Purpose This study aimed to investigate the interrater reliability of pediatric feeding assessments conducted via synchronous (real-time) telepractice. Secondary aims were to investigate parent and clinician satisfaction. Method The eating and/or cup drinking skills of 40 children (aged 4 months to 7 years) were simultaneously assessed by one speech-language pathologist (SLP) leading the appointment via telepractice and a second SLP present in the family home. A purpose-designed assessment form was used to assess (a) positioning, (b) development, (c) oral sensorimotor function, (d) prefeeding respiratory status, (e) observation of eating and drinking, (f) parent–child interaction, (g) overall feeding skills, and (h) feeding recommendations. The telepractice SLP completed a postappointment satisfaction questionnaire, and parents completed five questionnaires specifically investigating perceptions of and satisfaction with the telepractice feeding appointment. Results Agreement for all assessment components except intraoral examination (palate integrity and tonsils) was > 85%. All appointments were able to be conducted via telepractice, and for 90% of these ( n = 36), clinicians agreed that telepractice was an effective service delivery method. Parents reported high levels of satisfaction with telepractice, with 76% reporting that the telepractice appointment was similar to a traditional in-person appointment. Conclusion Study results demonstrated that synchronous pediatric feeding assessments conducted in family homes via telepractice were feasible, reliable, and acceptable to both clinicians and parents. Supplemental Material https://doi.org/10.23641/asha.14700228

Parents of children with Autism Spectrum Disorders (ASD) commonly report concerns regarding feeding difficulties and poor nutrition. Feeding difficulties, in the form of undesirable mealtime behaviours and/or skill deficits, can cause parental concern and impact on family dynamics. Poor nutrition can have an impact on development and health outcomes. The purpose of this paper was to review recent research regarding feeding difficulties in children with ASD, in order to describe: (1) the most frequently reported undesirable mealtime behaviours and skill deficits; and (2) dietary intake and weight patterns as markers of nutrition. While the ASD population is a somewhat heterogeneous group, this literature review of 44 research studies identified a number of common issues for these children. Restricted dietary variety, food neophobia, food refusal, limiting diet based on texture, and a propensity towards being overweight were frequently reported. Gaining a better understanding of the common features of feeding difficulties experienced by children with ASD will assist in directing intervention studies. Findings from such studies have the potential to enhance developmental and nutritional outcomes for this group. Well-designed longitudinal research would be valuable in monitoring the impact of feeding difficulties for these children as they age.

The reviewed literature consisted primarily of low-level evidence. Favourable intervention outcomes were observed in terms of increasing volume, but not necessarily variety of foods consumed in young children with ASD and feeding difficulties. Further research in the form of prospective randomized trials to further demonstrate experimental effect in this area is required.