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Randomized Controlled Trial
. 2019 Mar 1;44(2):164-175.
doi: 10.1093/jpepsy/jsy063.

Parent Training for Feeding Problems in Children With Autism Spectrum Disorder: Initial Randomized Trial

Cynthia R Johnson  1 , Kimberly Brown  2 , Susan L Hyman  2 , Maria M Brooks  3 , Courtney Aponte  2 , Lynne Levato  2 , Brianne Schmidt  2 , Victoria Evans  4 , Zhiguang Huo  4 , Roxanna Bendixen  5 , Heather Eng  3 , Theresa Sax  3 , Tristram Smith  2
Affiliations
Randomized Controlled Trial

Parent Training for Feeding Problems in Children With Autism Spectrum Disorder: Initial Randomized Trial

Cynthia R Johnson et al. J Pediatr Psychol. .

Abstract

Objective: Many children with autism spectrum disorder (ASD) have feeding and mealtime problems. To address these, we conducted a pilot randomized trial of a new 11-session, individually delivered parent training program that integrated behavioral strategies and nutritional guidance (PT-F).

Methods: Forty-two young children (age: 2 to 7-11 years) with ASD and feeding problems were assigned to 11 sessions of PT-F intervention over 20 weeks or a waitlist control. Outcomes included attendance, parent satisfaction, therapist fidelity, and preliminary assessments of child and parent outcomes.

Results: Of the 21 PT-F families, attendance was high (85%) as was parent satisfaction (94% would recommend to others). Treatment fidelity was also high (97%-therapist integrity; 94%-parent adherence). Compared with waitlist, children whose parents participated in PT-F showed significantly greater reductions on the two parent-completed primary outcomes (Brief Autism Mealtime Behavior Inventory-Revised; Twald = -2.79; p = .003; About Your Child's Eating; Twald = -3.58; p = .001). On the independent evaluator-completed secondary eating outcome, the Clinical Global Impression-Improvement, 48.8% of the participants in PT-F were rated as "responders" compared with 0% in waitlist (p = .006). General child disruptive behavior outcomes decreased more in PT-F but not significantly. Parent outcomes of caregiver stress showed nonsignificant trends favoring PT-F with moderate to small effect sizes.

Conclusions: This trial provides evidence for feasibility, satisfaction, and fidelity of implementation of PT-F for feeding problems in young children with ASD. Feeding outcomes also appeared favorable and lends support for conducting a larger efficacy trial.

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Figures

Figure 1.
Figure 1.
CONSORT chart.
See this image and copyright information in PMC

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