None listed
Conditions
Brief summary
This study is a randomised controlled trial to evaluate the clinical benefits, and cost-effectiveness of two feeding treatment programs for children with ASD and feeding difficulties, including a restricted range of dietary intake (<30 foods across the food groups). Baseline assessment will include parent-completed questionnaires and on-site (Herston) feeding and growth assessments. There are two arms of intervention. Arm One is an individual behaviour modification program. Arm Two involves individual systematic desensitisation therapy. Both arms will involve parent education regarding nutrition and behaviour management for children with feeding difficulties. Intervention will be provided over two phases. Parents will elect to participate in weekly intervention (10 sessions over 10 weeks) or intensive intervention (10 sessions over one week).
Interventions
Arm One: One-on-one behaviour modification therapy Run in an individual session for 1 hour per week over ten weeks (weekly schedule) or 10 times over one week (intensive schedule) Involves providing a verbal prompt to encourage consumption of spoonfuls of new food/s, with positive reinforcement (verbal and/or with toys etc) upon consumption of these foods. Parents initially observe from behind a one-way mirror and assist in collecting information about the behaviours they are observing in their
Arm One: One-on-one behaviour modification therapy Run in an individual session for 1 hour per week over ten weeks (weekly schedule) or 10 times over one week (intensive schedule) Involves providing a verbal prompt to encourage consumption of spoonfuls of new food/s, with positive reinforcement (verbal and/or with toys etc) upon consumption of these foods. Parents initially observe from behind a one-way mirror and assist in collecting information about the behaviours they are observing in their child. As sessions continue, parents are transitioned into the room, and are trained to offer new foods and provide positive reinforcement by the end of the therapy block. Parents also receive standardised information about nutrition, behaviour management and feeding development. Arm Two: Systematic desensitisation therapy Run in an individual session for 1 hour per week over ten weeks (weekly schedule) or 10 times in one week (intensive schedule) Involves the child being exposed to gradually more challenging modelling and play with food (based on a sensory hierarchy of look>touch>smell>taste). Parents initially observe the sessions from behind a one-way mirror with a second therapist and assist in observing transitions and reactions in their children. As the block continues, parents are rotated in and out of the room to assist in modelling play using the sensory hierarchy. Parents also receive standardised information about nutrition, behaviour management and feeding development.
Sponsors
Queensland Children's Medical Research Institute
Royal Children's Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
1 Years to 11 Years
Healthy volunteers
No
Inclusion criteria
Children with a diagnosis of Autism Spectrum Disorder, or a pending diagnosis of Autism Spectrum Disorder Limited dietary variety across core food groups: diet currently includes less than 10 foods which are predominantly carbohydrates, 10 foods which are predominantly proteins, and 10 fruits/vegetables; limited range of textures consumed; don’t eat an age-appropriate range of textures; limit diet to only 1 or 2 textures of foods; consume predominantly ‘easy-to-eat’ junk foods Mealtimes are taking longer than 30 minutes There are problematic behaviours at mealtimes, which are contributing to parental stress
Exclusion criteria
Children who are medically unstable: this describes acutely unwell children who may experience a deterioration in health. Children with documented aspiration on any solid food textures (children on modified liquids will be accepted) Children with severe malnutrition, whose primary goal of nutrition could only be achieved by supplementary tube feeding Children with gut malabsorption disorders, which are not well controlled or understood Children with an allergy or current intolerance to more than 2 types of foods Children whose primary health carer has a known/declared mental health condition Children whose family’s primary language is that other than English or children identified as being of Aboriginal or Torres Strait Islander background
Outcome results
None listed