toddler-caregiver mealtime observationnursing.msu.edu/neat/docs/tpmbo_definitions.doc · web...

Toddler-Parent Mealtime Behavior Observation

Checklist DefinitionsCaregiver Mealtime Behaviors

Length of Meal

Indicate how many minutes the meal takes from the time food is served until the time the caregiver decides the meal has ended, regardless of the toddler’s behavior. This includes if the child expresses desire for more food, but the caregiver refuses, or the toddler stops eating, and the caregiver requires the child to continue eating.

I. Mealtime TV Watching Distractions

1. The TV/Computer is on during the meal/snack time.

The TV/PC is on during the meal or snack time while the child is eating. (The child or caregiver may or may not be watching the TV/PC, or the TV/PC may not be in view of the child or caregiver but it is ON and can be heard).

2. The mother watches TV during the meal/snack time

The caregiver watches, makes eye contact, focuses on the TV during the feeding.

3. The child watches TV during the meal/snack time.

The child watches, makes eye contact, focuses on the TV during the feeding. The high chair is in front of the TV.

4. There are distractions during the meal/snack time.

The child is focused on other things happening around him/her other than eating or interacting with the parent.

Example: Someone is on the phone in the same room with the child during the meal or snack or people are walking in and out of the room where the child is

eating.

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Nutrition EducationAimed at Toddlers

5. The TV plays in the same room during the mealtime.

The TV is physically on and is in view of the caregiver and/or the child in the same room while the child is eating. (The child or mother may not be watching the TV, but the TV is on, and can be heard and is in the SAME room/space where the meal/snack is being eaten.) II. Mealtime Socialization/Parent-Toddler Interaction

6. The mother sits down with the child during the meal or snack.

The parent physically sits down with the child, wherever the meal is taking place, eg. at the table, on the floor, on the sofa, on the bed.

Example: The caregiver is sitting at the same table as the child, or in a position near the child that allows for face-to-face contact.

7. The mother and the child eat together.

The caregiver has set up the food to have a joint mealtime with her child.

8. The mother and child face each other while eating.

The caregiver and child are physically facing each other during the meal or snack. Direct eye contact is not necessary, just needs to be possible. The mother does not have to be eating.

9. The mother encourages the child to respond to her conversation and allows time for the child to respond during the meal or snack.

The caregiver attempts to initiate conversation by making comments or questions based on what the child is looking at, doing, or saying. The mother tries to engage the child verbally, supplying time for the child to respond as if the child is able to converse, this includes yes/no and nodding. The mother tries to help the child form or complete a word.

Example: “Do you like the mashed potatoes?”; “Are you trying to say…”



10.The child gets the mother’s full attention during the meal or snack.

The caregiver pays attention to the child while the child is eating and does not engage in other activities while the child is eating.

The caregiver is looking at the child and pays attention to what the child is doing during the feeding.Example: the mother does not talk on the phone, get up to do a chore, clean up, or read

the newspaper while the child is eating or still engaged in the mealtime activity.

III. Caregiver Mealtime Distress

11.The mother gets upset with the child’s behavior during the meal or snack.

If the child spills something or throws his food, the caregiver becomes visibly upset.

Nonverbally: The caregiver frowns, looks away from the child, or exerts force on the child during the meal or snack.

Verbally: The caregiver makes negative comments or uses a loud or impatient tone of voice to the child.

“You are a bad boy for making such a mess of your food.”“NO!”

12.The mother stays generally calm during the meal or snack.

The caregiver takes the feeding in stride regardless of the toddler’s behavior during the meal/snack. The caregiver does not get upset with the child, either non-verbally or verbally, with the child’s behavior during the meal/snack.

Example: The caregiver does not make negative comments, scolds, or shows verbal disapproval for the child not eating, or making a mess.

“Don’t worry about it, I can get your more.”

IV. Toddler Eating Behavior/Toddler Makes Decision

13. The child readily accepts any food served (for example-will take a bite or taste of any food served).

The child does not refuse to eat a food, or will accept a taste when asked to or told to by his/her parent. There is no visible resistance when a new food is offered.



14. The child determines how much he/she eats at the mealtime (momdoes not try to make child eat more).

The child is allowed to stop eating without being told to stop eating. The child is not told to continue eating when he or she tries to stops eating. However, a one-time gentle reminder by the caregiver, followed by acceptance of the child's continuing refusal to eat more, should count as an indication that "the child determines how much he/she eats.'

15. The child decides what to eat from the foods served (chooses fromfoods already prepared).

The child, either verbally or nonverbally, determines what food he/she will eat. The child can state what he/she wants to eat, or can decide through nonverbal means such as pointing, which foods to eat.

16. The child decides when he/she has had enough to eat.

The child is allowed to stop eating when he/she wants to. The mealtime does not have to stop, and the child may not be allowed to leave the eating area, but the mother does not force the child to eat more.

V. Mother Feeding Behavior/Mother Makes Mealtime Decisions

17. Mother offers the child food.

The mother gives the child food.

18. The mother tries to put food into the child’s mouth if the child refuses to eat on his/her own.

The mother physically puts food into the child’s mouth in order to get the child to eat. 19. The mother threatens the child in order to get the child to eat (threatens to take something away, such as no TV).

The mother verbally threatens (tells child there will be consequences) if the child does not eat.

Examples: “If you don’t eat your food, you won’t get to go outside and play.”“If you don’t eat the rest of your meat, you can’t have anymore mashed

potatoes.”



20. The mother bribes the child in order to get the child to eat (offers the child a reward such as a dessert, toy or clapping).

The parent tells the child that he/she will get a food reward or any reward for eating any amount.

Examples: “If you eat your food, you can go outside and play when you are finished” “If you eat the rest of your meat or drink all of your milk, you can have dessert.”

21. The mother hurries the child to eat.

The parent rushes the child to eat.

Example: “Hurry up and eat your food.” “Hurry up, we only have 10 minutes.” The caregiver feeds the child at a quick pace. The caregiver feeds the child to

hurry the feeding. The caregiver ends the feeding without the child communicating (non- verbally or verbally) fullness or being done,

such as taking the food away before the child is finished eating.22. The mother encourages the child to taste all the foods offered (NOT beverages).

The caregiver verbally or nonverbally offers or suggests to the child to take a bite of all of the foods on the child’s plate. Must encourage ALL foods even if toddler is already eating some.

Example: “We have corn, beans, peas, and meat. Let’s take a little bite of each.” “Johnny, your food is getting cold, let’s try a bite of everything before it gets cold.” “Why don’t you take a bite of your carrots?”

23. The mother encourages the child to use a spoon or fork.

There is a spoon or fork available for the child where he or she is eating (On the highchair tray or table). The mother verbally asks or tells the child to use a spoon or fork, or physically puts a spoon or fork into the child’s hand.

24. The child feeds him/her self.

The child feeds him/her self. The child does not have to use a utensil, but does put food into his/her mouth.

25. The child is a picky eater (child will only eat certain foods on the plate/high chair tray).

The child picks or moves the food around on his/her plate and /or will only eat certain foods on the plate. The child turns head away from certain foods offered but takes other foods, for example, the child will eat mashed potatoes but will not eat the meat or peas.



26. The mother makes sure that the child tastes all foods served (NOT beverages). If there is only one food served which the child is readily eating unprompted, then there is no need for encouragement and the correct answer is “NO”.

The caregiver forces the child, either non-verbally or verbally, or physically to take a bite of everything on the child’s plate. The parent verbally directs the child to take a bite of a specific item on the plate if the child has not tasted or eaten that food.”

Example: The caregiver physically forces/puts a piece of food into the child’s mouth. “Take a bite of your carrots.”

27. The mother decides when the child has eaten enough (Does not serve more food/drink even if the child asks, takes the food away.)

The caregiver ends the meal/snack regardless of whether the child is still eating or asks/wants more.

Example: The parent does not give more food even if the child indicates, verbally or non-verbally, that they want more of something.

28. The mother makes her child eat everything on the plate.

The caregiver forces the child to eat everything on the plate. The caregiver forces the child, either non-verbally, verbally, or physically to eat everything on the child’s plate. The parent verbally directs the child to eat all of the food on his/her plate.

Example: The caregiver physically forces a piece of food into the child’s mouth. “Eat everything on your plate.” “You can’t get up ‘til you eat everything.”The caregiver spoons-feeds the child to get him/her to finish all of the food on

the plate.

29. The child will eat fruits or vegetables if served

The child will eat a fruit or vegetable IF one is served. This only applies to fruits and/or vegetables served on their own. Carrots in beef stew would not count as a vegetable. Fries are considered a vegetable. Beverages such as juice do not count.



Mealtime Observation Checklist

***Be sure to complete this page. Complete when the meal is finished and mother indicates the child is done.

Type of Meal

Have the mother identify which meal/snack she is serving her toddler.

Breakfast Lunch Dinner Snack

Typical time of day for the child to eat this meal or snack?

Be sure to ask the mother is this is the toddler’s usual time to eat:

Yes No

Typical behavior of the child during a meal (according to the parent)?

Ask the mother if this is the toddler’s typical behavior during meals vs. distracted/showing off due to presence of an observer. Ask this at the end of the mealtime.

Yes No

The mother offers the child appropriate portion sizes.

The caregiver gives food portion appropriate to the age of the child. (Based only on first serving, not additional helpings)

Milk = ½ cup Vegetable/fruit (includes juice) = ¼ cup or 2 oz.Cereal = ¼ cup Cooked dry beans = ¼ cupBread/grains = ½ slice of bread Large egg = ½ of an eggCheese = 1 oz (or about 1 cheese slice) Meat/chicken/fish = 1 oz or 1/3 palm

How many people are included in the mealtime (eating at the same time as the child, or sitting in the same room/area where the child is eating) and what is their relationship to the toddler?

Please write the number of people interacting with the toddler or mother and their relationship to the toddler. Include anyone who is involved in the mealtime, even if they are not eating.



Please draw a diagram of the eating area (for example, table or room) including where each person is sitting, identify each person by his or her relationship to the toddler, and identify where the meal is taking place (kitchen, dining room, etc.):

Please draw as accurate a picture as you can of the place where the mealtime is occurring. Indicate what room/area the meal takes place in, and draw where each person listed in the previous question is in this space, along with his or her relationship to the toddler.

Beverages and foods prepared/served for the child (List ALL).

List ALL foods and beverages served to the child, put on the child’s plate, given to the child to eat or drink—whether or not the child ate or drank any of the food/drink served.

Beverages and foods eaten by the parent (List ALL).

List ALL foods and beverages the mother eats and drinks during the meal/snack time with her toddler.

BE SURE ALL ITEMS ARE MARKED!


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