Family-centered feeding support and nutritional quality in children with neurodevelopmental disorders: A comparative cross-sectional study.

PURPOSE: To compare eating behaviors, caregiver feeding practices, and nutritional quality between children with neurodevelopmental disorders (NDDs) and typically developing (TD) peers, and to identify feeding-related constraints relevant to pediatric nursing assessment. DESIGN AND METHODS: This comparative cross-sectional study included 205 children aged 3-10 years from pediatric clinics in Guangdong and Hunan Provinces, China: 91 with NDDs and 114 TD children. Caregivers completed validated questionnaires, and trained staff obtained anthropometric measurements. Data were analyzed using group comparisons, multigroup structural equation modeling, and necessary condition analysis. RESULTS: Children with NDDs had lower total Nutrition Quotient for Preschoolers scores than TD children (55.19 ± 13.52 vs. 62.01 ± 8.99, P < 0.001), with lower Balance, Moderation, exogenous eating, and initiative eating scores. BMI-related measures did not differ between groups. In the structural models, control over eating was negatively associated with initiative eating in children with NDDs, whereas promoting and encouragement to eat was positively associated with initiative eating. Necessary condition analyses indicated that Balance and Moderation were potential constraints on achieving higher nutritional quality. CONCLUSIONS: Nutritional vulnerability in children with NDDs was associated with lower dietary balance, lower initiative eating, and distinct caregiver-feeding pathways. PRACTICE IMPLICATIONS: Pediatric nurses should assess dietary variety and family feeding practices and promote balanced, supportive, and noncoercive feeding strategies.