Texture related feeding difficulties in children with Down syndrome

Charles Benjamin Bernhard

Children with food texture sensitivity (TS) struggle with food textures, sometimes restricting them to a diet deficient in nutrients. Children with developmental diagnoses, specifically Down syndrome (DS), are disproportionately affected by TS and information is lacking on food texture tolerance in these children. The first study aimed to understand the perception of food textures identified by parents as "easy" or "difficult" for their child. Data responses were collected from a survey of parents of typically developing children (n=573) and of children with DS (n=157). Textures that were less likely (p<0.05) to be cited as "easy" were chewy, gummy/rubbery, hard, and pasty. Textures including creamy, dry, puree, thick, and thin were less likely (p<0.05) to be cited as "difficult." Parents of children with DS tended to use more texture terms to describe their child's liking. These data suggest that prior experience with technical terms differed among parents of children with DS compared to parents of children without DS. Next, the national child feeding study commenced, with the objective of this large-scale home-use-test (HUT) being to measure the acceptance of solid snack food products (SSFP) in children with and without TS who either had a DS diagnosis or did not. In the pilot study, using sensory data from an experienced panel, 15 SSFP were selected to represent the texture spectrum and evaluated by children with and without TS (n=12). Pilot study results suggested that children with TS preferred SSFP that were dissolvable and smooth. For the large-scale study, the trained panel (n=13) evaluated 41 SSFP for a series of sensory properties. SSFP (n=16) representative of the texture spectrum were selected for the national child feeding study in which children 1-4 years of age with DS (n=227) participated (42% TS). The assignation of products to children was controlled for flavor preferences and children evaluated 4 samples/day, for 6 consecutive days with video recording by parents. All videos were evaluated by trained coders. Drawing on principles of food and sensory science, this research describes the development of a novel method that allowed for off-site evaluations of a hard-to-reach population of children.

Texture related feeding difficulties in children with Down syndrome

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