Parental experiences of eating concerns in autistic children during COVID-19 lockdowns: implications for future practice

Prior to the COVID-19 pandemic, some autistic children exhibited maladaptive eating behaviours, yet the pandemic presented additional challenges for families beyond the general disruption COVID-19. The present study investigated parental perspectives of their autistic child's eating behaviours in the United Kingdom during the COVID-19 pandemic. Using reflexive thematic analysis, semi-structured interviews of 15 caregivers of children diagnosed with autism spectrum disorder were analysed. Three main themes were constructed: importance of control; exposure to food and family mealtimes; and an increase in snack and 'junk' food. Eating behaviours in autistic children were both positively and negatively affected by the COVID-19 lockdown. Whilst all parents felt under pressure with extra care responsibilities, some described less concern over food intake during the first lockdown because they were able to support their child's mealtimes and have new food experiences. By the end of the lockdowns, many parents reported worsening of eating behaviours, with children more likely to have a restricted diet, and eating more snack foods. Food shortages also triggered additional stress with parents unable to access their child's preferred food. The findings suggested reducing anxiety triggers and increasing food exposure in safe contexts may aid autistic children in trying new varieties of food. However, to minimise long-term eating difficulties during times of uncertainty when food access may be difficult, parents of autistic children would benefit from wider understanding, acceptance and support managing their child's selective eating.