None listed
Conditions
Brief summary
This study is a randomised clinical trial designed to evaluate the clinical benefits of two child-focused feeding intervention programs for children with feeding difficulties and restricted range of dietary intake. Baseline assessments will include parent-completed questionnaires, on-site assessment, and feeding and growth evaluations. After assessment, participants will be randomised into one of two intervention arms. Arm One is an individual operant conditioning program. Arm Two involves systematic desensitisation therapy. Although dose of intervention will be the same (10 sessions), intervention will either be provided in a weekly (once/ week for 10 weeks), or intensive format (all 10 sessions within a week). Parents will be able to choose between weekly or intensive therapy. Some outcome measures will be reviewed immediately post-treatment, and the participants will return for a full evaluation at 3-months post treatment.
Interventions
Arm One: Operant conditioning therapy. Run in a 30-60 minute 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 with a sec
Arm One: Operant conditioning therapy. Run in a 30-60 minute 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 with a second therapist. 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: Systematic desensitisation therapy. Run in a 30-60 minute individual or 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 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 hierarchy. 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
Dr Pamela Dodrill
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
2 Years to 6 Years
Healthy volunteers
No
Inclusion criteria
Children will be eligible for assessment to further determine suitability for participation if: *Child is aged between 2 and 6 years *Child must present with at least one of the following features: 1. Limited range of textures (e.g. only eats puree); 2. Limited range of foods (<10 carbohydrates, <10 proteins, <10 fruits/ vegetables); 3. Prolonged mealtime duration (>30 minutes); 4. Battles or problematic behaviour at mealtimes that are contributing to parental stress
Exclusion criteria
* Acutely unwell children * Children with severe oral motor disorders/ oropharyngeal dysphagia where aspiration is occurring * Children who are nutritionally unstable (severe malnutrition, gut malabsorption disorders, allergy/intolerance to > 2 food types). * Children who are tube-fed * Children whose parent/carer has a documented mental health condition
Outcome results
None listed