None listed
Conditions
Brief summary
This study will be a randomised controlled trial to evaluate the clinical benefits of two feeding intervention programs for children with a history of fussy eating, but no major medical history. Baseline assessment will include parent completed questionnaires and on-site feeding and growth assessments. There are two arms of intervention. Arm One is an individual operant conditioning arm. Arm Two involves small group systematic desensitisation therapy. Both arms will involve group parent education sessions regarding nutrition, behaviour management and feeding development. Intervention will be provided in either an intensive format (10 times over the course of a week) or in a weekly format (10 times over 10 weeks) at the discretion of the parent.
Interventions
Arm One: One-on-one operant conditioning therapy. Run in a 1 hour individual session for 10 sessions with a primary therapist (speech pathologist or occupational therapist). Involves providing a verbal prompt to encourage consumption of spoonfuls of new food/s with positive reinforcement (verbal and/or with toys) 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 s
Arm One: One-on-one operant conditioning therapy. Run in a 1 hour individual session for 10 sessions with a primary therapist (speech pathologist or occupational therapist). Involves providing a verbal prompt to encourage consumption of spoonfuls of new food/s with positive reinforcement (verbal and/or with toys) 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 will also receive standardised education about nutrition, behaviour management and feeding development. Arm Two: Small group systematic desensitisation therapy. Run in a 1 hour small group session for 10 sessions with a primary therapist (speech pathologist or occupational therapist). Involves the child being exposed to gradually more challenging modelling and play with food (based on a sensory hierarchy of look>smell>touch>taste). Parents initially observe the sessions from behind a one-way mirror with a second therapist and assist in observing transitions and reactions for their child. As the block continues, parents are rotated in and out of the room to assist in modelling play using the sensory hierarchy (i.e. 1 parent and primary therapist in room, 2 parents and secondary therapist outside of room). Parents will also receive standardised education about nutrition, behaviour management and feeding development. Therapy will be offered in an intensive format (10 times over 1 week) or in a weekly format (10 times over 10 weeks). This will be based on parent choice.
Sponsors
Queensland Children's Medical Research Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
1 Years to 6 Years
Healthy volunteers
Yes
Inclusion criteria
Children with a history of ongoing fussy eating (persisting for a period of 6 months or longer) but who have never been hospitalized for a primary medical condition (e.g gastroesophageal reflux), or who have never received a medical diagnosis with significant intellectual or developmental implications (e.g. Down Syndrome). "Fussy eating" includes: * Limited dietary variety across the 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 1 or 2 food textures; 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: 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 disorders which are not well controlled or understood (e.g. dumping syndrome) 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 primary language is that other than English, or children identified as being from an Aboriginal or Torres Strait Islander background
Outcome results
None listed