The Autism Managing Eating Aversions and Limited Variety Plan vs Parent Education: A Randomized Clinical Trial

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 c...

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Veröffentlicht in:	The Journal of pediatrics Jg. 211; S. 185 - 192.e1
Hauptverfasser:	Sharp, William G., Burrell, T. Lindsey, Berry, Rashelle C., Stubbs, Kathryn H., McCracken, Courtney E., Gillespie, Scott E., Scahill, Lawrence
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Elsevier Inc 01.08.2019
Schlagworte:	autism Autism Spectrum Disorder - psychology avoidant/restrictive food intake disorder behavioral intervention Child Child, Preschool feeding Feeding and Eating Disorders of Childhood - rehabilitation Feeding Behavior - psychology Female Food Preferences - psychology food selectivity Humans Male nutrition Parents - education pediatric feeding disorders MEAL ARFID behavioral intervention PSI-SF autism CGI-I nutrition ASD BAMBI feeding food selectivity avoidant/restrictive food intake disorder pediatric feeding disorders PEP
ISSN:	0022-3476, 1097-6833, 1097-6833
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Abstract	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.
AbstractList	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. To assess the feasibility and initial efficacy of a structured parent training program for children with autism spectrum disorder and moderate food selectivity.OBJECTIVETo 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.STUDY DESIGNThis 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).RESULTSThere 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.CONCLUSIONSThe 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.TRIAL REGISTRATIONClinicaltrials.gov: NCT02712281.
Author	Sharp, William G. Berry, Rashelle C. Stubbs, Kathryn H. Gillespie, Scott E. Scahill, Lawrence Burrell, T. Lindsey McCracken, Courtney E.
Author_xml	– sequence: 1 givenname: William G. surname: Sharp fullname: Sharp, William G. email: wgsharp@emory.edu organization: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA – sequence: 2 givenname: T. Lindsey surname: Burrell fullname: Burrell, T. Lindsey organization: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA – sequence: 3 givenname: Rashelle C. surname: Berry fullname: Berry, Rashelle C. organization: Marcus Autism Center, Atlanta, GA – sequence: 4 givenname: Kathryn H. surname: Stubbs fullname: Stubbs, Kathryn H. organization: Marcus Autism Center, Atlanta, GA – sequence: 5 givenname: Courtney E. surname: McCracken fullname: McCracken, Courtney E. organization: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA – sequence: 6 givenname: Scott E. surname: Gillespie fullname: Gillespie, Scott E. organization: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA – sequence: 7 givenname: Lawrence surname: Scahill fullname: Scahill, Lawrence organization: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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Keywords	MEAL ARFID behavioral intervention PSI-SF autism CGI-I nutrition ASD BAMBI feeding food selectivity avoidant/restrictive food intake disorder pediatric feeding disorders PEP
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SubjectTerms	autism Autism Spectrum Disorder - psychology avoidant/restrictive food intake disorder behavioral intervention Child Child, Preschool feeding Feeding and Eating Disorders of Childhood - rehabilitation Feeding Behavior - psychology Female Food Preferences - psychology food selectivity Humans Male nutrition Parents - education pediatric feeding disorders
Title	The Autism Managing Eating Aversions and Limited Variety Plan vs Parent Education: A Randomized Clinical Trial
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