This study was designed to objectively measure dietary skills of diabetic children and their mothers and to assess dietary adherence in specific situations. Subjects were 34 children with Type I diabetes mellitus and their mothers. Recall of diet prescriptions and performance on skills tests averaged around 50% for both children and mothers. Adherence problems were most frequent during afternoon snack, while at school, with friends, and at restaurants. Significant relationships between glycosylated hemoglobin values and adherence at school and with friends were observed. Older children had more adherence problems with afternoon snack, while alone, and while with parents. Dietary skills were unrelated to adherence. These findings demonstrate that children with diabetes and their mothers have substantial dietary skills deficits and situationally related dietary adherence problems.