Observations of toddlers' sensory-based exploratory behaviors

Authors: MOMIN, SHABNAM - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); HUGHES, SHERYL - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); ELIAS, CINDY - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); PAPAIOANNOU, MARIA - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); PHAN, MIMI - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); VIDES, DAVID - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); WOOD, ALEXIS - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: Appetite
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/28/2018
Publication Date: 8/29/2018
Citation: Momin, S.R., Hughes, S.O., Elias, C., Papaioannou, M.A., Phan, M., Vides, D., Wood, A.C. 2018. Observations of toddlers' sensory-based exploratory behaviors. Appetite. https://doi.org/10.1016/j.appet.2018.08.035.
DOI: https://doi.org/10.1016/j.appet.2018.08.035

Interpretive Summary: As children start to eat solid foods, they typically go through a phase of "picky eating" where they resist eating certain foods, particularly "novel" or "new" foods. For many children this is a developmentally normal phase which passes by the end of toddlerhood, however, some children retain the desire to resist eating new foods – a behavior known as "food neophobia". Food neophobia is a problem as it hinders children's likelihood of eating a wide variety of healthy foods, which is best for optimum health. At the moment, we do not know which children will develop food neophobia and so this study examined whether five behaviors: smelling, licking, spitting, manipulating and / or swallowing predicted toddler's progress towards accepting a novel food, to see whether these could be used a predictors of food neophobia in the future and/or intervention targets to reduce the development of food neophobia. We presented toddlers (children ages 24-35 months) with a novel food (hummus) over 16 successive occasions and carefully coded their behavioral responses. We saw very little spitting, smelling, or licking from the toddlers, but did see manipulation and swallowing. However, manipulation of, and swallowing the novel food did not associate with parent-assessed food fussiness, nor consumption of the novel food. In addition, a secondary and surprising finding was that repeated servings of the novel food (which should reduce its novelty to the children) did not increase consumption of the food. Taken together, this study suggests that spitting, smelling, licking, manipulation and swallowing cannot be used as predictors of novel food acceptance, as so also not as toddlerhood intervention targets to reduce the prevalence of food neophobia in older children. This information will be useful for practitioners such as pediatricians and dieticians working with picky eaters who need to be aware that (1) as yet, it is not possible to observe a child over a few mealtimes and deduce the tendency to accept or reject novel foods; and (2) strategies other than repeated food exposure may be necessary to increase novel food acceptance in young children; it is now acknowledged by the American Academy of Pediatrics repeated exposure is only one of several useful strategies (American Academy of Pediatrics, 2018) but may not have reached clinical practice widely as yet. This study is also useful for researchers studying how to predict and reduce the development of food neophobia: we have highlighted the need for more studies identifying the behavioral predictors of novel food acceptance. Finally, if researchers are successful in identifying these behaviors, and are able to incorporate these into effective interventions which improve the acceptance of novel foods, then the strategies used in these studies may eventually form the basis of clinical practice or clinical guidelines.

Technical Abstract: Food neophobia hinders the acceptance of healthy foods in young children, and may be overcome by repeated food exposure. Prevalent literature states that children exhibit five sensory-based exploratory behaviors (SBEBs): smelling, licking, spitting, manipulating and/or swallowing as they progress towards accepting a novel food, yet there is a paucity of research on these behaviors. This study aimed to use direct observations of SBEBs across first-time exposures to hummus to (1) determine the prevalence of five SBEBs (smelling, licking, spitting, manipulating and swallowing) in 12-35 month olds, (2) quantify the psychometric properties of the SBEB assessment; and (3) examine the association of SBEBs with parent-assessed food fussiness, and consumption of the novel food. Direct observations of SBEBs during a 15-20 minute snack time were conducted by trained staff members for 55 hummus-naïve toddlers ages 12-35 months, across 16 exposures to a novel food (hummus). Parents completed the child eating behavior questionnaire. Hummus consumption was measured using digital plate waste method. Very low base rates of spitting (.06%), smelling (.97%) and licking (1.95%) were observed but manipulation (26.36%) and swallowing (62.15%) were more prevalent. Observation data on two behaviors over 16 occasions gave rise to a reliability coefficient from our G study portion of our generalizability analyses of Ep^2 =0.65. SBEBs did not significantly associate with parent-assessed food fussiness, nor hummus consumption. Although literature refers to the prevalence of SBEBs, we did not observe this for three proposed behaviors. We did observe manipulation, but more research is needed to determine if there are additional SBEBs not noted in the literature, and to better delineate the process that leads to acceptance/rejection of novel food.