Poster #161 - Characterization of Self-Feeding and Problem Solving in Children with Arm Movement Impairments

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Perceptual, Sensory, Motor

Integrative Statement

Introduction: Self-feeding is a critical self-care skill that allows a child to become more independent from caregivers (Nelson, 1999). Experimentation with food and feeding tools also facilitates problem solving (McCarty et. al., 1999, 2001). Children with arm movement impairments (AMI) may have difficulty lifting their arms against gravity and flexing their arms at the elbows, which limits the ability to reach for and manipulate objects, including food and utensils (Staheli et al., 1998). Limited active experience with these objects may impact problem-solving ability with feeding tools. The goal of this study was to compare self-feeding behavior between children with and without arm movement impairments.
Methods: The study included 18 children with AMI due to arthrogryposis multiplex congenita (multiple joint contractures and weakness present from birth; 5 males, Mean = 23.83 months, SD = 10.86 months, range 12 to 50 months) and 18 typically developing (TD) children, age- and sex-matched with the sample of children with AMI. All children were tested once on their self-feeding and problem-solving behavior across 4, 2-minute trials with a bowl of cereal and 2 spoons, the spoons presented in a different orientation for each trial (Figure 1). Behavioral coding from recorded videos allowed calculation of the percent time each child contacted the food and utensils, had the food on the spoon, placed the food into the mouth, chewed the food, and grasped the correct (handle) vs. incorrect (bowl) side of the spoon.
Results: Compared to their TD peers, children with AMI showed fewer occasions of lifting the spoon (p=.002) or food (p=.004) from the table, less transport of the spoon (p=.030) or food (p<.0001) to the mouth, fewer occasions of grasping the correct side of the spoon (p<.0001) or having food on the spoon (p=.030), fewer instances of chewing the food (p<.0001), more movement of the trunk to facilitate self-feeding (p=.027), and more looking at the food/utensils (p<.0001). For all children, more looking at the food/utensils did not relate to more grasping of the correct side of spoon (p=.302), whereas more instances of correct spoon grasping were related to more occasions of food being on spoon (p=.007), which, in turn, translated into more chewing (p=.040).
Discussion: Children with AMI were less successful than their TD peers in self-feeding. They had difficulty with motor aspects of the task (e.g., grasping the spoon and food, lifting the spoon and food from the table, and bringing the spoon and food to the mouth), which resulted in less food transported into the mouth. Decreased experience manipulating tools like spoons also resulted in challenges with problem solving skills (e.g., grasping the correct side of the spoon), which negatively impacted self-feeding success for children with AMI. Further studies are necessary to document the challenges individuals with AMI face in relation to self-feeding and to assess the impact of assistive technologies and interventions aimed at addressing these challenges to increase independence in self-care for individuals with AMI.

Authors

• Iryna Babik, University of Delaware
  Presenting Author

• Naimisha Movva, Yale University
  Non-Presenting Author

• Andrea Baraldi Cunha, University of Delaware
  Non-Presenting Author

• Michele A. Lobo, University of Delaware
  Non-Presenting Author