Science - November 1, 2012

As normal as possible

Children's gluten allergy dealt with through careful communication by parents. Researchers analysed 63 hours of table talk.

"But it is nice, isn't it, dear?"
Needless to say, a gluten allergy, or coeliac disease, is a pain in the neck for children. No bread rolls, no pizza, no spaghetti. None of the treats that their friends can indulge in to their heart's content. Parents sometimes find this hard to deal with. After all, you don't want to have to play the policeman all the time, yet you do have to keep an eye on your child's health.
How Dutch daddies and mummies go about this has been the subject of a recent study by Wageningen communication scientists and ethicists. They took recordings in seven families with children with a gluten allergy. This produced 63 hours of mealtime conversation. An analysis of this talk generated insights which will be published soon in the journal Sociology of Health and Illness.
One significant conclusion is that parents do all they can to prevent children with a gluten allergy from seeing themselves as patients. During mealtimes, parents first discuss between them whether certain foods are 'allowed'. They do not talk about limitations to the child but constantly ask whether what they are eating is tasty.
'This way their message is: I can't tell you what tastes nice. That is your decision,' says Hedwig te Molder, associate professor of Communication Sciences. 'That confirms their freedom of choice.' The forbidding of foods is also done quite subtly. Parents do not do it explicitly but refer instead to an earlier 'deal'. Te Molder: 'By referring to an earlier rule they can cope with limits to their freedom.'
Delicate issue
'But the balance between freedom and health remains a delicate issue,' says Te Molder. Even after children have already answered in the affirmative, parents keep on asking whether it tastes good. 'It seems as though they are never completely satisfied with the answer.' Te Molder thinks there is a risk that the stream of questions on one point could feel like pressure for the children. And interference from the parents is not always tolerated. 'Among older children you see then claiming their freedom.' Te Molder describes an irritated response from a young adult when her mother asks whether it is such a good idea to eat a Mars Bar: 'I like it and that's why I am eating it.'
The researchers hope their findings will help towards developing treatment methods that are a better fit with the way the patient experiences things.

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