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.
Children with autism spectrum disorders (ASD) have a fivefold increase in the odds of developing a feeding problem compared with peers. With autism rates of 6 to 14 per 1000 children, high prevalence of feeding concerns in ASD poses a significant public health concern. We will complete development and evaluate a patient-training group intervention to address these behaviors in children with ASD, with the ultimate goal of accelerating recovery and improving the lives of children with ASD.