Dyadic and triadic interactions with children with Infantile Anorexia: a pilot study.

Background. Infantile Anorexia (IA) is a subcategory of Feeding Behavior Disorders included in the last version of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and early Childhood Revised – DC:0-3R (Zero To Three, 2005). IA occurs when the child refuses to eat adequate amounts of food for at least 1 month, and shows growth deficiency; the child does not communicate hunger and lacks interest in food but shows strong interest in exploration, interaction with caregiver or both. The child’s food refusal does not follow a traumatic event and is not due to an underlying medical illness. As the food refusal begins during the transition to spoon and self-feeding, studies evidence that the feeding interactions between children with IA and their mothers are charaterized by low dyadic reciprocity, greater interactional conflict and negative affect in both mother and child (Ammaniti et al., 2010; Chatoor at al., 2000). To date, research about infantile feeding disorders has focused almost exclusively on the mother–child dyad, in particular co-parental and family interactions in clinical population of children with IA are less studied. The current study investigated mother–child-father interactions with children having a diagnosis of IA, exploring their possible role in maintaining the low quality of mother-child relationship. Method. This exploratory study aims at observing dyadic and triadic interactions in families with a preschool child with IA. Mother-child interaction was observed during feeding and during free-play; family interaction was observed during a triadic play. In order to assess psychopathological symptoms and marital Dyadic Adjustment, self-reports were administered to mothers and fathers. Three observative procedures were used to asses parents-child dyadic and triadic interactive pattern: the Feeding Scale - Observational Scale for Mother-Infant Interaction during Feeding (Chatoor et al., 1997; italian validation by Lucarelli et al., 2002) developed to assess the dyadic interactive pattern during feeding; the Coding Interactive Behavior (Feldman, 1998) applyed to a mother-child free play and the Lausanne Trilogue Play (Fivaz-Depeursinge & Corboz-Warnery, 1999) developed to assess the family alliance. Results. Results of the present research in progress evidence the low quality of mother-child-father interactions in families with the presence of IA, compared to matched non-referred families. The difficult in cooperation and sharing of positive affect observed during feeding persists in a playful context and at the family level.