Home⇛The PCMC Journal⇛vol. 21 no. 1 (2025)

Factors associated with mealtime behaviors among Filipino children aged 3–11 years old diagnosed with autism spectrum disorder using the Filipino version of the Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire: a cross-sectional study

Carolyn Grace T. Madariaga | Ermenilda L. Avendaño | Maria Fatima D. Chiong-Boniol

Discipline: medicine by specialism

 

Abstract:

OBJECTIVES: This study aimed to identify risk factors associated with problematic mealtime behaviors in Filipino children aged 3-11 years diagnosed with ASD and to validate the Filipino-translated Brief Autism Mealtime Behavior Inventory (BAMBI) for clinical use. The study examined demographics, socioeconomic status, and clinical characteristics of children with ASD in relation to feeding difficulties. MATERIALS AND METHODS: A cross-sectional study was conducted with 166 caregivers of Filipino children with ASD at the Philippine Children’s Medical Center. The BAMBI questionnaire, translated and validated into Filipino, was administered among patients evaluated under the Section of Neurodevelopmental Pediatrics. Content validity was established through neurodevelopmental pediatric experts, while face validity was achieved with feedback from 17 caregivers during the pilot test. Descriptive statistics and logistic regression were performed to identify the factors. RESULTS: The Filipino-translated BAMBI demonstrated good content and face validity based on reviews and pilot testing. The tool showed acceptable internal consistency, with a Cronbach’s alpha of 0.75, indicating good reliability. Seventy-seven percent (77%) of participants scored above the threshold for problematic mealtime behaviors, with multivariate analysis revealing a significant association between these behaviors and sensory sensitivities (OR = 3.0, 95% CI: 1.2 to 7.3, p = 0.0150). Additional factors, such as dietary habits and familystructure, also showed trends toward significance but did not reach statistical significance. CONCLUSIONS AND RECOMMENDATIONS: This study validates the Filipino BAMBI as a reliable tool for assessing mealtime behaviors in children with ASD, highlighting the high prevalence of feeding problems in this population. Sensory sensitivities emerged as a significant factor contributing to problematic mealtime behaviors, underscoring the importance of incorporating sensory processing strategies in interventions. Further research should explore other contributing factors, such as dietary habits and family dynamics, to develop more comprehensive, tailored interventions for children with ASD and their families.



References:

  1. Augustyn M. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis. UpToDate. 2022 May 16.
  2. American Speech-Language-Hearing Association (ASHA), American               Association on Intellectual and          Developmental Disabilities (AAIDD).
  3. Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Asadi A, Khaledi-Paveh B, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr. 2022; 48(1):112.
  4. Shrestha M, Basukala S, Thapa N, Shrestha A, Pant R, Sharma S, et al. Prevalence of autism spectrum disorder among children in Southeast Asia from 2002 to 2022: An updated systematic review and meta‐analysis. Health Sci Rep. 2024; 7(2):e1310.
  5. Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in autism spectrum disorders. Res Autism Spectr Disord. 2015; 12:10–21.
  6. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc. 2010; 110(2):238–46. doi:10.1016/j.jada.2009.10.032
  7. Jiao F, Quilendrino MI. Patterns of feeding difficulties and behaviors in Filipino children with autism spectrum disorder seen in a Philippine tertiary hospital and the impact of the COVID-19 pandemic. University of the Philippines–Philippine General Hospital; 2021.
  8. Provost B, Crowe TK, Osbourn PL, McClain C, Skipper BJ. Mealtime behaviors of preschool children: comparison of children with autism spectrum disorder and children with typical development. Phys Occup Ther Pediatr. 2010; 30(3):220–33. doi:10.3109/01942631003757669
  9. Emond A, Emmett P, Steer C, Golding J. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics. 2010; 126(2):e337–42. doi:10.1542/peds.2009-2391
  10. Margari L, Marzulli L, Gabellone A, De Giambattista C. Eating and mealtime behaviors in patients with autism spectrum disorder: Current perspectives. Neuropsychiatr Dis Treat. 2020; 16:2083–102. doi:10.2147/NDT.S224779
  11. Zulkifli MN, Kadar M, Hamzaid NH. Weight status and associated risk factors of mealtime behaviours among children with autism spectrum disorder. Children (Basel). 2022; 9(6):854.
  12. Patton SR, Odar Stough C, Pan TY, Beebe DW, Yin J, Donovan EF, et al. Associations between autism symptom severity and mealtime behaviors in young children presented with an unfamiliar food. Res Dev Disabil. 2020; 103:103676.
  13. Nadon G, Feldman DE, Dunn W, Gisel E. Mealtime problems in children with autism spectrum disorder and their typically developing siblings: a comparison study. Autism. 2011; 15(1):98–113.
  14. Molina-López J, Leiva-García B, Planells E, Planells P. Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children. Int J Eat Disord. 2021; 54(12):2155–61. doi:10.1002/eat.23631
  15. Jui IJ, Mahazabin M, Akter M. Mealtime challenges and maternal health history of children with autism: A cross-sectional investigation. Khulna Univ Stud. 2023; 23(1):44–56.
  16. Park H, Choi SJ, Kim Y, Lee S, Jang J, Kim M, et al. Mealtime behaviors and food preferences of students with autism spectrum disorder. Foods. 2021; 10(4):837.
  17. Stough CO, Gillette MD, Roberts MC, Jorgensen LA, Patton SR. Mealtime behaviors associated with consumption of unfamiliar foods by young children with autism spectrum disorder. Appetite. 2015; 95:324–33.
  18. Shmaya Y, Eilat-Adar S, Leitner Y, Gal E. Mealtime behavior difficulties but not nutritional deficiencies correlate with sensory processing in children with autism spectrum disorder. Res Dev Disabil. 2017; 66:27–33.
  19. Lane AE, Geraghty ME, Young GS, Rostorfer J. Problem eating behaviors in autism spectrum disorder are associated with suboptimal daily nutrient intake and taste/smell sensitivity. ICAN: Infant Child Adolesc Nutr. 2014; 6(3):172–80.
  20. Lukens CT, Linscheid TR. Development and validation of an inventory to assess mealtime behavior problems in children with autism. J Autism Dev Disord. 2008; 38(2):342–52. doi:10.1007/s10803-007-0401-5
  21. DeMand A, Johnson C, Foldes E. Psychometric properties of the Brief Autism Mealtime Behaviors Inventory. J Autism Dev Disord. 2015; 45(9):2667–73. doi:10.1007/s10803-015-2435-4
  22. Castro K, Perry IS, Ferreira GP, Cunha GR, Dutra ES, Figueiredo RM, et al. Validation of the Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire. J Autism Dev Disord. 2019; 49(7):2536–44. doi:10.1007/s10803-019-04006-z
  23. Lamboglia A, Romano R, Valente D, Gallone MS, Cannito L, Petruzzellis L, et al. Brief Autism Mealtime Behavior Inventory (BAMBI): Italian translation and validation. Children (Basel). 2023; 10(7):1201. doi:10.3390/children10071201
  24. Nguyễn MH, Nguyen T, Vu N, Nguyen B, Nguyen H, Nguyen Q, et al. Validation of Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire in Vietnam in 2021. J Prev Med (Vietnam). 2022; 32(2):32–8. doi:10.51403/0868-2836/2022/681
  25. Dfy C, Ccw Y, Hk S, Chan SS, Tsang N. Mealtime behavioral problems in Hong Kong Chinese preschoolers with autism spectrum disorder. [Unpublished or            incomplete citation; journal/source name needed] or incomplete citation; journal/source name needed]
  26. Chistol LT, Bandini LG, Must A, Phillips S, Cermak SA, Curtin C. Sensory sensitivity and food selectivity in children with autism spectrum disorder. J Autism Dev Disord. 2018; 48(2):583–91.
  27. Zobel-Lachiusa J, Andrianopoulos MV, Mailloux Z, Cermak SA. Sensory differences and mealtime behavior in children with autism. Am J Occup Ther. 2015; 69(5):6905185050.
  28. Elsayed HE, Thompson KL, Conklin JL, Watson LR. Systematic review of the relation between feeding problems and sensory processing in children with autism spectrum disorder. Am J Speech Lang Pathol. 2022; 31(4):1700–25.
  29. Nimbley E, Golds L, Sharpe H, Gillespie‐Smith K, Duffy F. Sensory processing and eating behaviours in autism: A systematic review. Eur Eat Disord Rev. 2022; 30(4):538–59.
  30. Handayani M, Herini ES, Takada S. Eating behavior of autistic children. Nurse Media J Nurs. 2012; 2 (2):281–94.
  31. Faye EB, Bucog M, Velle R, Baroro C. Mealtime experiences of children with autism spectrum disorder from the perspectives of Filipino occupational therapists in Cebu: Implications for practice. [Unpublished undergraduate thesis or local publication; complete reference needed

Tools


Copyright © 2025  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic