20001
Parent Training for Feeding Problems in Young Children with Autism Spectrum Disorder
Preliminary evidence suggests that behavioral interventions can reduce feeding problems in young children with autism spectrum disorder (ASD). These interventions have primarily been delivered in highly specialized settings (inpatient or day treatment centers that have feeding experts on staff) with little parental involvement or attention to nutrition. Moreover, randomized clinical trials of these interventions are currently unavailable.
Objectives:
The primary goal of this two-site project (University of Florida and University of Rochester) was to develop and then pilot an 11-session behavioral parent training program for feeding problems (PT-F) in children with ASD. PT-F is innovative in that it is time-limited, takes place in an outpatient setting with ongoing parent engagement, and involves an interdisciplinary collaboration of behavior specialists and nutrition experts.
Methods:
We conducted an initial case series of 14 children with ASD (11 males), mean age = 4.86 years. Each PT-F session was 60 to 90 minutes in duration, delivered 1:1 with the primary caregiver by a trained, masters- or doctoral-level therapist. Children’s presenting problems included feeding selectivity (93%), parent-reported nutrition concerns (79%), family stress at mealtime (64%), and disruptive mealtime behavior (57%). We rated therapists’ fidelity to the PT-F manual and parents’ adherence to PT-F activities. The primary outcome measure was the Brief Autism Mealtime Behavior Inventory (BAMBI). Secondary outcome measures included the Irritability and Hyperactivity scales of the Aberrant Behavior Checklist (ABC) and the Parenting Stress Index (PSI). All outcome measures were administered at baseline and Week 16.
Results:
Therapist fidelity and parent adherence to PT-F were high. Children showed statistically significant reductions on the BAMBI (effect size [ES] = 1.50), ABC-Irritability (ES = 0.62), and ABC-Hyperactivity (ES = 0.75). Parents showed a statistically significant reduction on the PSI (ES = 0.45).
Conclusions:
Our initial evaluation of PT-F yielded promising results. We are currently conducting a pilot randomized clinical trial to evaluate the feasibility of implementing this intervention and our study protocol across sites.