Mealtime interaction patterns between young children with cerebral palsy and their mothers: characteristics and relationship to feeding impairment

Abstract

Background: A significant proportion of children with cerebral palsy have some degree of feeding impairment, which not only affects their ability to obtain adequate nourishment, but may also impinge on their ability to interact with their mothers during mealtimes. The quality of the maternal-child interaction may also be affected by the mealtime being prolonged and/or stressful. Patterns of interaction between mothers and their children with cerebral palsy have typically been described in play situations. There is limited information about interaction during mealtimes. The purpose of this study therefore, was to observe and describe the characteristics of mealtime interaction between mothers and their young children with cerebral palsy, and to determine whether feeding impairment and other sample characteristics were related to interaction patterns.

Methods: The participants were 20 mothers and their children with cerebral palsy. Physical, cognitive, and feeding abilities varied. Video recordings of each mother-child dyad interacting during a typical mealtime were analysed in order to describe the structure of the interaction, the communicative functions used, and what method the children used to communicate. The characteristics of the interaction were summarized and compared and the relationship between feeding ability and other child factors and interaction patterns were explored.

Results: Results revealed that interactions were maternally dominated. Mothers produced most of the communicative behaviour during the mealtime and used more directive functions than their children. The severity of feeding impairment was related to child patterns of interaction, but not to maternal interaction patterns. Language delay was also related to interaction patterns.

Conclusions: The results of this study highlight the importance for professionals to consider mealtime interactions for children with cerebral palsy and their mothers as an integral part of feeding investigations and ongoing interventions, as feeding impairment does seem to have a bearing on aspects of interaction.