group compared to those with a single diagnosis.

Read it on PubMed →