The Marcus Autism Center, USA Emory University School of Medicine, USA
The Marcus Autism Center, USA Texas Tech University, USA.
Autism. 2014 Aug;18(6):712-22. doi: 10.1177/1362361313489190. Epub 2013 Oct 7.
Feeding problems represent a frequent concern reported by caregivers of children with autism spectrum disorders, and growing evidence suggests atypical patterns of intake may place this population at risk of nutritional and/or related medical issues, including chronic vitamin and mineral deficiencies, poor bone growth, and obesity. This combination of factors emphasizes a clear need to identify and disseminate evidence-based treatment of feeding problems associated with autism spectrum disorders. Behavioral intervention represents an effective treatment for chronic feeding concerns in this population; however, evidence has largely been established with trained therapists working in highly structured settings. This pilot study seeks to fill this gap in the literature by describing and evaluating the Autism MEAL Plan, a behaviorally based parent-training curriculum to address feeding problems associated with autism spectrum disorders. We assessed the feasibility of the intervention in terms of program content and study protocol (e.g. recruitment and retention of participants, assessment procedures), as well as efficacy in terms of changes in feeding behaviors. A total of 10 families participated in the treatment condition, and the program was evaluated using a waitlist control design (n = 9), representing the first randomized-control study of a feeding intervention in autism spectrum disorders. Results provide provisional support regarding the utility of the program, including high social validity, parent perception of effectiveness, and reduced levels of caregiver stress following intervention. Implications, limitations, and future directions for this line of research are discussed.
喂养问题是自闭症谱系障碍儿童照顾者经常报告的一个问题,越来越多的证据表明,摄入的不规律模式可能使该人群面临营养和/或相关医疗问题的风险,包括慢性维生素和矿物质缺乏、骨骼生长不良和肥胖。这些因素的结合强调了明确需要确定和传播与自闭症谱系障碍相关的喂养问题的循证治疗方法。行为干预是治疗该人群慢性喂养问题的有效方法;然而,证据主要是由在高度结构化环境中工作的训练有素的治疗师建立的。这项试点研究通过描述和评估自闭症 MEAL 计划来填补该领域文献的空白,这是一种基于行为的家长培训课程,旨在解决与自闭症谱系障碍相关的喂养问题。我们评估了干预措施在方案内容和研究方案方面的可行性(例如,参与者的招募和保留、评估程序),以及在喂养行为变化方面的效果。共有 10 个家庭参加了治疗组,该计划采用等待名单对照设计进行评估(n=9),这是自闭症谱系障碍中喂养干预的第一项随机对照研究。结果为该计划的效用提供了初步支持,包括高社会有效性、家长对疗效的看法以及干预后照顾者压力水平降低。讨论了该研究方向的意义、限制和未来方向。