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

 描述(由申请人提供)：与同龄人相比，患有自闭症谱系障碍(ASD)的儿童出现喂养问题的几率增加了五倍。食物选择性(即只吃很少种类的食物)是与自闭症有关的最广泛记录的喂养问题，往往涉及对淀粉和零食的强烈偏好，同时对水果和蔬菜的偏见。据估计，患有自闭症的儿童对食物的选择性高达95%，这表明在这一人群中，喂养问题可能发生在接近流行水平的水平。由于自闭症每1000名儿童中有6至14名儿童患有自闭症，自闭症患者中喂养问题的高流行率构成了一个重大的公共卫生问题。拒绝进食可以用行为疗法来治疗，但对受影响的个人及其家人来说，代价是巨大的。此外，现有的干预措施也适用于有严重喂养问题的儿童。我们将确定患者训练组干预的效用，以解决中等食物选择性问题 患有自闭症的儿童。在喂养问题的治疗方面的一系列成功的研究将扩大对患有自闭症的幼儿的经验性、有时限和成本效益的干预措施的可用性。该项目将父母的行为训练与专注于喂养问题的具体技术相结合，是这种治疗方法发展的必要步骤。我们将检验修订的基于人工的父母训练干预ASD儿童喂养问题行为的社会有效性、可行性和初步效果。我们之前的工作重点是开发一个基于行为的父母培训计划，即自闭症膳食计划，这是解决自闭症喂养问题的唯一集体治疗方法。我们建议在这项基础性试点工作的指导下，通过促进在家庭环境中推广技能、复制 我们的初步发现(例如，高社交效度、减少育儿压力)，以及评估其他结果(例如，孩子和父母的行为)。这一建议有可能改变ASD喂养问题的治疗方法，提供一种创新的、具有成本效益的治疗手册，具有在ASD社区广泛应用和快速分发的潜力。埃默里处于支持这一努力的独特地位。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。该计划是美国为数不多的专门治疗儿童喂养障碍的治疗中心之一，每年治疗400多名儿童，因此它有能力招募和支持喂养干预试验。

 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.