ASSESSING MOTHER-CHILD INTERACTION FROM FEEDING TO PLAY IN INFANTS/TODDLERS WITH RESTRICTIVE FOOD INTAKE

The Parent-Child Play Scale has been developed as a scale that complements the Parent-Child Feeding Scale to evaluate mother-infant/toddler interactions in different caregiving contexts of the child’s everyday life, specifically play and feeding. When assessing the quality of the parent-child relationship in children with feeding disorders (FD), it seems to be crucial not only to observe interactions in settings where the child and his/her mother are distressed, but also in settings where activities can be pleasurable. Free play is an example of an unstructured activity, and there is evidence that observational settings which provide opportunities to play enhance the validity of the interpretation of the overall observations. This study aimed to examine the psychometric properties of the Play Scale, the basic factor structure, and the ability of the Play Scale to differentiate between healthy children and children with different subtypes of FD. In addition, we examined the relationship between the measures of feeding and mother-infant/toddler play interactions. The construct validity, inter-rater and test-retest reliability of the Play Scale have been demonstrated. Results also showed that Play Scale discriminates between children with and without FD, as well as between children with different subtypes of FD defined by the DC:0-3 1st Revision (Feeding Disorder of State Regulation, Feeding Disorder of Caregiver-Infant Reciprocity, and Infantile Anorexia). Moreover, significant correlations between the Feeding and Play subscales for infants/toddlers with FD and their mothers emerged. Findings suggest that specific features of dysfunctional play in combination with dysfunctional feeding interactions indicate more pervasive maladaptive interactional patterns in mother-child dyads, and reaffirm the role of good enough maternal scaffolding for the early development of the child’s biological, emotional, and social regulation.