Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Marcus Autism Center, Atlanta, GA.
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Marcus Autism Center, Atlanta, GA.
J Pediatr. 2019 Aug;211:185-192.e1. doi: 10.1016/j.jpeds.2019.03.046. Epub 2019 May 3.
To assess the feasibility and initial efficacy of a structured parent training program for children with autism spectrum disorder and moderate food selectivity.
This 16-week randomized trial compared the Managing Eating Aversions and Limited variety (MEAL) Plan with parent education. MEAL Plan (10 core and 3 booster sessions) provided parents with nutrition education and strategies to structure meals and expand the child's diet. Parent education (10 sessions) provided information about autism without guidance on nutrition, meal structure, or diet. In addition to feasibility outcomes, primary efficacy outcomes included the Clinical Global Impression - Improvement scale and the Brief Autism Mealtime Behaviors Inventory. Grams consumed during a meal observation served as a secondary outcome.
There were 38 eligible children (19 per group, 32 males). For MEAL Plan, attrition was <10% and attendance >80%. Therapists achieved >90% fidelity. At week 16, positive response rates on the Clinical Global Impression - Improvement scale were 47.4% for the MEAL Plan and 5.3% for parent education (P < .05). The adjusted mean difference (SE) on Brief Autism Mealtime Behaviors Inventory at week 16 was 7.04 (2.71) points (P = .01) in favor of MEAL Plan. For grams consumed, the adjusted standard mean difference (SE) was 30.76 (6.75), also in favor of MEAL Plan (P = .001).
The MEAL Plan seems to be feasible, and preliminary efficacy results are encouraging. If further study replicates these results, the MEAL Plan could expand treatment options for children with autism spectrum disorder and moderate food selectivity.
Clinicaltrials.gov: NCT02712281.
评估针对自闭症谱系障碍且有中度食物选择性的儿童的结构化家长培训计划的可行性和初步疗效。
这是一项为期 16 周的随机试验，比较了管理饮食厌恶和选择有限（MEAL）计划与家长教育。MEAL 计划（10 次核心和 3 次强化课程）为家长提供营养教育和策略，以构建膳食并扩大孩子的饮食。家长教育（10 次课程）提供了有关自闭症的信息，但没有关于营养、膳食结构或饮食的指导。除了可行性结果外，主要疗效结果包括临床总体印象-改善量表和简短自闭症用餐行为量表。用餐观察期间消耗的克数作为次要结果。
共有 38 名符合条件的儿童（每组 19 名，32 名男性）。对于 MEAL 计划，失访率<10%，出勤率>80%。治疗师的保真度>90%。在第 16 周，MEAL 计划的临床总体印象-改善量表的阳性反应率为 47.4%，而家长教育的阳性反应率为 5.3%（P<0.05）。第 16 周时，Brief Autism Mealtime Behaviors Inventory 的调整后平均差异（SE）为 7.04（2.71）点，MEAL 计划有优势（P=0.01）。对于消耗的克数，调整后的标准平均差异（SE）为 30.76（6.75），也有利于 MEAL 计划（P=0.001）。
MEAL 计划似乎是可行的，初步疗效结果令人鼓舞。如果进一步的研究复制这些结果，MEAL 计划可以为自闭症谱系障碍且有中度食物选择性的儿童扩大治疗选择。
Clinicaltrials.gov：NCT02712281。
