The Relationship Between Cooking and Food Preparation Skills of Mothers with Children Diagnosed with Autism Spectrum Disorder and Child's Eating Behaviors and Gastrointestinal Symptoms

The Relationship Between Cooking and Food Preparation Skills of Mothers with Children Diagnosed with Autism Spectrum Disorder and Child's Eating Behaviors and Gastrointestinal Symptoms | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship Between Cooking and Food Preparation Skills of Mothers with Children Diagnosed with Autism Spectrum Disorder and Child's Eating Behaviors and Gastrointestinal Symptoms Fatma KOÇ, Hacı Ömer YILMAZ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4103087/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Mothers have an important role in feeding children. The aim of this study was to determine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and the child's eating behaviors and gastrointestinal symptoms. A significant negative correlation was found between the mothers' total scores on the cooking and food preparation skills and their children's eating behaviors and gastrointestinal symptoms scores. In addition, it was determined that mothers with low scores on the cooking and food preparation skills experienced more eating problems such as food refusal and autism-specific behaviors and gastrointestinal symptoms such as abdominal pain, reflux, diarrhea, indigestion and constipation in their children with autism. It was found that there was a relationship between food preparation and cooking skills of mothers and eating behaviors and gastrointestinal symptoms of their children with autism. Autism spectrum disorder Mother Cooking skills Eating behavior Gastrointestinal symptoms Introduction Autism spectrum disorder is a complex neurodevelopmental disorder that develops due to deficits in communication, behavior and social interaction, in which genetic factors are mainly involved in the etiology and environmental factors increase the risk with their interaction. Autism spectrum disorder, which is seen in 1 in every 44 children, is more common in boys than girls (Maenner, 2021; Manoli et al., 2021). One of the most common symptoms of autism is malnutrition. Individuals with autism are usually very selective and sensitive to a certain food or food group. Especially children with autism refuse to consume certain food groups and experience various problems with their parents in this regard. This can lead to inadequate nutrient intake and various eating behavior disorders in children with autism (Berding & Donovan, 2016). Due to nutritional problems, inadequate or unbalanced nutrient intake and associated malnutrition, iron deficiency, calcium deficiency and related health problems can be seen in children with autism. The risk of obesity increases in children with autism who consume insufficient mineral-vitamins and foods with high amounts of refined sugar and high fat content (Leader et al., 2020). These disturbances in the eating behaviour of children with autism can lead to body weight loss or gain in children (Dhaliwal et al., 2019). It is stated that the prevalence of obesity in children with autism is more than 40% compared to other healthy children (Gray et al., 2018). In addition to eating behaviors, lifestyle and medications used are also among the obesity factors seen in children with autism (Dhaliwal et al., 2019). In addition to nutritional problems, gastrointestinal symptoms, sleep problems, epileptic seizures, behavioral disorders, attention deficit, hyperactivity disorder, learning disabilities, intellectual disabilities, multiple psychiatric disorders such as anxiety and depression, and immune problems are also seen in autism (Leader et al., 2020; Styles et al., 2020). These gastrointestinal symptoms are seen in all age groups of children with autism (Abdellatif et al., 2020). Constipation is among the most common gastrointestinal symptoms. This is thought to be due to the refusal of children with autism to consume foods with high fiber content such as vegetables, and approximately 23-70% of individuals with autism have such gastrointestinal symptoms. It has been found that the severity of these symptoms is associated with the severity of behavioral symptoms seen in children with autism (Huxham et al., 2021; Babinska et al., 2020). The behaviors and attitudes of parents affect the eating behaviors of children with autism. For this reason, it is recommended that parents with children diagnosed with autism regulate their children's eating behavior and have knowledge about their child's nutrition (Girli et al., 2016). In addition, the mother's nutritional knowledge affects the type and amount of food prepared at home (Ulu, 2019). In a study on mothers' nutritional behavior, it was observed that mothers' accurate nutritional knowledge, behavior and application of this knowledge improved the nutritional status of school-age children (Angeles-Agdeppa et al., 2019). Inadequate nutrition knowledge may cause nutrition-related health problems in children. In particular, mothers with inadequate nutritional knowledge may have gastrointestinal problems experienced by their children with autism can make symptoms even more severe (Ulu, 2019). There are many children diagnosed with autism in the world. Almost all children diagnosed with autism experience gastrointestinal symptoms and eating disorders. These problems and disturbances in eating behaviors are closely related to the nutritional status of individuals with autism. Here, the food that the mother cooks at home, the meals she prepares and the eating method she applies to her child play an active role. As a result of the literature review, no study was found on mothers' cooking and food preparation skills and eating behavior and gastrointestinal symptoms of children with autism. The aim of this study was to examine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and the child's eating behaviors and gastrointestinal symptoms. Methods Study Desing and Sample This study is a cross-sectional study and the research model is a relational survey model. The study was conducted with the questionnaire method. This study was conducted between June 2023 and December 2023. The sample of the study consisted of mothers whose children with autism were receiving education in two different rehabilitation centers selected in Istanbul. Before starting the study, official permission was obtained from the relevant institutions. At the beginning of the study, the necessary explanations were made to the mothers by the researchers, and the participants who agreed to participate in the study were included in the study after signing the "Informed Voluntary Consent" form. The sample size of the study was calculated with the G Power 3.1 computer-aided software program by examining similar studies on the subject in the literature (Sharabi et al., 2018; Magoo et al., 2015). Accordingly, the minimum required sample size was determined as 67 using an effect size of 0.35, 95% confidence interval, 5% margin of error and 85% power values. In order to prevent possible data loss, at least 75 participants were targeted and the study was completed with 85 participants. The inclusion criteria for this study were that the child was between the ages of 2 and 18, the child was diagnosed with autism, the mother did not have hearing, speech or mental disability, the mother volunteered to participate in the study, literate and 18 years of age or older. Mothers who did not meet these criteria were not included in the study. Measures The data of the study were obtained by using the face-to- face method with a questionnaire form created by the researchers by reviewing the literature and considering expert views. The questionnaire consists of 4 sections. The first part of the questionnaire included socio-demographic questions about the mother and child, the second part included the Brief Autism Meal Behavior Inventory (BAMBI), the third part included the Cooking and Food Preparation Skills Scale (CS and FS), and the fourth part included the Gastrointestinal Symptom Rating Scale (GSRS). Demographic Information about Mother and Child In this section, there are three subheadings: "Demographic information of the mother", "Information on the mother's cooking and food preparation" and "General information on the child, information on eating habits and nutritional problems". The maternal demographic information section included questions about the mother's age, education level, occupation, number of children, and folic acid use during pregnancy. In the section on the mother's cooking and food preparation, questions were asked about the time spent by the mother in preparing food at home, what kind of food she cooks and menu planning. The section on general information about the child, eating habits and nutritional problems includes questions on the child's age, height, body weight, degree of autism, age of autism diagnosis and nutritional problems experienced by children with autism. Body Mass Index (BMI) values of the children were calculated by the researcher according to the height and body weight of the children with autism reported by their mothers. The calculated BMI values were classified according to the BMI percentile curves according to age from the percentile curves created by Neyzi et al. (2008) by determining the BMI reference values of Turkish children according to body weight, height and age. Accordingly, 0-5 percentile values indicate underweight, 5-85 percentile values indicate normal weight, 85-95 percentile values indicate mild obesity and 95 and above percentile values indicate obese children (Neyzi et al., 2008). Gastrointestinal Symptom Rating Scale (GSRS) Prevalence of gastrointestinal symptoms and detection of clinical findings by Revicki et al. The scale was developed to be used in the assessment of diarrhea, abdominal pain, constipation, indigestion and reflux and includes five sub-dimensions and a total of 15 items (Revicki et al., 1998). The scale is a Likert-type scale with options ranging from "no discomfort at all" to "very severe discomfort" and is scored between 1-7. The 1st, 4th, and 5th items of the scale are designed to assess abdominal pain; 2nd and 3rd items are designed to assess reflux; 6th, 7th, 8th, and 9th items are designed to assess indigestion; 11th, 12th, and 14th items are designed to assess diarrhea and 10th, 13th, and 15th items are designed to assess constipation. The scale score is obtained by summing the scores. A maximum of 105 points and a minimum of 15 points can be obtained from the scale. Higher scores indicate that the gastrointestinal symptoms experienced are more severe. The Cronbach's alpha value of the scale was found to be 0.82. The validity and reliability of the scale in our country was conducted by Turan et al. (Turan et al., 2017). Brief Autism Meal Behavior Brief (BAMBI) Autism meal behavior brief scale (BAMBI) developed by Lukens and Lischeid to determine the behavioral and nutritional problems exhibited by children with autism at mealtime consists of a total of 18 items. The scale includes 5 different options indicating the frequency of occurrence of each item (Lukens et al., 2008). The adaptation of the scale to Turkish children with autism was conducted by Meral and Fidan. In the study conducted on its Turkish validity and reliability, it was reported that the frequency of occurrence options marked for each item should be scored as 1 for never, 2 for rarely/seldom, 3 for occasionally/sometimes, 4 for frequently and 5 for always, and reverse scoring should be done for items 3, 9, 10 and 15 (Meral et al., 2014). As a result of the total score obtained, the total score of items 1, 2, 4, 7, 8 for the BAMBI-total score and the scores of the sub- dimensions; the total score of items 1, 2, 4, 7, 8 for the food rejection score, the total score of items 3, 5, 6, 9, 12 for the determination of the score of autism-specific behaviors, and the sum of the scores of items 10, 11, 13, 14, 15, 16, 17 and 18 for the limited food variety score were evaluated. The higher the BAMBI-total score and the higher the score obtained from the sub-dimensions, the higher the autism- specific negative behaviors seen in children (Lukens et al., 2008). Cooking and Food Preparation Skills Scale (CS and FS) The cooking and food preparation skills scale developed by Lavelle et al. is a scale consisting of 33 items and two sub- dimensions (Lavelle et al., 2017). The cooking skills (CS) sub-dimension consists of 14 items and the food preparation skills (FS) sub-dimension consists of 19 items. The reliability coefficients of the sub-dimensions; the internal consistency reliability for the "Cooking Skills" reliability scale was found to be between 0.78 and 0.93 in all cohorts, and the Cronbach alpha value of the "Food Preparation Skills" reliability scale was between 0.89 and 0.94 (highly reliable). The scale is Likert-type, ranging from 1 (very bad) to 7 (very good) with a never/rarely option. A minimum score of 0 and a maximum score of 231 points can be obtained from the scale. The scale has no cut-off point. As the score obtained from the scale increases, cooking and food preparation skills increase. In this study, according to the median value of the total score of mothers' cooking and food preparation skills, mothers with a score below 138 points were grouped as having low cooking and food preparation skills and mothers with a score above 138 points were grouped as having high cooking and food preparation skills. The Turkish validity and reliability of the scale in Turkey was conducted by Keles (Keles & Akcil, 2021). Ethics Committee Approval of the Research Ethics committee approval was obtained with the meeting No. 04 of XXX University Non-Interventional Ethics Committee held on 28/04/2023. Data Analysis The data obtained from the questionnaires applied to the participants in the study were analyzed using the Statistical Package for Social Sciences (SPSS) 27.0 program. The suitability of the obtained data for normal distribution was evaluated with the "Kolmogorov-Simirnov Test" and if the p values were greater than 0.05 as a result of the test, the data were accepted as suitable for normal distribution. In this study, according to the Kolmogorov-Simirnov Test, all of the relevant scores were found to be suitable for normal distribution. In the statistical evaluation of the descriptive data of the participants who participated in the study; number, percentage, mean, standard deviation, median, minimum and maximum values were used. Since all of the independent variables were suitable for normal distribution, "Independent Sample T Test" was applied to compare the difference between the two groups. At the same time, the scales were analyzed with Pearson correlation test to determine the direction and strength of the relationship between the scales. In the results obtained in this study, the significance level was accepted as p<0.05. Results The study was conducted with 85 mothers with children diagnosed with autism who met the inclusion criteria. The mean age of the mothers who participated in the study was 35.71±9.03 years and the mean age at the time of conception of their children with autism was 27.89±6.27 years. The youngest of the mothers participating in the study was 21 years old and the oldest was 62 years old. It was observed that the earliest age at which they conceived their children with autism was 18 years and the latest age at which they conceived their children with autism was 45 years. 28.2% of them (n=24) high school, 64.6% of them (n=55) were housewives, and 28.2% of them (n=24) had 1 child (Table 1). Table 1. Demographic findings of the mothers (X̄ ± SD) Median Min-max Age (years) 35.71±9.03 35 21-62 Age at conception (years) 27.89±6.27 27 18-45 n % Education status Primary school Middle school High school University Master's degree 13 22 24 23 3 15.3 25.9 28.2 27.1 3.5 Profession Housewife Officer Worker Self-employment Retired Other 55 11 2 6 1 10 64.6 12.9 2.4 7.1 1.2 11.8 Total number of children 1 2 3 4 5 6 or more 24 37 18 3 1 2 28.2 43.5 21.2 3.5 1.2 2.4 How many children diagnosed with autism 1. 2. 3. 4. 6. or more 46 23 13 2 1 54.0 27.1 15.3 2.4 1.2 Having the necessary nutritional knowledge for the child Yes No 44 41 51.8 48.2 Findings related to cooking and food preparation of the mothers presented in Table 2. It was found that 67.1% (n=57) cooked every day. According to the period in which cooking skills were acquired, 41.2% (n=35) learnt to cook as an adult (18+). When the source from which they learnt to cook was questioned; 77.6% (n=66) learnt cooking from their mothers. According to the average cooking time of the mothers 58.8% (n=50) spent one to two hours, 67.1% (n=57) cooked elaborate meals requiring manual labour and 68.2% (n=58) cooked easy-to-prepare meals (Table 2). Table 2. Cooking and food preparation of the mothers n % Frequency of cooking Every day 1-2 days a week 34- days a week 5-6 days a week 57 3 4 21 67.1 3.5 4.7 24.7 Period of acquisition of cooking skills As a child (12 years and under) When young (13-18 years) As an adult (18+) 16 34 35 18.8 40.0 41.2 The source learned to cook* Mother Father Relative Friend Course Television programs Internet Other 66 8 19 18 5 25 45 7 77.6 9.4 22.4 21.2 5.9 29.4 52.9 8.2 Liking to cook Yes No 64 21 75.3 24.7 Menu planning status Yes No Sometimes 30 27 28 35.3 31.8 32.9 Shopping list preparation status Yes No Sometimes 39 28 18 45.9 32.9 21.2 Average meal preparation time per day Less than half an hour Half to one hour One to two hours More than two hours 1 29 50 5 1.2 34.1 58.8 5.9 Type of food usually cooked* Dishes requiring manual labor Frozen or other prepared meals Easy to prepare meals Other 57 32 58 11 67.1 37.6 68.2 12.9 Reading the label information on the packaging Yes No 76 9 89.4 10.6 What you read on the packaging* Production and expiration date Preparation recipe Nutritional value Content Other 69 23 15 35 7 90.8 30.3 19.7 46.1 9.2 *More than one option is marked. Table 3 shows the socio-demographic information obtained from the mothers of children with autism. The mean age of the children included in the study was 7.36±4.64 years, and the mean age at diagnosis of autism was 30.69±11.51 months. Of the children, 16.5% (n=14) were girls, 83.5% (n=71) were boys, 35.3% (n=30) were obese, and 40% (n=34) had moderate autism level (Table 3). Table 3. General information about the child with autism (X̄ ± SD) Median Min-max Age (years) 7.36±4.64 6 2-18 Age at autism diagnosis (month) 30.69±11.51 30 12-72 Height (cm) 125.03±29.98 122 54-190 Weight (kg) 35.55±24.20 25 8.5-98 n % Gender Boy Girl 71 14 83.5 16.5 Percentile grouping (BMI by age) Weak (<5 th ) Normal (5 th to 85 th ) Overweight (85 th to 95 th ) 13 31 11 30 15.3 36.5 12.9 35.3 Degree of autism Lightweight Middle Heavy 33 34 18 38.8 40.0 21.2 Breast milk intake Did not receive 0-6 months 6-12 months 12-18 months 18-24 months Longer than 24 months 11 15 18 19 12 10 12.9 17.6 21.2 22.4 14.1 11.8 Information on eating behaviors of children with autism is shown in Table 4. It was found that 25.9% of them (n=22) consumed two main meals and 37.6% (n=32) consumed one snack meal in a day. Also, according to the nutritional problem status of the children with autism included in the study, 71.8% (n=61) had food selectivity by type, 49.4% (n=42) had food selectivity by texture, 55.3% (n=47) had food rejection, 48.2% (n=41) had rejection of new foods According to the food groups rejected by children with autism, it was found that 34.1% (n=29) rejected milk and dairy products,18.8% (n=16) meat and meat products, 7.1% (n=6) bread and cereal group, 20% (n=17) fruit group, 6.2% (n=58) vegetable group, 10.6% (n=9) other food groups (Table 4). Table 4. Eating habits and problems of children with autism n % Number of main meals (day) 2 3 22 63 25.9 74.1 Number of snacks (day) 1 2 3 or more snacks 32 35 18 37.6 41.2 21.2 Meal skipping status Yes No 65 20 76.5 23.5 Most frequently skipped meal Morning Birdhood Noon Afternoon Evening Night 27 8 15 3 5 7 41.5 12.3 23.1 4.6 7.7 10.8 Reason for skipping meal* Loss of appetite Nausea Bowel problems Stubbornness Meal time coinciding with school Other 40 18 20 33 13 11 61.5 27.7 30.8 50.8 20.0 16.9 Nutrition problems* Food selectivity by species Food selectivity according to food texture Food refusal Rejection of new food Chewing difficulty Swallowing difficulty Problem swallowing without chewing Other 61 42 47 41 10 11 7 7 71.8 49.4 55.3 48.2 11.8 12.9 8.2 8.2 Preferred food group* Milk and dairy products Meat and meat products Bread and cereals Fruit group Vegetable group Other 27 45 60 34 12 5 31.8 52.9 70.6 40.0 14.1 5.9 Preferred food texture* Solid Liquid Soft Rough Smooth Other 60 51 47 26 28 4 70.6 60.0 55.3 30.6 32.9 4.7 Rejected food group* Milk and dairy products Meat and meat products Bread and cereals Fruit group Vegetable group Other 29 16 6 17 58 9 34.1 18.8 7.1 20.0 68.2 10.6 *More than one option is marked. The relationship between the BAMBI scores of the children and the scores of the mothers from the scale of CS and FS was analysed and presented in Table 5. As a result, there was no significant difference (t=1.833; p>0.05) although the total BAMBI scale score of the mothers with low scores from the scale of CS and FS (x̄ =53.02) was higher than that of the mothers with high scores from the scale of CS and FS (x̄ =47.66). There was a significant difference between the "Food Rejection" dimension, one of the sub-dimensions of the BAMBI scale, and the scores of the mothers from the CS and FS scale (t=2.164; p<0.05). There was a significant difference between the "Autism Specific Behaviour" sub-dimension of the subscales of the BAMBI scale and the scores obtained by the mothers from the CS and FS scale (t=3.388; p<0.05). There was no significant difference between the sub-dimension of "Limited Food Selectivity", one of the sub-dimensions of the BAMBI scale, and the scores obtained by the mothers from the CS and FS scale (t=-0.762; p>0.05) (Table 5). In addition, the relationship between children's GSRS scores and mothers' scores on the CS and FS scale was analysed, it was found that GSRS total score and mothers' scores on the CS and FS scale were correlated. There was a significant difference between the scores obtained from the scale (t=3.086; p<0.05). There was a significant difference between the "Abdominal Pain" dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=2.050; p<0.05). There is a significant difference between the "Reflux" dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=3.007; p<0.05) (Table 5). There is a significant difference between the "Diarrhoea" dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=2.382; p<0.05). There is a significant difference between the "Indigestion" dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=3.098; p<0.05) (Table 5). Tablo 5. Statistics of the relationship between mothers' scores on the CS and FS scales and children's GSRS and BAMBI total and subscale scores CS and FS scale low score (<138) (n=43) CS and FS scale high score (≥138) (n=42) t p BAMBI X̄ SD X̄ SD Food refusal Autism specific behavior Limited food selectivity Total BAMBI 14.37 15.48 23.16 53.02 5.97 4.71 6.52 11.80 11.64 12.04 24.26 47.66 5.64 4.64 6.77 14.98 2.164 3.388 -0.762 1.833 0.033** 0.001** 0.448 0.070 GSRS Abdominal pain Reflux Diarrhea Indigestion Constipation Total GSRS 7.79 5.34 8.18 13.51 10.00 44.83 4.00 2.81 4.29 6.94 5.32 19.10 6.16 3.57 6.14 9.50 8.14 33.52 3.24 2.63 3.57 4.83 4.29 14.28 2.050 3.007 2.382 3.098 1.767 3.086 0.044** 0.003** 0.020** 0.003** 0.081 0.003** independent sample t test **p<0.001 *p<0.005 A significant negative correlation was found between "Food Refusal" from the BAMBI sub-dimension and the CS and FS sub-dimension of the scale (r=-0.259). There was a significant negative correlation between "Autism Specific Behaviours" from the BAMBI sub-dimension and CS and FS sub-dimension (r=-0.349) and total CS and FS scale (r=-0.265). There was a significant negative correlation between the total BAMBI scores of the children and the sub-dimensions of CS and FS (r=-0.267). Also, there was a negative correlation between the GSRS sub dimension "Reflux" and CS and FS total scale (r=-0.258) and FS dimension (r=-0.287). There is a significant negative correlation between GSRS sub-dimensions "Diarrhoea" (r=-0.233) and "Indigestion" (r=-0.286) and the dimension of FS. There is a significant negative correlation between the GSRS scale and the sub-dimension of FS (r=-0.276) (Table 6). Table 6. The relationship between children's BAMBI and GSRS scores and mothers' scores on the CS and FS scales CS FS Total score r r r BAMBI-nutrient rejection BAMBI-autism – specific behaviors BAMBI- limited food selectivity 0.095 -0.100 0.206 -0.159* -0.349** -0.044 -0.111 -0.265* 0.077 BAMBI-total 0.099 -0.267* -0.114 GSRS-abdominal pain GSRS-reflux GSRS-diarrhea GSRS-indigestion GSRS-constipation -0.166 -0.162 -0.087 0.008 0.163 -0.194 -0.287** -0.233* -0.286** -0.123 -0.204 -0.258* -0.187 -0.180 0.007 GSRS-total 0.038 -0.276* -0.189 **p<0.001 *p<0.005 r: correlation coefficient Discussion This study is the first study known in the literature that was planned and conducted to determine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and their children's eating behaviors and gastrointestinal symptoms. It is thought that parents having sufficient knowledge about the nutrition of their children with autism will reduce the symptoms of autism seen in children with autism (Senguzel et al., 2021 ). In line with the data obtained in this study, approximately half of the mothers stated that they had knowledge about the nutrition of their children with autism. Similarly, Kabasakal et al. ( 2021 ) reported that two-thirds of parents with children with autism had sufficient knowledge for their children with autism. In contrast to these results, Zeybek ( 2023 ) found that most of the parents did not have sufficient knowledge about the nutrition of their children with autism and that parents wanted to have information about the nutrition of their children with autism. When the results obtained from the literature review are compared, it is thought that one of the reasons why mothers declared that they had nutritional information about their children may be due to the awareness raising in rehabilitation centers and hospitals where they take their children for treatment. When the mothers were questioned about their cooking at home, it was observed that the majority of them cooked every day and that they learned cooking from their mothers or from the internet as adults. Generally, mothers reported that they spent one to two hours a day in the kitchen preparing meals and that the meals cooked were easy to prepare and required manual labor. In a study conducted on adults, it was found that the majority of individuals cooked every day, learned to cook from their mothers, and generally cooked dishes that required manual labor and were easy to prepare (Keles & Akcil, 2021). Likewise, it was found that the majority of students learned to cook at an early age and from a family member (Colton & Bulbul, 2020 ). The findings of our study are consistent with the literature, it is thought that mothers tend to cook easier because they take their children to the rehabilitation center on certain days, and they prefer to cook dishes that require manual labor when they are at home. In line with the data obtained, it was found that the majority of mothers read the label information on the packaging and the most read information was the production and expiration date. Bulak and Ersu ( 2023 ) reported that all of the parents read the labels on the food when purchasing products, and women and men generally looked at the expiration date. Similarly, it was found that when mothers' conscious consumption behaviors increased, they paid attention to the expiration date, content and naturalness of the foods they purchased (Kestane, 2020 ). In this case, it can be said that individuals who read the label information on the product they buy are conscious consumers. A meta-analysis showed that the average age at diagnosis of autism in developed countries ranged between 38–120 months, while in less developed countries the age at diagnosis was even later (Fuentes et al., 2021 ). In this study, according to the statements of the mothers, the average age at diagnosis of autism for children with autism was found to be 30.69 ± 11.51 months. The meta-analysis of 56 studies covering 40 countries on this topic between 2012 and 2019 reported that the mean age at diagnosis of autism in participants aged ≤ 10 years ranged between 30.90 months and 74.70 months. It was also observed that as the age of the participating children increased, the age at diagnosis also increased (van't Hof et al., 2021 ). It was observed that between 12 months and 55 months elapsed between the time when parents felt that there was a difference in their children and were concerned about autism and when they were diagnosed with autism, and parents could not diagnose their children with autism (Bejarano-Martín et al., 2020 ). It is thought that parents have a great influence on the age of early diagnosis in children with autism. Looking at the epidemiology of autism spectrum disorder, it is 4.2 times more common in boys than in girls (CDC, 2023). In this study, the ratio of boys to girls was 5.07. The information obtained overlaps with the literature. One of the strongest known etiologic factors for autism is male gender. The reason for this is that girls have a protective effect from autism compared to boys (Elsabbagh, 2020 ; Lord et al., 2018 ). This supports the higher number of boys with autism compared to girls. Obesity is frequently seen in children with autism due to the nutritional problems they experience and their preference for foods with high refined sugar and fat content in terms of food selectivity. As a result, the risk of obesity in children with autism increases compared to other children with typical development (Leader et al., 2020 ). The finding obtained from this study is in line with the literature and children with autism are generally in the normal weight or obese group. Similarly, Kaynar and Yılmaz ( 2020 ) found that children with autism were obese. It is thought that children with autism are more inclined to ready-made and processed foods containing starch and sweeteners due to food selectivity (Gursoy & Ozturk, 2019 ). This explains the obesity seen in children with autism. According to the statements of the mothers, the majority of children with autism eat three main meals and two snacks, and the majority skip meals, especially the morning and midday meals. The main reason for skipping meals was found to be stubbornness and lack of appetite. Similarly, Elshafie ( 2021 ) found that children with autism eat less than three meals, are tense during meals and experience loss of appetite, so they skip breakfast and dinner. It is thought that the reason for this is the lack of healthy hunger-fullness perception of individuals with autism, digestive problems they experience or the content of meals, and that children with autism skip meals because mothers do not make appropriate meal and nutrition planning for their children with autism. Children diagnosed with autism have more than one eating problem. In this study, the most common eating problems were found to be food selectivity by type and food refusal, and the most preferred food textures of children with autism were solid and liquid foods. A comparison of children with autism and typically developing children as a control group showed that children with autism had more food selectivity and mealtime problems compared to the control group (Babinska et al., 2020 ). Children diagnosed with autism are thought to be picky about food due to gastrointestinal symptoms. According to the statements of the mothers included in the study, children with autism prefer bread and cereals, meat and meat products more, while they refuse to consume vegetables, milk and dairy products. Similarly, Raspini et al. ( 2021 ) reported that children with autism consumed more foods containing high energy and carbohydrates such as rice, biscuits and chocolate, and consumed very little fruits, vegetables, milk and cheese compared to other children; therefore, children with autism may have low calcium and protein levels compared to healthy children. Kaynar and Yılmaz ( 2020 ) examined the nutritional records of children with autism aged 7–14 years and found that children with autism had high protein intake, low fiber intake, and inadequate nutrition in terms of B1, B6, calcium, folate and potassium. This is thought to be due to the fact that children with autism consume less vegetables. An analysis of the relationship between the low and high scores of mothers on the CS and FS scale and the BAMBI and GSRS scores of children with autism showed that children with autism of mothers with low scores on the CS and FS scale exhibited more food refusal and autism-specific behaviors, and experienced more gastrointestinal symptoms such as abdominal pain, reflux, diarrhea and indigestion. In Japan, it was observed that low cooking and food preparation skills of mothers with healthy children were associated with their children consuming fewer vegetables, leading to obesity in children (Tani et al., 2021 ). Mengi and friends (2023) found that there is a relationship between food preparation and cooking skills of university students and their healthy diets. There is a significant relationship between the quality of dietary practices of individuals with high cooking skills and adults with high cooking skills consume less packaged food (Lavelle et al., 2020 ). Similarly, it has been reported that as parents' cooking skills increase, consumption of processed food at home decreases (Martins et al., 2020 ). According to the results obtained; mothers' cooking skills indirectly affect the nutrition of their children with autism. Children included in the study had an age range of 2–18 years. Since children at this age are dependent on their mothers, they consume food cooked by their mothers at home. In short, it is seen that a decrease in mothers' cooking skills leads to an increase in nutritional and gastrointestinal symptoms experienced by children with autism. When the relationship between mothers' cooking skills and food selectivity of children with autism was examined, it was found that the food selectivity experienced in children with autism decreased with the increase in mothers' cooking skills. Looking at the studies in the literature, when basic cooking skills training was given to the parents of kindergarten children, it was observed that the consumption of vegetables and fruits of the children of the parents who received cooking skills training increased after the training compared to the control group. This was reported to be due to the change in the texture and structure of foods with the application of the correct cooking method (Garcia et al., 2020 ). Similarly, children's refusal to consume the vegetable group was found to be related to the mother's cooking skills (Confer et al., 2023 ). In this case, it was observed that children's vegetable consumption would increase with an increase in mothers' cooking skills (Sharkey et al., 2023). According to this information, it is thought that providing training to mothers on food preparation and cooking skills will reduce nutritional problems in children with autism. The findings of the study revealed that food refusal behaviors and abdominal pain in children with autism increased with decreasing food preparation skills and label reading/consumer awareness of mothers. Since this is the first study on this subject, there is no similar study. It is thought that the finding obtained may be due to the fact that children with autism have sensitive intestines, have difficulty in digesting foods containing casein and gluten, and mothers' poor label reading skills may indirectly cause their children to experience abdominal pain. At the same time, in this study, it was observed that autism-specific behaviors, diarrhea, constipation and indigestion exhibited by children with autism increased with the decrease in mothers' shopping resourcefulness, budgeting, food preparation, label reading/consumer awareness and shopping awareness. Bulak and Ersu ( 2023 ) found that parents pay attention to the healthiness of food when buying food for their children. Mothers with children with autism think that their children with autism are not different from children with normal development in terms of nutrition (Sinaga & Pandede, 2021 ). It was observed that the majority of mothers did not have sufficient knowledge about the nutrition of their children with autism (Anderson et al., 2020 ). This explains the serious eating problems and gastrointestinal symptoms experienced by children with autism. In Turkish culture, the mother is usually responsible for preparing meals for the individuals in the household (Unver & Demirli, 2022 ). The type of food cooked by the mother indirectly affects the individuals at home. Children with autism generally have problems in terms of both bowel function and eating behaviors. For this reason, it is thought that they should be fed much more carefully than normal individuals. If mothers are aware of this issue, it is thought that children with autism will have fewer nutritional and behavioral problems. As a result, mothers' food preparation and cooking skills indirectly affect gastrointestinal symptoms and eating behaviors of children with autism. As a solution to this situation, training programs should be organized to improve the cooking and food preparation skills of mothers and expectant mothers. The mothers who have children with autism should be made especially aware of this issue. Declarations Competing Interests The authors have no relevant financial or nonfinancial interests to disclose. Funding : The study has not received financial support. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Ethics committee approval was obtained with the meeting No. 04 of Usküdar University Non-Interventional Ethics Committee held on 28/04/2023. Informed consent to participate All participants provided written informed consent prior to enrollment. Conflict of interest The authors have no relevant financial or nonfinancial interests to disclose. Acknowledgments Author contributions HÖY and FK designed the study. FK collected the data, HÖY and FK performed the statistical analyses and wrote the manuscript. HÖY reviewed the manuscript and contributed to the discussion. both authors read and approved the manuscript. Note This article was produced from the master's thesis of the corresponding author. 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International Journal of Social Inquiry , 15 (1), 143- 156. van’t Hof, M., Tisseur, C., van Berckelear-Onnes, I., van Nieuwenhuyzen, A., Daniels, A. M., Deen, M., ... & Ester, W. A. (2021). Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019. Autism, 25 (4), 862-873. Li, Y., Wang, Y., & Zhang, T. (2022). Fecal microbiota transplantation in autism spectrum disorder. Neuropsychiatric Disease and Treatment, 2905-2915. Zeybek, S. G. (2023). Evaluation of medical nutrition therapy application status of children with autism spectrum diagnosis in northern cyprus. Journal of Cyprus Studies , 23 (48), 17-30. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4103087","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":279815670,"identity":"68d4b33f-e4c5-4bf5-a07a-5139be3e6e62","order_by":0,"name":"Fatma KOÇ","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Fatma","middleName":"","lastName":"KOÇ","suffix":""},{"id":279815671,"identity":"0a44aba7-c98e-4e4b-bb8b-7c512356d7f2","order_by":1,"name":"Hacı Ömer YILMAZ","email":"","orcid":"","institution":"Bandırma Onyedi Eylul University","correspondingAuthor":false,"prefix":"","firstName":"Hacı","middleName":"Ömer","lastName":"YILMAZ","suffix":""}],"badges":[],"createdAt":"2024-03-14 19:29:17","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4103087/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4103087/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53331998,"identity":"79b01c7e-fb8e-4e78-a1cd-3f499e342d5c","added_by":"auto","created_at":"2024-03-24 11:15:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":347061,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4103087/v1/55a4f517-f998-4cfe-bbc7-d40ca0eea198.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Relationship Between Cooking and Food Preparation Skills of Mothers with Children Diagnosed with Autism Spectrum Disorder and Child's Eating Behaviors and Gastrointestinal Symptoms","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAutism\u0026nbsp;spectrum\u0026nbsp;disorder\u0026nbsp;is\u0026nbsp;a\u0026nbsp;complex\u0026nbsp;neurodevelopmental disorder that develops due to deficits in communication, behavior and social interaction, in which genetic factors are mainly involved in the etiology and environmental factors increase the risk with their interaction. Autism spectrum disorder, which is seen in 1 in every 44 children, is more common in boys than girls (Maenner, 2021; Manoli et al., 2021).\u003c/p\u003e\n\u003cp\u003eOne of the most common symptoms of autism is malnutrition. Individuals with autism are usually very selective and sensitive to a certain food or food group. Especially children with autism refuse to consume certain food groups and experience various problems with their parents in this regard. This can lead to inadequate nutrient intake\u0026nbsp;and\u0026nbsp;various\u0026nbsp;eating\u0026nbsp;behavior\u0026nbsp;disorders\u0026nbsp;in\u0026nbsp;children\u0026nbsp;with autism (Berding \u0026amp; Donovan, 2016). Due to nutritional problems, inadequate or unbalanced nutrient intake and associated malnutrition, iron deficiency, calcium deficiency and related health problems can be seen in children with autism. The risk of obesity increases in children with autism who consume insufficient mineral-vitamins and foods\u0026nbsp;with\u0026nbsp;high\u0026nbsp;amounts\u0026nbsp;of\u0026nbsp;refined\u0026nbsp;sugar\u0026nbsp;and\u0026nbsp;high\u0026nbsp;fat\u0026nbsp;content\u0026nbsp;(Leader\u0026nbsp;et\u0026nbsp;al.,\u0026nbsp;2020).\u0026nbsp;These disturbances in the eating behaviour of children with autism can lead to body weight loss or gain in children (Dhaliwal et al., 2019). It is stated that the prevalence of obesity in children with autism is more than 40% compared to other\u0026nbsp;healthy children (Gray et al., 2018). In addition to eating behaviors, lifestyle and medications\u0026nbsp;used are also among the obesity factors\u0026nbsp;seen in children with autism (Dhaliwal et al., 2019).\u003c/p\u003e\n\u003cp\u003eIn addition to nutritional problems, gastrointestinal symptoms, sleep problems, epileptic seizures, behavioral disorders, attention deficit, hyperactivity disorder, learning disabilities, intellectual disabilities, multiple psychiatric disorders such as anxiety and depression, and immune problems\u0026nbsp;are\u0026nbsp;also\u0026nbsp;seen\u0026nbsp;in\u0026nbsp;autism\u0026nbsp;(Leader\u0026nbsp;et\u0026nbsp;al.,\u0026nbsp;2020;\u0026nbsp;Styles et\u0026nbsp;al.,\u0026nbsp;2020).\u0026nbsp;These\u0026nbsp;gastrointestinal\u0026nbsp;symptoms\u0026nbsp;are\u0026nbsp;seen\u0026nbsp;in\u0026nbsp;all age groups\u0026nbsp;of children with autism (Abdellatif et al., 2020). Constipation is among the most common gastrointestinal symptoms.\u0026nbsp;This\u0026nbsp;is\u0026nbsp;thought\u0026nbsp;to\u0026nbsp;be\u0026nbsp;due\u0026nbsp;to\u0026nbsp;the\u0026nbsp;refusal\u0026nbsp;of\u0026nbsp;children with autism to consume foods with high fiber content such as\u0026nbsp;vegetables,\u0026nbsp;and\u0026nbsp;approximately\u0026nbsp;23-70%\u0026nbsp;of\u0026nbsp;individuals\u0026nbsp;with autism have such gastrointestinal symptoms. It has been found\u0026nbsp;that\u0026nbsp;the\u0026nbsp;severity\u0026nbsp;of these\u0026nbsp;symptoms\u0026nbsp;is\u0026nbsp;associated\u0026nbsp;with the severity of behavioral symptoms seen in children with autism (Huxham et al., 2021; Babinska et al., 2020).\u003c/p\u003e\n\u003cp\u003eThe behaviors\u0026nbsp;and attitudes\u0026nbsp;of parents affect the\u0026nbsp;eating behaviors of children with autism. For this reason, it is recommended that parents with children diagnosed with autism regulate their children\u0026apos;s eating behavior and have knowledge\u0026nbsp;about\u0026nbsp;their\u0026nbsp;child\u0026apos;s\u0026nbsp;nutrition\u0026nbsp;(Girli\u0026nbsp;et\u0026nbsp;al.,\u0026nbsp;2016). In addition,\u0026nbsp;the\u0026nbsp;mother\u0026apos;s\u0026nbsp;nutritional\u0026nbsp;knowledge\u0026nbsp;affects\u0026nbsp;the\u0026nbsp;type and\u0026nbsp;amount\u0026nbsp;of\u0026nbsp;food\u0026nbsp;prepared\u0026nbsp;at\u0026nbsp;home\u0026nbsp;(Ulu,\u0026nbsp;2019). In\u0026nbsp;a\u0026nbsp;study on mothers\u0026apos; nutritional behavior, it was observed that mothers\u0026apos; accurate nutritional knowledge, behavior and application\u0026nbsp;of\u0026nbsp;this\u0026nbsp;knowledge\u0026nbsp;improved\u0026nbsp;the\u0026nbsp;nutritional\u0026nbsp;status of school-age children (Angeles-Agdeppa et al., 2019). Inadequate nutrition knowledge may\u0026nbsp;cause nutrition-related health problems in children. In particular, mothers with inadequate nutritional knowledge may have gastrointestinal problems experienced by their children with autism can\u0026nbsp;make\u0026nbsp;symptoms\u0026nbsp;even\u0026nbsp;more severe (Ulu, 2019).\u003c/p\u003e\n\u003cp\u003eThere are many children diagnosed with autism in the world. Almost all children diagnosed with autism experience gastrointestinal symptoms and eating disorders. These problems and disturbances in eating behaviors are closely related to the nutritional status of individuals with autism. Here, the food that the mother cooks at home, the meals she prepares and the eating method she applies to her child play an active role. As a result of the literature review, no study was found on mothers\u0026apos; cooking and food preparation skills and eating behavior and gastrointestinal symptoms of children with autism. The aim of this study was to examine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and the child\u0026apos;s eating behaviors and gastrointestinal symptoms.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch2\u003e\u003cem\u003eStudy Desing and Sample\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThis study is a cross-sectional study and the research model is a relational survey model. The study was conducted with the questionnaire method. This\u0026nbsp;study\u0026nbsp;was\u0026nbsp;conducted\u0026nbsp;between\u0026nbsp;June\u0026nbsp;2023\u0026nbsp;and\u0026nbsp;December 2023. The sample of the study consisted of mothers whose children with autism were receiving education in two different rehabilitation centers selected in Istanbul. Before starting\u0026nbsp;the\u0026nbsp;study,\u0026nbsp;official\u0026nbsp;permission\u0026nbsp;was\u0026nbsp;obtained\u0026nbsp;from\u0026nbsp;the relevant institutions. At the beginning of the study, the necessary explanations were made to the mothers by the researchers,\u0026nbsp;and\u0026nbsp;the\u0026nbsp;participants\u0026nbsp;who\u0026nbsp;agreed\u0026nbsp;to\u0026nbsp;participate\u0026nbsp;in the study were included in the study after signing the \u0026quot;Informed Voluntary Consent\u0026quot; form.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe sample size of the study was calculated with the G Power 3.1 computer-aided software program by examining similar\u0026nbsp;studies\u0026nbsp;on\u0026nbsp;the\u0026nbsp;subject\u0026nbsp;in\u0026nbsp;the\u0026nbsp;literature\u0026nbsp;(Sharabi\u0026nbsp;et\u0026nbsp;al., 2018; Magoo et al., 2015). Accordingly, the minimum required sample size was determined as 67 using an effect size of 0.35, 95% confidence interval, 5% margin of error and\u0026nbsp;85%\u0026nbsp;power\u0026nbsp;values.\u0026nbsp;In\u0026nbsp;order\u0026nbsp;to\u0026nbsp;prevent\u0026nbsp;possible\u0026nbsp;data\u0026nbsp;loss, at least 75 participants were targeted and the study was completed with 85 participants.\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria for this study were that the child was between the ages of 2 and 18, the child was diagnosed with autism, the mother did not have hearing, speech or mental disability,\u0026nbsp;the\u0026nbsp;mother\u0026nbsp;volunteered\u0026nbsp;to\u0026nbsp;participate\u0026nbsp;in\u0026nbsp;the\u0026nbsp;study, literate and 18 years of age or older. Mothers who did not meet these criteria were not included in the study.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eMeasures\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe data of the study were obtained by using the face-to- face method with a questionnaire form created by the researchers by reviewing the literature and considering expert views.\u0026nbsp;The\u0026nbsp;questionnaire\u0026nbsp;consists\u0026nbsp;of\u0026nbsp;4\u0026nbsp;sections.\u0026nbsp;The\u0026nbsp;first part of the questionnaire included socio-demographic questions about the mother and child, the second part included the Brief Autism Meal Behavior Inventory (BAMBI), the third part included the Cooking and Food Preparation Skills Scale (CS and FS), and the fourth part included the Gastrointestinal Symptom Rating Scale (GSRS).\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eDemographic\u0026nbsp;Information\u0026nbsp;about\u0026nbsp;Mother\u0026nbsp;and\u0026nbsp;Child\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eIn this section, there are three subheadings: \u0026quot;Demographic information of the mother\u0026quot;, \u0026quot;Information on the mother\u0026apos;s cooking and\u0026nbsp;food\u0026nbsp;preparation\u0026quot;\u0026nbsp;and\u0026nbsp;\u0026quot;General information on the child, information on eating habits and nutritional problems\u0026quot;.\u0026nbsp;The maternal demographic information section included questions about the mother\u0026apos;s age, education level, occupation, number of children, and folic acid use during pregnancy. In the section on the mother\u0026apos;s cooking and food preparation, questions were asked about the time spent by the mother in preparing food at home, what kind of food she cooks and menu planning.\u003c/p\u003e\n\u003cp\u003eThe section on general information about the child, eating habits and nutritional problems includes questions on the child\u0026apos;s age, height, body weight, degree of autism, age of autism diagnosis and nutritional problems experienced by children with autism.\u003c/p\u003e\n\u003cp\u003eBody Mass Index (BMI) values of the children were calculated by the researcher according to the height and body weight of the children with autism reported by their mothers. The calculated BMI values were classified according to the BMI percentile curves according to age from the percentile curves created by Neyzi et al. (2008) by determining the BMI reference values of Turkish children according to body weight, height and age. Accordingly, 0-5 percentile values indicate underweight, 5-85 percentile values indicate normal weight, 85-95 percentile values indicate mild obesity and 95 and above percentile values indicate obese children (Neyzi et al., 2008).\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eGastrointestinal\u0026nbsp;Symptom\u0026nbsp;Rating\u0026nbsp;Scale\u0026nbsp;(GSRS)\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003ePrevalence of gastrointestinal symptoms and detection of clinical findings by Revicki et al. The scale was developed to be used in the assessment of diarrhea, abdominal pain, constipation, indigestion and reflux and includes five sub-dimensions and a total of 15 items (Revicki et al., 1998).\u0026nbsp;The scale is a Likert-type scale with options ranging from \u0026quot;no discomfort at all\u0026quot; to \u0026quot;very severe discomfort\u0026quot; and is scored between 1-7. The 1st, 4th, and 5th items of the scale are designed to assess abdominal pain; 2nd and 3rd items are designed to assess reflux; 6th, 7th, 8th, and 9th items are designed to assess indigestion; 11th, 12th, and 14th items are designed to assess diarrhea and 10th, 13th, and 15th items are designed to assess constipation. The scale score is obtained by summing the scores. A maximum of 105 points and a minimum of 15 points\u0026nbsp;can\u0026nbsp;be\u0026nbsp;obtained\u0026nbsp;from\u0026nbsp;the\u0026nbsp;scale.\u0026nbsp;Higher\u0026nbsp;scores\u0026nbsp;indicate that the gastrointestinal symptoms experienced are more severe.\u0026nbsp;The\u0026nbsp;Cronbach\u0026apos;s\u0026nbsp;alpha\u0026nbsp;value\u0026nbsp;of\u0026nbsp;the\u0026nbsp;scale\u0026nbsp;was\u0026nbsp;found\u0026nbsp;to be 0.82. The validity and reliability of the scale in our country was conducted by Turan et al. (Turan et al., 2017).\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eBrief\u0026nbsp;Autism Meal Behavior\u0026nbsp;Brief\u0026nbsp;(BAMBI)\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eAutism meal behavior brief scale (BAMBI) developed by Lukens and Lischeid to determine the behavioral and nutritional problems exhibited by children with autism at mealtime\u0026nbsp;consists\u0026nbsp;of\u0026nbsp;a\u0026nbsp;total\u0026nbsp;of\u0026nbsp;18\u0026nbsp;items.\u0026nbsp;The\u0026nbsp;scale\u0026nbsp;includes\u0026nbsp;5 different options indicating the frequency of occurrence of each item (Lukens et al., 2008).\u0026nbsp;The adaptation of the scale to\u0026nbsp;Turkish\u0026nbsp;children\u0026nbsp;with\u0026nbsp;autism\u0026nbsp;was\u0026nbsp;conducted\u0026nbsp;by\u0026nbsp;Meral\u0026nbsp;and Fidan. In the study conducted on its Turkish validity and reliability, it was reported that the frequency of occurrence options\u0026nbsp;marked\u0026nbsp;for\u0026nbsp;each\u0026nbsp;item\u0026nbsp;should\u0026nbsp;be\u0026nbsp;scored\u0026nbsp;as\u0026nbsp;1\u0026nbsp;for\u0026nbsp;never, 2 for rarely/seldom, 3 for occasionally/sometimes, 4 for frequently and 5 for always, and reverse scoring should be done\u0026nbsp;for\u0026nbsp;items\u0026nbsp;3,\u0026nbsp;9,\u0026nbsp;10\u0026nbsp;and\u0026nbsp;15\u0026nbsp;(Meral\u0026nbsp;et\u0026nbsp;al.,\u0026nbsp;2014).\u0026nbsp;As\u0026nbsp;a\u0026nbsp;result of\u0026nbsp;the\u0026nbsp;total\u0026nbsp;score\u0026nbsp;obtained,\u0026nbsp;the\u0026nbsp;total\u0026nbsp;score\u0026nbsp;of\u0026nbsp;items\u0026nbsp;1,\u0026nbsp;2,\u0026nbsp;4,\u0026nbsp;7, 8 for the BAMBI-total score and the scores of the sub- dimensions;\u0026nbsp;the\u0026nbsp;total score\u0026nbsp;of\u0026nbsp;items\u0026nbsp;1,\u0026nbsp;2,\u0026nbsp;4,\u0026nbsp;7,\u0026nbsp;8\u0026nbsp;for\u0026nbsp;the food rejection score, the total score of items 3, 5, 6, 9, 12 for the determination\u0026nbsp;of\u0026nbsp;the\u0026nbsp;score\u0026nbsp;of\u0026nbsp;autism-specific\u0026nbsp;behaviors, and the sum of\u0026nbsp;the scores\u0026nbsp;of\u0026nbsp;items\u0026nbsp;10, 11, 13, 14, 15, 16, 17\u0026nbsp;and 18 for the limited food variety score were evaluated. The higher the BAMBI-total score and the higher the score obtained from the sub-dimensions, the higher the autism- specific negative behaviors seen in children (Lukens et al., 2008).\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eCooking\u0026nbsp;and\u0026nbsp;Food\u0026nbsp;Preparation\u0026nbsp;Skills\u0026nbsp;Scale\u0026nbsp;(CS\u0026nbsp;and FS)\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe cooking and food preparation skills scale developed by Lavelle et al. is a scale consisting of 33 items and two sub- dimensions (Lavelle et al., 2017). The cooking skills (CS) sub-dimension\u0026nbsp;consists\u0026nbsp;of\u0026nbsp;14\u0026nbsp;items\u0026nbsp;and\u0026nbsp;the\u0026nbsp;food\u0026nbsp;preparation skills (FS) sub-dimension consists of 19 items. The reliability coefficients of the sub-dimensions; the internal consistency reliability for the \u0026quot;Cooking Skills\u0026quot; reliability scale was found to be between 0.78 and 0.93 in all cohorts, and the Cronbach alpha value of the \u0026quot;Food Preparation Skills\u0026quot;\u0026nbsp;reliability\u0026nbsp;scale\u0026nbsp;was\u0026nbsp;between\u0026nbsp;0.89\u0026nbsp;and\u0026nbsp;0.94\u0026nbsp;(highly reliable).\u0026nbsp;The\u0026nbsp;scale\u0026nbsp;is\u0026nbsp;Likert-type,\u0026nbsp;ranging\u0026nbsp;from\u0026nbsp;1\u0026nbsp;(very\u0026nbsp;bad) to\u0026nbsp;7\u0026nbsp;(very\u0026nbsp;good)\u0026nbsp;with\u0026nbsp;a\u0026nbsp;never/rarely\u0026nbsp;option.\u0026nbsp;A\u0026nbsp;minimum\u0026nbsp;score\u0026nbsp;of 0 and a maximum score of 231 points can be obtained from the scale. The scale has no cut-off point.\u0026nbsp;As the score obtained from the scale increases, cooking and food preparation skills increase. In this study, according to the median\u0026nbsp;value\u0026nbsp;of\u0026nbsp;the\u0026nbsp;total\u0026nbsp;score\u0026nbsp;of\u0026nbsp;mothers\u0026apos;\u0026nbsp;cooking\u0026nbsp;and\u0026nbsp;food preparation skills, mothers with a score below 138 points were grouped as having low cooking and food preparation skills and mothers with a score above 138 points were grouped\u0026nbsp;as\u0026nbsp;having\u0026nbsp;high\u0026nbsp;cooking\u0026nbsp;and\u0026nbsp;food\u0026nbsp;preparation\u0026nbsp;skills. The Turkish validity and reliability of the scale in Turkey was conducted by Keles (Keles \u0026amp; Akcil, 2021).\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eEthics\u0026nbsp;Committee\u0026nbsp;Approval of\u0026nbsp;the\u0026nbsp;Research\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eEthics committee approval was obtained with the meeting No. 04 of XXX University Non-Interventional Ethics Committee held on 28/04/2023.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eData\u0026nbsp;Analysis\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe data obtained from the questionnaires applied to the participants in the study were analyzed using the Statistical Package for Social Sciences (SPSS) 27.0 program. The suitability of the obtained data for normal distribution was evaluated with the \u0026quot;Kolmogorov-Simirnov Test\u0026quot; and if the p values were greater than 0.05 as a result of the test, the data were accepted as suitable for normal distribution. In this study, according to the Kolmogorov-Simirnov Test, all of the relevant scores were found to be suitable for normal distribution. In the statistical evaluation of the descriptive data of the participants who participated in the study; number, percentage, mean, standard deviation, median, minimum and maximum values were used. Since all of the independent variables were suitable for normal distribution, \u0026quot;Independent Sample T Test\u0026quot; was applied to compare the difference between the two groups. At the same time, the scales were analyzed with Pearson correlation test to determine the direction and strength of the relationship between the scales. In the results obtained in this study, the significance level was accepted as p\u0026lt;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study was conducted with 85 mothers with children diagnosed with autism who met the inclusion criteria.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe mean age of the mothers who participated in the study was 35.71\u0026plusmn;9.03 years and the mean age at the time of conception of their children with autism was 27.89\u0026plusmn;6.27 years. The youngest of the mothers participating in the study was 21 years old and the oldest was 62 years old. It was observed that the earliest age at which they conceived their children with autism was 18 years and the latest age at which they conceived their children with autism was 45 years. 28.2% of them (n=24) high school, 64.6% of them (n=55) were housewives, and 28.2% of them (n=24) had 1 child (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;1.\u003c/strong\u003e Demographic findings of the mothers\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.6124763705104%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.958412098298677%\" valign=\"top\"\u003e\n \u003cp\u003e(X̄ \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.76937618147448%\" valign=\"top\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.659735349716446%\" valign=\"top\"\u003e\n \u003cp\u003eMin-max\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.6124763705104%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.958412098298677%\" valign=\"top\"\u003e\n \u003cp\u003e35.71\u0026plusmn;9.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.76937618147448%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.659735349716446%\" valign=\"top\"\u003e\n \u003cp\u003e21-62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.6124763705104%\" valign=\"top\"\u003e\n \u003cp\u003eAge at conception (years) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.958412098298677%\" valign=\"top\"\u003e\n \u003cp\u003e27.89\u0026plusmn;6.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.76937618147448%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.659735349716446%\" valign=\"top\"\u003e\n \u003cp\u003e18-45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.6124763705104%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.958412098298677%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.76937618147448%\" valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.659735349716446%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation\u0026nbsp;status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePrimary school\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMiddle school\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHigh school\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003cp\u003eMaster\u0026apos;s\u0026nbsp;degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003cp\u003e25.9\u003c/p\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003cp\u003e27.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eProfession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHousewife\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eOfficer\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eWorker\u003c/p\u003e\n \u003cp\u003eSelf-employment\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e64.6\u003c/p\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2.4\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1.2\u003c/p\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;number\u0026nbsp;of\u0026nbsp;children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e6 or\u0026nbsp;more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3.5\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1.2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHow\u0026nbsp;many\u0026nbsp;children\u0026nbsp;diagnosed with\u0026nbsp;autism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.\u003c/p\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003cp\u003e3.\u003c/p\u003e\n \u003cp\u003e4.\u003c/p\u003e\n \u003cp\u003e6. or\u0026nbsp;more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003cp\u003e27.1\u003c/p\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2.4\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHaving\u0026nbsp;the\u0026nbsp;necessary\u0026nbsp;nutritional knowledge\u0026nbsp;for\u0026nbsp;the\u0026nbsp;child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.5%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803030303030305%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.696969696969695%\" valign=\"top\"\u003e\n \u003cp\u003e51.8\u003c/p\u003e\n \u003cp\u003e48.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFindings related to cooking and food preparation of the mothers presented in Table 2. It was found that 67.1% (n=57) cooked every day. According to the period in which cooking skills were acquired, 41.2% (n=35) learnt to cook as an adult (18+). When the source from which they learnt to cook was questioned; 77.6% (n=66) learnt cooking from their mothers. According to the average cooking time of the mothers 58.8% (n=50) spent one to two hours, 67.1% (n=57) cooked elaborate meals requiring manual labour and 68.2% (n=58) cooked easy-to-prepare meals (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;2.\u003c/strong\u003e Cooking and food preparation of the mothers\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eFrequency of cooking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eEvery day\u003c/p\u003e\n \u003cp\u003e1-2 days a week\u003c/p\u003e\n \u003cp\u003e34- days a week\u003c/p\u003e\n \u003cp\u003e5-6 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e67.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3.5\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.7\u003c/p\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003ePeriod of acquisition of cooking skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eAs a child (12 years and under)\u003c/p\u003e\n \u003cp\u003eWhen young (13-18 years)\u003c/p\u003e\n \u003cp\u003eAs an adult (18+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eThe source learned to cook*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eMother\u003c/p\u003e\n \u003cp\u003eFather\u003c/p\u003e\n \u003cp\u003eRelative\u003c/p\u003e\n \u003cp\u003eFriend\u003c/p\u003e\n \u003cp\u003eCourse\u003c/p\u003e\n \u003cp\u003eTelevision programs\u003c/p\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5\u003c/p\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e77.6\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 9.4\u003c/p\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5.9\u003c/p\u003e\n \u003cp\u003e29.4\u003c/p\u003e\n \u003cp\u003e52.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eLiking to cook\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e75.3\u003c/p\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eMenu planning status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003cp\u003e31.8\u003c/p\u003e\n \u003cp\u003e32.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eShopping list preparation status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003cp\u003e32.9\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eAverage meal preparation time per day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eLess than half an hour\u003c/p\u003e\n \u003cp\u003eHalf to one hour\u003c/p\u003e\n \u003cp\u003eOne to two hours\u003c/p\u003e\n \u003cp\u003eMore than two hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 1\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 1.2\u003c/p\u003e\n \u003cp\u003e34.1\u003c/p\u003e\n \u003cp\u003e58.8\u003c/p\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eType of food usually cooked*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eDishes requiring manual labor\u003c/p\u003e\n \u003cp\u003eFrozen or other prepared meals\u003c/p\u003e\n \u003cp\u003eEasy to prepare meals\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e67.1\u003c/p\u003e\n \u003cp\u003e37.6\u003c/p\u003e\n \u003cp\u003e68.2\u003c/p\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eReading the label information on the packaging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e89.4\u003c/p\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eWhat you read on the packaging*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"62.275449101796404%\" valign=\"top\"\u003e\n \u003cp\u003eProduction and expiration date\u003c/p\u003e\n \u003cp\u003ePreparation recipe\u003c/p\u003e\n \u003cp\u003eNutritional value\u003c/p\u003e\n \u003cp\u003eContent\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962075848303392%\" valign=\"top\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.7624750499002%\" valign=\"top\"\u003e\n \u003cp\u003e90.8\u003c/p\u003e\n \u003cp\u003e30.3\u003c/p\u003e\n \u003cp\u003e19.7\u003c/p\u003e\n \u003cp\u003e46.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;*More than one option is marked.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 shows the socio-demographic information obtained from the mothers of children with autism. The mean age of the children included in the study was 7.36\u0026plusmn;4.64 years, and the mean age at diagnosis of autism was 30.69\u0026plusmn;11.51 months. Of the children, 16.5% (n=14) were girls, 83.5% (n=71) were boys, 35.3% (n=30) were obese, and 40% (n=34) had moderate autism level (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eGeneral\u0026nbsp;information\u0026nbsp;about\u0026nbsp;the\u0026nbsp;child\u0026nbsp;with\u0026nbsp;autism\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e(X̄ \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003eMedian\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003eMin-max\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e7.36\u0026plusmn;4.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e2-18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eAge at autism diagnosis (month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e30.69\u0026plusmn;11.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e12-72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eHeight (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e125.03\u0026plusmn;29.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e54-190\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eWeight (kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;35.55\u0026plusmn;24.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e8.5-98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eBoy\u003c/p\u003e\n \u003cp\u003eGirl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e83.5\u003c/p\u003e\n \u003cp\u003e16.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003ePercentile grouping (BMI by age)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eWeak (\u0026lt;5\u003csup\u003eth\u003c/sup\u003e)\u003c/p\u003e\n \u003cp\u003eNormal (5\u003csup\u003eth\u003c/sup\u003e to 85\u003csup\u003eth\u003c/sup\u003e)\u003c/p\u003e\n \u003cp\u003eOverweight (85\u003csup\u003eth\u003c/sup\u003e to \u0026lt;95\u003csup\u003eth\u003c/sup\u003e)\u003c/p\u003e\n \u003cp\u003eObese (\u0026gt;95\u003csup\u003eth\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003cp\u003e36.5\u003c/p\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eDegree of autism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eLightweight\u003c/p\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003cp\u003eHeavy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e38.8\u003c/p\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eBreast milk intake\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.549019607843135%\" valign=\"top\"\u003e\n \u003cp\u003eDid not receive\u003c/p\u003e\n \u003cp\u003e0-6 months\u003c/p\u003e\n \u003cp\u003e6-12 months\u003c/p\u003e\n \u003cp\u003e12-18 months\u003c/p\u003e\n \u003cp\u003e18-24 months\u003c/p\u003e\n \u003cp\u003eLonger than 24 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.254901960784313%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.80392156862745%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.392156862745097%\" valign=\"top\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eInformation on eating behaviors of children with autism is shown in Table 4. It was found that 25.9% of them (n=22) consumed two main meals and 37.6% (n=32) consumed one snack meal in a day. Also, according to the nutritional problem status of the children with autism included in the study, 71.8% (n=61) had food selectivity by type, 49.4% (n=42) had food selectivity by texture, 55.3% (n=47) had food rejection, 48.2% (n=41) had rejection of new foods According to the food groups rejected by children with autism, it was found that 34.1% (n=29) rejected milk and dairy products,18.8% (n=16) meat and meat products, 7.1% (n=6) bread and cereal group, 20% (n=17) fruit group, 6.2% (n=58) vegetable group, 10.6% (n=9) other food groups (Table 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;4.\u003c/strong\u003e Eating habits and problems of children with autism\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of main meals (day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e25.9\u003c/p\u003e\n \u003cp\u003e74.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of snacks (day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e3 or more snacks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e37.6\u003c/p\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eMeal skipping status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003cp\u003e23.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eMost frequently skipped meal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eMorning\u003c/p\u003e\n \u003cp\u003eBirdhood\u003c/p\u003e\n \u003cp\u003eNoon\u003c/p\u003e\n \u003cp\u003eAfternoon\u003c/p\u003e\n \u003cp\u003eEvening\u003c/p\u003e\n \u003cp\u003eNight\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003cp\u003e23.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.6\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7.7\u003c/p\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eReason for skipping meal*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eLoss of appetite\u003c/p\u003e\n \u003cp\u003eNausea\u003c/p\u003e\n \u003cp\u003eBowel problems\u003c/p\u003e\n \u003cp\u003eStubbornness\u003c/p\u003e\n \u003cp\u003eMeal time coinciding with school\u003c/p\u003e\n \u003cp\u003eOther\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e61.5\u003c/p\u003e\n \u003cp\u003e27.7\u003c/p\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003cp\u003e50.8\u003c/p\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eNutrition problems*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eFood selectivity by species\u003c/p\u003e\n \u003cp\u003eFood selectivity according to food texture\u003c/p\u003e\n \u003cp\u003eFood refusal\u003c/p\u003e\n \u003cp\u003eRejection of new food\u003c/p\u003e\n \u003cp\u003eChewing difficulty\u003c/p\u003e\n \u003cp\u003eSwallowing difficulty\u003c/p\u003e\n \u003cp\u003eProblem swallowing without chewing\u003c/p\u003e\n \u003cp\u003eOther\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e71.8\u003c/p\u003e\n \u003cp\u003e49.4\u003c/p\u003e\n \u003cp\u003e55.3\u003c/p\u003e\n \u003cp\u003e48.2\u003c/p\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8.2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003ePreferred food group*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eMilk and dairy products\u003c/p\u003e\n \u003cp\u003eMeat and meat products\u003c/p\u003e\n \u003cp\u003eBread and cereals\u003c/p\u003e\n \u003cp\u003eFruit group\u003c/p\u003e\n \u003cp\u003eVegetable group\u003c/p\u003e\n \u003cp\u003eOther\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e31.8\u003c/p\u003e\n \u003cp\u003e52.9\u003c/p\u003e\n \u003cp\u003e70.6\u003c/p\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003ePreferred food texture*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eSolid\u003c/p\u003e\n \u003cp\u003eLiquid\u003c/p\u003e\n \u003cp\u003eSoft\u003c/p\u003e\n \u003cp\u003eRough\u003c/p\u003e\n \u003cp\u003eSmooth\u003c/p\u003e\n \u003cp\u003eOther\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e70.6\u003c/p\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003cp\u003e55.3\u003c/p\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003cp\u003e32.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eRejected food group*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.62068965517241%\" valign=\"top\"\u003e\n \u003cp\u003eMilk and dairy products\u003c/p\u003e\n \u003cp\u003eMeat and meat products\u003c/p\u003e\n \u003cp\u003eBread and cereals\u003c/p\u003e\n \u003cp\u003eFruit group\u003c/p\u003e\n \u003cp\u003eVegetable group\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.344827586206897%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03448275862069%\" valign=\"top\"\u003e\n \u003cp\u003e34.1\u003c/p\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 7.1\u003c/p\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003cp\u003e68.2\u003c/p\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e*More than one option is marked.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe relationship between the BAMBI scores of the children and the scores of the mothers from the scale of CS and FS was analysed and presented in Table 5. As a result, there was no significant difference (t=1.833; p\u0026gt;0.05) although the total BAMBI scale score of the mothers with low scores from the scale of CS and FS (x̄ =53.02) was higher than that of the mothers with high scores from the scale of CS and FS (x̄\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e=47.66). There was a significant difference between the \u0026quot;Food Rejection\u0026quot; dimension, one of the sub-dimensions of the BAMBI scale, and the scores of the mothers from the CS and FS scale (t=2.164; p\u0026lt;0.05). There was a significant difference between the \u0026quot;Autism Specific Behaviour\u0026quot; sub-dimension of the subscales of the BAMBI scale and the scores obtained by the mothers from the CS and FS scale (t=3.388; p\u0026lt;0.05). There was no significant difference between the sub-dimension of \u0026quot;Limited Food Selectivity\u0026quot;, one of the sub-dimensions of the BAMBI scale, and the scores obtained by the mothers from the CS and FS scale (t=-0.762; p\u0026gt;0.05) (Table 5).\u003c/p\u003e\n\u003cp\u003eIn addition, the relationship between children\u0026apos;s GSRS scores and mothers\u0026apos; scores on the CS and FS scale was analysed, it was found that GSRS total score and mothers\u0026apos; scores on the CS and FS scale were correlated. There was a significant difference between the scores obtained from the scale (t=3.086; p\u0026lt;0.05). There was a significant difference between the \u0026quot;Abdominal Pain\u0026quot; dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=2.050; p\u0026lt;0.05). \u0026nbsp; There is a significant difference between the \u0026quot;Reflux\u0026quot; dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=3.007; p\u0026lt;0.05) (Table 5).\u003c/p\u003e\n\u003cp\u003eThere is a significant difference between the \u0026quot;Diarrhoea\u0026quot; dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=2.382; p\u0026lt;0.05). There is a significant difference between the \u0026quot;Indigestion\u0026quot; dimension of the GSRS sub-dimensions and the scores obtained by the mothers from the CS and FS scale (t=3.098; p\u0026lt;0.05) (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTablo 5.\u003c/strong\u003e Statistics of the relationship between mothers\u0026apos; scores on the CS and FS scales\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eand children\u0026apos;s GSRS and BAMBI total and subscale scores\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.10951526032316%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.6983842010772%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCS and FS scale low score\u003c/p\u003e\n \u003cp\u003e(\u0026lt;138) (n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.59605026929982%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCS and FS scale high score\u003c/p\u003e\n \u003cp\u003e(\u0026ge;138) (n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.746858168761221%\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.8491921005386%\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.060931899641577%\" valign=\"top\"\u003e\n \u003cp\u003eBAMBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.21505376344086%\" valign=\"top\"\u003e\n \u003cp\u003eX̄\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.620071684587813%\" valign=\"top\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.498207885304659%\" valign=\"top\"\u003e\n \u003cp\u003eX̄\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.053763440860216%\" valign=\"top\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.724014336917563%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.060931899641577%\" valign=\"top\"\u003e\n \u003cp\u003eFood refusal\u003c/p\u003e\n \u003cp\u003eAutism specific behavior\u003c/p\u003e\n \u003cp\u003eLimited food selectivity\u003c/p\u003e\n \u003cp\u003eTotal BAMBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.21505376344086%\" valign=\"top\"\u003e\n \u003cp\u003e14.37\u003c/p\u003e\n \u003cp\u003e15.48\u003c/p\u003e\n \u003cp\u003e23.16\u003c/p\u003e\n \u003cp\u003e53.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.620071684587813%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 5.97\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.71\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6.52\u003c/p\u003e\n \u003cp\u003e11.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.498207885304659%\" valign=\"top\"\u003e\n \u003cp\u003e11.64\u003c/p\u003e\n \u003cp\u003e12.04\u003c/p\u003e\n \u003cp\u003e24.26\u003c/p\u003e\n \u003cp\u003e47.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.053763440860216%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 5.64\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.64\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6.77\u003c/p\u003e\n \u003cp\u003e14.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.724014336917563%\" valign=\"top\"\u003e\n \u003cp\u003e2.164\u003c/p\u003e\n \u003cp\u003e3.388\u003c/p\u003e\n \u003cp\u003e-0.762\u003c/p\u003e\n \u003cp\u003e1.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\" valign=\"top\"\u003e\n \u003cp\u003e0.033**\u003c/p\u003e\n \u003cp\u003e0.001**\u003c/p\u003e\n \u003cp\u003e0.448\u003c/p\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.060931899641577%\" valign=\"top\"\u003e\n \u003cp\u003eGSRS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.21505376344086%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.620071684587813%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.498207885304659%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.053763440860216%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.724014336917563%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.060931899641577%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal pain\u003c/p\u003e\n \u003cp\u003eReflux\u003c/p\u003e\n \u003cp\u003eDiarrhea\u003c/p\u003e\n \u003cp\u003eIndigestion\u003c/p\u003e\n \u003cp\u003eConstipation\u003c/p\u003e\n \u003cp\u003eTotal GSRS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.21505376344086%\" valign=\"top\"\u003e\n \u003cp\u003e7.79\u003c/p\u003e\n \u003cp\u003e5.34\u003c/p\u003e\n \u003cp\u003e8.18\u003c/p\u003e\n \u003cp\u003e13.51\u003c/p\u003e\n \u003cp\u003e10.00\u003c/p\u003e\n \u003cp\u003e44.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.620071684587813%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 4.00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2.81\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.29\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6.94\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 5.32\u003c/p\u003e\n \u003cp\u003e19.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.498207885304659%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 6.16\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3.57\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 6.14\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 9.50\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 8.14\u003c/p\u003e\n \u003cp\u003e33.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.053763440860216%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 3.24\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 2.63\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 3.57\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.83\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 4.29\u003c/p\u003e\n \u003cp\u003e14.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.724014336917563%\" valign=\"top\"\u003e\n \u003cp\u003e2.050\u003c/p\u003e\n \u003cp\u003e3.007\u003c/p\u003e\n \u003cp\u003e2.382\u003c/p\u003e\n \u003cp\u003e3.098\u003c/p\u003e\n \u003cp\u003e1.767\u003c/p\u003e\n \u003cp\u003e3.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\" valign=\"top\"\u003e\n \u003cp\u003e0.044**\u003c/p\u003e\n \u003cp\u003e0.003**\u003c/p\u003e\n \u003cp\u003e0.020**\u003c/p\u003e\n \u003cp\u003e0.003**\u003c/p\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003cp\u003e0.003**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;independent sample t test\u003c/em\u003e **p\u0026lt;0.001 *p\u0026lt;0.005\u003c/p\u003e\n\u003cp\u003eA significant negative correlation was found between \u0026quot;Food Refusal\u0026quot; from the BAMBI sub-dimension and the CS and FS sub-dimension of the scale (r=-0.259). There was a significant negative correlation between \u0026quot;Autism Specific Behaviours\u0026quot; from the BAMBI sub-dimension and CS and FS sub-dimension (r=-0.349) and total CS and FS scale (r=-0.265). There was a significant negative correlation between the total BAMBI scores of the children and the sub-dimensions of CS and FS (r=-0.267). Also, there was a negative correlation between the GSRS sub dimension \u0026quot;Reflux\u0026quot; and CS and FS total scale (r=-0.258) and FS dimension (r=-0.287). There is a significant negative correlation between GSRS sub-dimensions \u0026quot;Diarrhoea\u0026quot; (r=-0.233) and \u0026quot;Indigestion\u0026quot; (r=-0.286) and the dimension of FS. There is a significant negative correlation between the GSRS scale and the sub-dimension of FS (r=-0.276) (Table 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6.\u0026nbsp;\u003c/strong\u003eThe relationship between children\u0026apos;s BAMBI and GSRS scores and mothers\u0026apos; scores on the CS and FS scales\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003eBAMBI-nutrient rejection\u003c/p\u003e\n \u003cp\u003eBAMBI-autism \u0026ndash; specific behaviors\u003c/p\u003e\n \u003cp\u003eBAMBI- limited food selectivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003cp\u003e-0.100\u003c/p\u003e\n \u003cp\u003e0.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.159*\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.349**\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.111\u003c/p\u003e\n \u003cp\u003e-0.265*\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003eBAMBI-total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.267*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003eGSRS-abdominal pain\u003c/p\u003e\n \u003cp\u003eGSRS-reflux\u003c/p\u003e\n \u003cp\u003eGSRS-diarrhea\u003c/p\u003e\n \u003cp\u003eGSRS-indigestion\u003c/p\u003e\n \u003cp\u003eGSRS-constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003e-0.166\u003c/p\u003e\n \u003cp\u003e-0.162\u003c/p\u003e\n \u003cp\u003e-0.087\u003c/p\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.194\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.287**\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.233*\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;-0.286**\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.204\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.258*\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.187\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.180\u003c/p\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.72211720226843%\" valign=\"top\"\u003e\n \u003cp\u003eGSRS-total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.793950850661627%\" valign=\"top\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.415879017013232%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.276*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.068052930056712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; -0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e**p\u0026lt;0.001 *p\u0026lt;0.005 r: correlation coefficient\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study is the first study known in the literature that was planned and conducted to determine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and their children's eating behaviors and gastrointestinal symptoms.\u003c/p\u003e \u003cp\u003eIt is thought that parents having sufficient knowledge about the nutrition of their children with autism will reduce the symptoms of autism seen in children with autism (Senguzel et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In line with the data obtained in this study, approximately half of the mothers stated that they had knowledge about the nutrition of their children with autism. Similarly, Kabasakal et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) reported that two-thirds of parents with children with autism had sufficient knowledge for their children with autism. In contrast to these results, Zeybek (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) found that most of the parents did not have sufficient knowledge about the nutrition of their children with autism and that parents wanted to have information about the nutrition of their children with autism. When the results obtained from the literature review are compared, it is thought that one of the reasons why mothers declared that they had nutritional information about their children may be due to the awareness raising in rehabilitation centers and hospitals where they take their children for treatment.\u003c/p\u003e \u003cp\u003eWhen the mothers were questioned about their cooking at home, it was observed that the majority of them cooked every day and that they learned cooking from their mothers or from the internet as adults. Generally, mothers reported that they spent one to two hours a day in the kitchen preparing meals and that the meals cooked were easy to prepare and required manual labor. In a study conducted on adults, it was found that the majority of individuals cooked every day, learned to cook from their mothers, and generally cooked dishes that required manual labor and were easy to prepare (Keles \u0026amp; Akcil, 2021). Likewise, it was found that the majority of students learned to cook at an early age and from a family member (Colton \u0026amp; Bulbul, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The findings of our study are consistent with the literature, it is thought that mothers tend to cook easier because they take their children to the rehabilitation center on certain days, and they\u003c/p\u003e \u003cp\u003eprefer to cook dishes that require manual labor when they are at home.\u003c/p\u003e \u003cp\u003eIn line with the data obtained, it was found that the majority of mothers read the label information on the packaging and the most read information was the production and expiration date. Bulak and Ersu (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) reported that all of the parents read the labels on the food when purchasing products, and women and men generally looked at the expiration date. Similarly, it was found that when mothers' conscious consumption behaviors increased, they paid attention to the expiration date, content and naturalness of the foods they purchased (Kestane, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In this case, it can be said that individuals who read the label information on the product they buy are conscious consumers.\u003c/p\u003e \u003cp\u003eA meta-analysis showed that the average age at diagnosis of autism in developed countries ranged between 38\u0026ndash;120 months, while in less developed countries the age at diagnosis was even later (Fuentes et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In this study, according to the statements of the mothers, the average age at diagnosis of autism for children with autism was found to be 30.69\u0026thinsp;\u0026plusmn;\u0026thinsp;11.51 months. The meta-analysis of 56 studies covering 40 countries on this topic between 2012 and 2019 reported that the mean age at diagnosis of autism in participants aged\u0026thinsp;\u0026le;\u0026thinsp;10 years ranged between 30.90 months and 74.70 months. It was also observed that as the age of the participating children increased, the age at diagnosis also increased (van't Hof et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). It was observed that between 12 months and 55 months elapsed between the time when parents felt that there was a difference in their children and were concerned about autism and when they were diagnosed with autism, and parents could not diagnose their children with autism (Bejarano-Mart\u0026iacute;n et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). It is thought that parents have a great influence on the age of early diagnosis in children with autism.\u003c/p\u003e \u003cp\u003eLooking at the epidemiology of autism spectrum disorder, it is 4.2 times more common in boys than in girls (CDC, 2023). In this study, the ratio of boys to girls was 5.07. The information obtained overlaps with the literature. One of the strongest known etiologic factors for autism is male gender. The reason for this is that girls have a protective effect from autism compared to boys (Elsabbagh, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Lord et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This supports the higher number of boys with autism compared to girls.\u003c/p\u003e \u003cp\u003eObesity is frequently seen in children with autism due to the nutritional problems they experience and their preference for foods with high refined sugar and fat content in terms of food selectivity. As a result, the risk of obesity in children with autism increases compared to other children with typical development (Leader et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The finding obtained from this study is in line with the literature and children with autism are generally in the normal weight or obese group. Similarly, Kaynar and Yılmaz (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) found that children with autism were obese. It is thought that children with autism are more inclined to ready-made and processed foods containing starch and sweeteners due to food selectivity (Gursoy \u0026amp; Ozturk, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). This explains the obesity seen in children with autism.\u003c/p\u003e \u003cp\u003eAccording to the statements of the mothers, the majority of children with autism eat three main meals and two snacks, and the majority skip meals, especially the morning and midday meals. The main reason for skipping meals was found to be stubbornness and lack of appetite. Similarly, Elshafie (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that children with autism eat less than three meals, are tense during meals and experience loss of appetite, so they skip breakfast and dinner. It is thought that the reason for this is the lack of healthy hunger-fullness perception of individuals with autism, digestive problems they experience or the content of meals, and that children with autism skip meals because mothers do not make appropriate meal and nutrition planning for their children with autism.\u003c/p\u003e \u003cp\u003eChildren diagnosed with autism have more than one eating problem. In this study, the most common eating problems were found to be food selectivity by type and food refusal, and the most preferred food textures of children with autism were solid and liquid foods. A comparison of children with autism and typically developing children as a control group showed that children with autism had more food selectivity and mealtime problems compared to the control group (Babinska et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Children diagnosed with autism are thought to be picky about food due to gastrointestinal symptoms.\u003c/p\u003e \u003cp\u003eAccording to the statements of the mothers included in the study, children with autism prefer bread and cereals, meat and meat products more, while they refuse to consume vegetables, milk and dairy products. Similarly, Raspini et al. (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) reported that children with autism consumed more foods containing high energy and carbohydrates such as rice, biscuits and chocolate, and consumed very little fruits, vegetables, milk and cheese compared to other children; therefore, children with autism may have low calcium and protein levels compared to healthy children. Kaynar and Yılmaz (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) examined the nutritional records of children with autism aged 7\u0026ndash;14 years and found that children with autism had high protein intake, low fiber intake, and inadequate nutrition in terms of B1, B6, calcium, folate and potassium. This is thought to be due to the fact that children with autism consume less vegetables.\u003c/p\u003e \u003cp\u003eAn analysis of the relationship between the low and high scores of mothers on the CS and FS scale and the BAMBI and GSRS scores of children with autism showed that children with autism of mothers with low scores on the CS and FS scale exhibited more food refusal and autism-specific behaviors, and experienced more gastrointestinal symptoms such as abdominal pain, reflux, diarrhea and indigestion. In Japan, it was observed that low cooking and food preparation skills of mothers with healthy children were associated with their children consuming fewer vegetables, leading to obesity in children (Tani et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Mengi and friends (2023) found that there is a relationship between food preparation and cooking skills of university students and their healthy diets. There is a significant relationship between the quality of dietary practices of individuals with high cooking skills and adults with high cooking skills consume less packaged food (Lavelle et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Similarly, it has been reported that as parents' cooking skills increase, consumption of processed food at home decreases (Martins et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). According to the results obtained; mothers' cooking skills indirectly affect the nutrition of their children with autism. Children included in the study had an age range of 2\u0026ndash;18 years. Since children at this age are dependent on their mothers, they consume food cooked by their mothers at home. In short, it is seen that a decrease in mothers' cooking skills leads to an increase in nutritional and gastrointestinal symptoms experienced by children with autism.\u003c/p\u003e \u003cp\u003eWhen the relationship between mothers' cooking skills and food selectivity of children with autism was examined, it was found that the food selectivity experienced in children with autism decreased with the increase in mothers' cooking skills. Looking at the studies in the literature, when basic cooking skills training was given to the parents of kindergarten children, it was observed that the consumption of vegetables and fruits of the children of the parents who received cooking skills training increased after the training compared to the control group. This was reported to be due to the change in the texture and structure of foods with the application of the correct cooking method (Garcia et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Similarly, children's refusal to consume the vegetable group was found to be related to the mother's cooking skills (Confer et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In this case, it was observed that children's vegetable consumption would increase with an increase in mothers' cooking skills (Sharkey et al., 2023). According to this information, it is thought that providing training to mothers on food preparation and cooking skills will reduce nutritional problems in children with autism.\u003c/p\u003e \u003cp\u003eThe findings of the study revealed that food refusal behaviors and abdominal pain in children with autism increased with decreasing food preparation skills and label reading/consumer awareness of mothers. Since this is the first study on this subject, there is no similar study. It is thought that the finding obtained may be due to the fact that children with autism have sensitive intestines, have difficulty in digesting foods containing casein and gluten, and mothers' poor label reading skills may indirectly cause their children to experience abdominal pain. At the same time, in this study, it was observed that autism-specific behaviors, diarrhea, constipation and indigestion exhibited by children with autism increased with the decrease in mothers' shopping resourcefulness, budgeting, food preparation, label reading/consumer awareness and shopping awareness. Bulak and Ersu (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) found that parents pay attention to the healthiness of food when buying food for their children. Mothers with children with autism think that their children with autism are not different from children with normal development in terms of nutrition (Sinaga \u0026amp; Pandede, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). It was observed that the majority of mothers did not have sufficient knowledge about the nutrition of their children with autism (Anderson et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This explains the serious eating problems and gastrointestinal symptoms experienced by children with autism. In Turkish culture, the mother is usually responsible for preparing meals for the individuals in the household (Unver \u0026amp; Demirli, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). The type of food cooked by the mother indirectly affects the individuals at home. Children with autism generally have problems in terms of both bowel function and eating behaviors. For this reason, it is thought that they should be fed much more carefully than normal individuals. If mothers are aware of this issue, it is thought that children with autism will have fewer nutritional and behavioral problems.\u003c/p\u003e \u003cp\u003eAs a result, mothers' food preparation and cooking skills indirectly affect gastrointestinal symptoms and eating behaviors of children with autism. As a solution to this situation, training programs should be organized to improve the cooking and food preparation skills of mothers and expectant mothers. The mothers who have children with autism should be made especially aware of this issue.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e The authors have no relevant financial or nonfinancial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: The study has not received financial support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e This study was performed in line with the principles of the Declaration of Helsinki.\u0026nbsp;Ethics committee approval was obtained with the meeting No. 04 of Usk\u0026uuml;dar University Non-Interventional Ethics Committee held on 28/04/2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent to participate\u003c/strong\u003e All participants provided written informed consent prior to enrollment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e The authors have no relevant financial or nonfinancial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u0026nbsp;\u003c/strong\u003eH\u0026Ouml;Y and FK designed the study. FK collected the data, H\u0026Ouml;Y and FK performed the statistical analyses and wrote the manuscript. H\u0026Ouml;Y reviewed the manuscript and contributed to the discussion. both authors read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNote\u003c/strong\u003e This article was produced from the master\u0026apos;s thesis of the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAbdellatif, B., McVeigh C., Bendriss G., Chaari A. (2020). The promising role of probiotics in managing altered gut in autism spectrum disorders. \u003cem\u003eInternational Journal of Molecular Science, 21\u003c/em\u003e(11):4159.\u003c/li\u003e\n \u003cli\u003eAnderson, J., Marley, C., Gillespie-Smith, K., Carter, L., \u0026amp; MacMahon, K. (2020). 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Fecal microbiota transplantation in autism spectrum disorder. \u003cem\u003eNeuropsychiatric Disease and Treatment,\u003c/em\u003e 2905-2915.\u003c/li\u003e\n \u003cli\u003eZeybek, S. G. (2023). Evaluation of medical nutrition therapy application status of children with autism spectrum diagnosis in northern cyprus. \u003cem\u003eJournal of Cyprus Studies\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(48), 17-30.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Autism spectrum disorder, Mother, Cooking skills, Eating behavior, Gastrointestinal symptoms","lastPublishedDoi":"10.21203/rs.3.rs-4103087/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4103087/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eMothers have an important role in feeding children. The aim of this study was to determine the relationship between the cooking and food preparation skills of mothers with children diagnosed with autism spectrum disorder and the child's eating behaviors and gastrointestinal symptoms. A significant negative correlation was found between the mothers' total scores on the cooking and food preparation skills and their children's eating behaviors and gastrointestinal symptoms scores. In addition, it was determined that mothers with low scores on the cooking and food preparation skills experienced more eating problems such as food refusal and autism-specific behaviors and gastrointestinal symptoms such as abdominal pain, reflux, diarrhea, indigestion and constipation in their children with autism. It was found that there was a relationship between food preparation and cooking skills of mothers and eating behaviors and gastrointestinal symptoms of their children with autism.\u003c/p\u003e","manuscriptTitle":"The Relationship Between Cooking and Food Preparation Skills of Mothers with Children Diagnosed with Autism Spectrum Disorder and Child's Eating Behaviors and Gastrointestinal Symptoms","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-18 05:17:52","doi":"10.21203/rs.3.rs-4103087/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b2c21969-919a-49fb-bb96-b843fc191b7c","owner":[],"postedDate":"March 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-24T11:07:46+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-18 05:17:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4103087","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4103087","identity":"rs-4103087","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}