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.
This collaborative, two-site study will develop and pilot the feasibility and efficacy of a eleven session behavioral parent training program for feeding problems in children with autism compared to a wait list group. Children between the ages of 2 and 7 years diagnosed with an autism spectrum disorder who also have feeding problems will be recruited for this 5 month study.