1/2 Treatment of Feeding Problems in Children with Autism

描述（由申请人提供）：估计有46-89%的自闭症谱系障碍（ASD）儿童有进食问题，如特殊的食物选择性和食物拒绝，食物厌恶，进餐时的仪式和破坏性行为。对于ASD儿童，其发育已经受到一系列缺陷的影响，喂养，饮食和任何由此产生的营养问题的潜在影响可能是深远的。有限的治疗文献表明，行为干预可以有效地解决这一人群的喂养问题。然而，这些干预措施的随机临床试验目前尚不可用。此外，这些干预措施主要是在高度专业化的环境中（住院或有喂养专家的日间治疗中心）提供的，几乎没有父母参与。据我们所知，一个系统的父母培训模式，专门解决喂养问题的幼儿ASD在门诊设置，这可能是更广泛的访问和有效的比住院或日间治疗，还没有调查。为了响应计划公告PAR-12-071（精神障碍创新治疗试点研究的合作R34）和PA-11-283（自闭症谱系障碍的心理社会/行为干预和服务研究），这个两个地点的项目将开发，然后试用一个11节的喂养问题行为父母培训计划（PT-F）使用等待列表控制设计。参与者是50名2-7岁的ASD儿童及其照顾者。主要结果是孩子进餐行为的变化。其他结果集中在父母与孩子互动的变化上。这两个研究中心（匹兹堡和罗切斯特）在多中心试验、父母培训方案的制定以及饮食和营养评价方面具有丰富的经验。匹兹堡大学公共研究生院的流行病学数据中心（EDC）将提供数据管理和生物统计服务。罗切斯特将监督监测儿童饮食和营养状况的方案，汇集在父母培训和喂养和营养方面有经验的调查人员。两 研究中心将为PT-F的发展做出贡献。

DESCRIPTION (provided by applicant): An estimated 46-89% of children with Autism Spectrum Disorders (ASD) have feeding problems such as idiosyncratic food selectivity and food refusal, food aversion, mealtime rituals and disruptive behaviors at mealtime. For children with ASD whose development is already compromised by a range of deficits, the potential impact of feeding, eating and any resulting nutritional problems may be far reaching. The limited treatment literature suggests behavioral interventions can be effective in addressing the array of feeding problems in this population. However, randomized clinical trials of these interventions are currently unavailable. In addition, the interventions have primarily been delivered in highly specialized settings (inpatient or day treatment centers that have feeding experts on staff) with little parental involvement. To our knowledge, a systematic parent training model to specifically address feeding problems in young children with ASD in outpatient settings, which may be more widely accessible and efficient than inpatient or day treatment, has not been investigated. In response to Program Announcement PAR-12-071 (Collaborative R34s for Pilot Studies of Innovative Treatments in Mental Disorders) and PA-11-283 (Psychosocial/Behavioral Interventions and Services Research in Autism Spectrum Disorders), this two-site project will develop and then pilot a 11-session behavioral parent training program for feeding problems (PT-F) using a wait-list control design. Participants are 50 children with ASD, age 2-7 years, and their caregivers. Primary outcomes are changes in the child's mealtime behavior. Other outcomes center on changes in parent-child interactions. Both sites (Pittsburgh and Rochester) have extensive experience in multisite trials, development of parent training protocols, and evaluation of diet and nutrition. The Epidemiology Data Center (EDC) at the University of Pittsburgh's Graduate School of Public will provide data management and biostatistical services. Rochester will oversee protocols for monitoring children's diets and nutritional status brings together investigators with experience in parent training and in feeding and nutrition. Both sites will contribute to the development of PT-F.