Ausderau examining feeding challenges
and dynamics of family mealtime
for households caring for a child with autism
After earning an undergraduate degree in occupational therapy from UW–Madison in 1997, Karla Ausderau spent a decade working in the OT profession.
During this period, Ausderau explains that she became increasingly interested in feeding and family mealtimes en route to becoming the director of an interdisciplinary feeding clinic in Pasadena, Calif.
“I think working there further cemented for me how important eating and feeding are in the daily lives of families,” says Ausderau. “Parents must feed their children several times per day, seven days per week. And if feeding time is challenging, which is so often the case in families with a child who has autism, it can control their daily lives.”
Although Ausderau stresses that she truly enjoyed working as an occupational therapist, she ultimately decided she could make an even greater impact by pursuing a life in academia. She went on to earn a master’s and Ph.D. in Occupational Science from the University of Southern California before eventually joining the UW–Madison faculty in January 2012 as an assistant professor with the Department of Kinesiology’s Occupational Therapy program.
In addition to her research on feeding challenges and family mealtimes, Ausderau also helps oversee the OT program’s commitment to the Madison Metropolitan School District’s School Aged Parenting (SAPAR) program. This initiative is a partnership between the local Madison schools and UW–Madison’s Masters in Occupational Therapy (MSOT) program that grew out of research by Professor Emeritus Mary Schneider. The MSOT students provide educational presentations and work closely with the SAPAR students on ways to reduce stress and live healthier lives as pregnant/parenting teens.
Yet it is her determination to better understand feeding challenges and the dynamics of family mealtime that is the driving force behind Ausderau’s decision to bring her talents to a university campus.
“I really miss working with children and families on a daily basis but I felt that people in the field were missing assessment tools and needed better evidence-based practices,” she says. “As a researcher, I’m looking to contribute to those areas and better help OTs and families.”
According to the Centers for Disease Control, about 1 in 68 children have been identified with autism spectrum disorder (ASD). Feeding disorders are prevalent in children with autism, affecting up to 89 percent. Such challenges can disrupt family mealtime because a child with ASD may eat only a few specific foods, display disruptive behaviors, require more supervision and help than others at the table, or have difficulty with sensory experiences surrounding mealtimes.
This often leads to a great deal of stress for family members — in particular, mothers — who are both concerned about the health of their children and overcome by the many issues related to attempting to have a successful family mealtime. Indeed, one study of family routines for children with ASD reported over 90 percent of participants classified dinnertime as the most stressful part of the day.
Although there is a growing amount of research being done on feeding challenges in children with ASD, Ausderau says the purpose of her inquiry is to more deeply examine and comprehensively demonstrate the impact of these eating troubles on family mealtimes in an effort to develop targeted, family-centered interventions. To do so, she explains it’s necessary to understand the many parent-child behaviors and physiological responses to feeding interactions during mealtime.
For her current work, Ausderau is leading a mixed-methods study in which she goes into the homes of 20 Wisconsin families who have children with autism (ages 1 to 7) to examine mealtimes. The research includes observing and filming two mealtimes in the home to see what these look like, plus two to three interviews with members of the family to get a richer understanding of all the challenges that go into constructing mealtimes in a family context.
The next phase of her research will include bringing families into a video lab setting to assess the behavioral and physiological correlates of the feeding relationship in a more finely tuned manner.
On a related note, Ausderau also received funding to pilot an online version of a feeding assessment that has come out of her work. Through this assessment, she hopes to receive useful feedback from more than 500 families across the United States who have children with autism and feeding problems.
“We’re thinking about how to characterize and assess the intricate puzzle that surrounds family mealtimes for those who have children with autism,” says Ausderau, whose research is being funded via UW–Madison’s Fall Competition, which is backed by the Wisconsin Alumni Research Foundation (WARF).
“We’re trying to look at this in a more holistic way, so that one day we can develop evidence-based, parent-mediated interventions that OTs can teach to families to address different kinds of feeding challenges.”