The Autism MEAL Plan: A Parent Training Curriculum to Manage Eating Aversions and Limited Variety among Children with Autism

自闭症膳食计划：家长培训课程，用于管理自闭症儿童的饮食厌恶和有限多样性

• 批准号: 9111491
• 负责人: William Sharp
• 金额: $ 7.02万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-07 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9111491
• 关键词: Address; Adolescence; Adult; Affect; Agreement; Autistic Disorder; Behavior; Behavior Therapy; Behavioral; Benchmarking; Blinded; Bone Growth; Carbohydrates; Cardiovascular Diseases; Child; Child Behavior; Child Rearing; Childhood; Clinical; Communities; Complex; Constipation; Data; Development; Diet; Disease; Doctor of Philosophy; Eating; Educational Curriculum; Educational Intervention; Effectiveness; Elements; Epidemic; Family; Fatty acid glycerol esters; Feedback; Food; Goals; Growth; Health; Height; High Prevalence; Home environment; Individual; Intervention; Intervention Trial; Knowledge acquisition; Life; Manuals; Medical; Methods; Minerals; Nutritional; Obesity; Outcome; Parenting Education; Parents; Patient Education; Pattern; Performance; Play; Population; Positioning Attribute; Problem Solving; Problem behavior; Psychologist; Public Health; Quality of life; Questionnaires; Recovery; Recruitment Activity; Research; Risk; Role; Sampling; Starch; Stress; Structure; Sum; Techniques; Technology; Therapeutic; Time; Training; Training Programs; Vitamins; Weight; Wit; Work; alternative treatment; autism spectrum disorder; base; boys; clinical practice; cost; cost effective; cost efficient; effective therapy; efficacy testing; feeding; fruits and vegetables; group intervention; impression; improved; in vivo; innovation; interest; member; pediatric department; peer; preference; programs; satisfaction; skill acquisition; skills; social; success; therapy development; tool; treatment center; treatment group; waist circumference

 DESCRIPTION (provided by applicant): Children with autism spectrum disorders (ASD) have a fivefold increase in the odds of developing a feeding problem compared with peers. Food selectivity (i.e., only eating a narrow variety of foods) is the most widely documented feeding issue associated with ASD, often involving strong preferences for starches and snack foods coinciding with a bias against fruits and vegetables. Estimates of food selectivity in children wit ASD reach as high as 95%, suggesting feeding problems may occur at near epidemic levels in this population. With autism affecting 6 to14 children per 1000, high prevalence of feeding concerns in ASD poses a significant public health concern. Food refusal can be treated with behavioral therapy, but at a significant cost to affected individuals and their families. Further, available interventions are also intended for children with severe feeding concerns. We will identify the utility of patient-training group intervention to address moderate food selectivity in children with ASD. A successful line of research in the treatment of feeding problems would expand the availability of empirically- supported, time-limited, and cost-effective interventions fr young children with ASD. This project, which combines behavioral parent training with specific techniques focused on feeding problems, is necessary step in the development of this treatment. We will examine the social validity, feasibility, and preliminary efficacy of a revised manual- based parent-training intervention for feeding problem behaviors in children with ASD. Our previous work focusing on the development of a behaviorally-based parent training program, the Autism MEAL Plan, is the only group treatment approach to address feeding problems in ASD. We propose to complete development of the Autism MEAL plan guided by this foundational pilot work by promoting generalization of skills in the home setting, replicating our preliminary findings (e.g., high social validity, reduced parenting stress), and evaluating additional outcomes (e.g. child and parent behaviors). This proposal holds the possibility to transform treatment of feeding problems in ASD by providing an innovative, cost-efficient treatment manual with the potential for broad application and rapid distribution in the ASD community. Emory is uniquely positioned to support this endeavor. Dr. Sharp is a pediatric psychologist and Director of the Pediatric Feeding Disorders Program at the Emory Marcus Center. The Program is one of the few treatment centers in the U.S. specializing in the treatment of pediatric feeding disorders and it treats over 400 children per year, thus it is well equipped to recruit and support feeding intervention trials.

 描述（由申请人提供）：与同龄人相比，自闭症谱系障碍（ASD）儿童出现喂养问题的几率增加了五倍。食物选择性（即，只吃种类有限的食物）是与ASD相关的最广泛记录的喂养问题，通常涉及对淀粉和零食的强烈偏好，同时对水果和蔬菜的偏见。ASD儿童的食物选择性估计高达95%，这表明喂养问题可能在该人群中接近流行水平。自闭症影响每1000名儿童中有6至14名儿童，ASD中喂养问题的高患病率构成了重大的公共卫生问题。食物拒绝可以通过行为疗法来治疗，但对受影响的个人及其家庭来说代价高昂。此外，现有的干预措施也是针对有严重喂养问题的儿童。我们将确定病人培训小组干预的效用，以解决中度食物选择性， ASD儿童。一个成功的喂养问题的治疗研究将扩大经验支持的，有时间限制的，成本效益的干预措施的可用性与ASD的幼儿。该项目将行为父母培训与专注于喂养问题的特定技术相结合，是这种治疗发展的必要步骤。我们将检验一个修订的以手册为基础的家长训练干预ASD儿童喂养问题行为的社会有效性、可行性和初步疗效。我们以前的工作重点是发展一个基于行为的父母培训计划，自闭症膳食计划，是唯一的小组治疗方法，以解决喂养问题的ASD。我们建议在这项基础性试点工作的指导下，通过促进家庭环境中技能的普遍化， 我们的初步发现（例如，更高的社会有效性，减少父母的压力），并评估额外的结果（如儿童和父母的行为）。该提案有可能通过提供一种创新的、具有成本效益的治疗手册来改变ASD喂养问题的治疗，该手册有可能在ASD社区中广泛应用和快速分发。埃默里大学在支持这一奋进方面处于独特的地位。夏普博士是一名儿科心理学家，也是埃默里马库斯中心儿科喂养障碍项目的主任。该计划是美国少数几个专门治疗儿科喂养障碍的治疗中心之一，每年治疗400多名儿童，因此有充分的条件招募和支持喂养干预试验。