A Systematic Review of Caregiver-Implemented Mealtime Interventions for Children With Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) frequently have difficult mealtimes. A systematic review analyzed current evidence relevant to occupational therapy (OT) and mealtime interventions (a) for children with ASD, (b) occurring in the natural contexts, and (c) with parents/caregivers as interventionists. Database search identified 13 relevant articles. Each article was reviewed for practicality of implementation through a modified Feasibility, Appropriateness, Meaningfulness and Effectiveness (FAME) scale and for quality of research design using three measures specifically designed for single-case experimental design research. The majority of articles reviewed demonstrated rigorous research design with strong evidence for the effectiveness of caregiver-implemented interventions. Six intervention techniques were identified, with all studies using a reinforcement strategy and at least one other technique. This review identifies evidence-based practices for OTs to support children with ASD and their families within the natural co-occupation of mealtimes. Effective techniques and recommendations for practice are included.