1. Maternal Perceptions of Toddler Body Size: Accuracy and Satisfaction Differ by Toddler Weight Status Hager ER, Candelaria M, Latta LW, et al. Maternal perceptions of toddler body size: accuracy and satisfaction differ by toddler weight status. Arch Pediatr Adolesc Med. 2012;166(5):417-422. Copyright restrictions may apply

2. Introduction Parents are often inaccurate when assessing children’s weight status. Inaccurate perceptions of children’s body size may influence feeding behaviors. Most research to date has focused on preschool- and school-aged children. Factors associated with maternal accuracy and satisfaction with toddler body size can be evaluated. Copyright restrictions may apply

3. Methods Study Design –Baseline data from the Toddler Overweight Prevention Study. Sample/Participants –Biological mothers of toddlers (aged 12-32 months, full term, and >2500 g at birth). –281 mother/toddler dyads. –67.3% at or below poverty level. Copyright restrictions may apply

4. Methods Toddler Silhouette Scale Instructions: 1. Which picture looks most like your child? 2. Which picture do you want your child to look like? Definitions: Accuracy: question 1, within 1 silhouette representing measured weight for length. Satisfaction: questions 1 and 2, choosing the same silhouette for both. Copyright restrictions may apply

5. Methods Data Analysis –Fisher exact test, t tests, and exact logistic regression, adjusting for covariates. Limitations –May not be generalizable to other populations. –Cross-sectional. –Data on biological fathers were not included. Copyright restrictions may apply

6. Results More than two-thirds of low-income mothers were inaccurate when assessing their toddlers’ body size. Accuracy –Least: mothers of overweight toddlers (6% accurate). –Most: mothers of underweight toddlers (83% accurate). Satisfaction –Highest: mothers of overweight toddlers (82% satisfied). –Lowest: mothers of underweight toddlers (33% satisfied). Copyright restrictions may apply

7. Results Copyright restrictions may apply

8. Results Copyright restrictions may apply

9. Comment Implications for future clinical work: –Pediatric providers can plot and discuss toddler weight status with families. –Parent perceptions and accuracy of toddler body size can be assessed in clinical visits. Implications for future research in this area: –Need to examine the relationship between parental satisfaction and accuracy with parental feeding behaviors and physical activity. Copyright restrictions may apply

10. Contact Information If you have questions, please contact the corresponding author: –Erin R. Hager, PhD, Division of Growth and Nutrition, Department of Pediatrics, University of Maryland School of Medicine, 737 W Lombard St, Room 163, Baltimore, MD 21201 (ehager@peds.umaryland.edu). Funding/Support Data collection during the baseline evaluation of the Toddler Overweight Prevention Study (TOPS) was supported by National Research Initiative grant 2006-55215-17362 from the US Department of Agriculture National Institute of Food and Agriculture Human Nutrition and Obesity Program and Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R01HD056099. Copyright restrictions may apply