Feeding and Eating Disorders of Childhood, Premature Birth
Conditions
Keywords
early intervention, pediatric feeding, assessment
Brief summary
Preterm infants are at risk for feeding problems which can persist through early childhood. These feeding problems may include oral motor, sensory, digestive, nutritional, respiratory, and/or behavioral components. In North Carolina's early intervention program, speech pathologists or occupational therapists are responsible for completing feeding evaluations, and may not know when to refer infants out to medical specialists to address these other domains. This study will test a decision support tool in hypothetical feeding evaluation scenarios. The hypothetical scenarios will consist of real feeding videos of preterm infants who recently participated in a multidisciplinary feeding evaluation. Parent-reported outcomes of the infant's real evaluation will be compared to those of the speech pathologists and occupational therapists in our study who do, and do not, use the decision support tool. The investigators hypothesize that therapists with the tool will make recommendations that are closer to those of the multidisciplinary team, and that they will find the tool useful and easy to use. Due to recruitment limitations with families, the study was adapted in October, 2021 prior to enrollment of subjects to use case studies, rather than infant videos, as the hypothetical situation from which to test the tool. Therapists will then answer clinical questions without using the tool when viewing the first case study, and will use the tool to answer questions when viewing the second case study. Order of case study presentation will be randomized among participants.
Interventions
BEHAVIORALDecision Support Tool
The decision support tool is an observational checklist with recommendations for specific specialist referrals based on what the provider observed during the feeding evaluation.
Sponsors
North Carolina Translational and Clinical Sciences Institute
University of North Carolina, Chapel Hill
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SCREENING
Masking
SINGLE (Caregiver)
Intervention model description
Therapists will answer clinical questions about a case study (A or B, randomized order of presentation) without using the tool. They will then be presented with the tool and will answer the same clinical questions about a second case study (A or B, randomized order of presentation)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* at least 18 years of age, * speech language pathologist or occupational therapist, * at least 2 years of experience evaluating and treating pediatric feeding, * have worked in early intervention in last 5 years, * English proficiency, * currently reside in North Carolina
Exclusion criteria
* \<2 years of experience in pediatric feeding, * have not worked in Early Intervention in last 5 years, * younger than 18 years old
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants That Recommend Feeding Therapy | Immediately after reading feeding case study, within approximately 5 minutes | After reading a feeding case study, early intervention professionals will answer the question Would you recommend feeding therapy? with two choices: yes or no. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B. |
| Number of Participants That Recommend Referral to Other Providers | Immediately after reading feeding case study, within approximately 5 minutes | After reading a feeding case study, early intervention professionals will answer the question Would you refer this family to any other providers/specialists for evaluation/treatment? with two answer choices: yes or no. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B. |
| Number of Participants That Recommend Referral by Specialty | Immediately after reading feeding case study, within approximately 5 minutes | After reading the feeding case study, early intervention professionals will answer the question What other professionals would you refer this child to? Check all that apply. with the following choices: nutritionist/dietician, gastroenterologist, otolaryngologist (ENT), aerodigestive clinic, pulmonologist, occupational therapist, speech language pathologist, psychologist/social worker, applied behavior analyst (ABA), or allergist. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Decision Support Tool Appropriateness Score. | Immediately after using tool, within approximately 5 minutes | The Intervention Appropriateness Measure (IAM) will be used to measure appropriateness of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) seems fitting; (Intervention) seems suitable; (Intervention) seems applicable; (Intervention) seems like a good match. |
| Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Immediately after reading feeding case study, within approximately 5 minutes | After reading the feeding case study, early intervention professionals who recommended feeding therapy will answer the question With what frequency would you recommend therapy? with three choices: 2 times per week or more, 1 time per week, less than one time per week. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B. |
| Decision Support Tool Feasibility Score. | Immediately after using tool, within approximately 5 minutes | The Feasibility of Intervention Measure (FIM) will be used to measure feasibility of use of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) seems implementable; (Intervention) seems possible; (Intervention) seems doable; (Intervention) seems easy to use. |
| Number of Participants That Recommend Intervention Target Choices | Immediately after reading feeding case study, within approximately 5 minutes | After reading the feeding case study, early intervention professionals who recommended feeding therapy will answer the question What therapy targets might you include for this child? and may check all that apply from the following choices: oral motor skills, sensory, behavioral, medication, modification of food/liquid, modification of equipment (seating, utensils, etc.), modification of environment (location, distractions, routine, etc.), parent coaching, or other. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B. |
| Decision Support Tool Acceptability Score | Immediately after using tool, within approximately 5 minutes | The Acceptability of Intervention Measure (AIM) will be used to measure acceptability of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) meets my approval; (Intervention) is appealing to me; I like (Intervention) and I welcome (Intervention). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Case A Then Case B Participant will first review and answer questions about Case A without using the tool. Then, they will use the tool to answer questions about case B.
Decision Support Tool: The decision support tool is an observational checklist with recommendations for specific specialist referrals based on what the provider observed during the feeding evaluation. | 28 |
| Case B Then Case A Participant will first review and answer questions about Case B without using the tool. Then, they will use the tool to answer questions about case A.
Decision Support Tool: The decision support tool is an observational checklist with recommendations for specific specialist referrals based on what the provider observed during the feeding evaluation. | 28 |
| Total | 56 |
Baseline characteristics
| Characteristic | — | Total | Case A Then Case B | Case B Then Case A |
|---|---|---|---|---|
| Age, Continuous | — years | — | — | — |
| Race and Ethnicity Not Collected | — | 0 Participants | — | — |
| Region of Enrollment United States | — | 56 Participants | 28 Participants | 28 Participants |
| Sex: Female, Male Female | — | 56 Participants | 28 Participants | 28 Participants |
| Sex: Female, Male Male | — | 0 Participants | 0 Participants | 0 Participants |
| Year of Graduation For Clinical Degree 1980-1989 | — | 2 Participants | 1 Participants | 1 Participants |
| Year of Graduation For Clinical Degree 1990-1999 | — | 9 Participants | 5 Participants | 4 Participants |
| Year of Graduation For Clinical Degree 2000-2009 | — | 5 Participants | 1 Participants | 4 Participants |
| Year of Graduation For Clinical Degree 2010-2019 | — | 39 Participants | 21 Participants | 18 Participants |
| Year of Graduation For Clinical Degree 2020 or later | — | 0 Participants | 0 Participants | 0 Participants |
| Years of Pediatric Feeding Experience 12 or more years | — | 10 Participants | 4 Participants | 6 Participants |
| Years of Pediatric Feeding Experience 2 years or less | — | 8 Participants | 4 Participants | 4 Participants |
| Years of Pediatric Feeding Experience 3-5 years | — | 25 Participants | 15 Participants | 10 Participants |
| Years of Pediatric Feeding Experience 6-8 years | — | 9 Participants | 2 Participants | 7 Participants |
| Years of Pediatric Feeding Experience 9-11 years | — | 4 Participants | 3 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 28 | 0 / 28 | 0 / 28 | 0 / 28 |
| other Total, other adverse events | 0 / 28 | 0 / 28 | 0 / 28 | 0 / 28 |
| serious Total, serious adverse events | 0 / 28 | 0 / 28 | 0 / 28 | 0 / 28 |
Outcome results
Primary
Number of Participants That Recommend Feeding Therapy
After reading a feeding case study, early intervention professionals will answer the question Would you recommend feeding therapy? with two choices: yes or no. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B.
Time frame: Immediately after reading feeding case study, within approximately 5 minutes
Population: Participant responses to Case A and Case B were analyzed separately.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case A-Yes response | 27 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case A-No response | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case B-Yes response | 26 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case B-No response | 2 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case B-No response | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case A-Yes response | 27 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case B-Yes response | 25 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy | Case A-No response | 1 Participants |
Primary
Number of Participants That Recommend Referral by Specialty
After reading the feeding case study, early intervention professionals will answer the question What other professionals would you refer this child to? Check all that apply. with the following choices: nutritionist/dietician, gastroenterologist, otolaryngologist (ENT), aerodigestive clinic, pulmonologist, occupational therapist, speech language pathologist, psychologist/social worker, applied behavior analyst (ABA), or allergist. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B.
Time frame: Immediately after reading feeding case study, within approximately 5 minutes
Population: The question was only answered by those participants who recommended referring to another professional. Participant responses to Case A and Case B were analyzed separately.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Nutritionist/dietician | 10 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Otolaryngologist (ENT) | 2 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Gastroenterologist | 15 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Psychologist/social worker | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Otolaryngologist (ENT) | 10 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Gastroenterologist | 20 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Aerodigestive clinic | 15 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Applied behavior analyst (ABA) | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Pulmonologist | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Pulmonologist | 0 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Occupational therapist and speech language pathologist | 10 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Allergist | 0 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Psychologist/social worker | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Aerodigestive clinic | 9 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Applied behavior analyst (ABA) | 2 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Multi-disciplinary team | 12 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Allergist | 4 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Occupational therapist and speech language pathologist | 16 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Multi-disciplinary team | 21 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Other | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Other | 6 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A Nutritionist/dietician | 11 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Other | 7 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A Nutritionist/dietician | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Gastroenterologist | 17 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Otolaryngologist (ENT) | 4 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Aerodigestive clinic | 1 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Other | 8 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Pulmonologist | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Occupational therapist and speech language pathologist | 14 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Psychologist/social worker | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Applied behavior analyst (ABA) | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Allergist | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case A-Multi-disciplinary team | 11 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Nutritionist/dietician | 8 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Gastroenterologist | 11 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Otolaryngologist (ENT) | 6 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Aerodigestive clinic | 4 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Pulmonologist | 1 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Occupational therapist and speech language pathologist | 12 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Psychologist/social worker | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Applied behavior analyst (ABA) | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Allergist | 1 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral by Specialty | Case B-Multi-disciplinary team | 14 Participants |
Primary
Number of Participants That Recommend Referral to Other Providers
After reading a feeding case study, early intervention professionals will answer the question Would you refer this family to any other providers/specialists for evaluation/treatment? with two answer choices: yes or no. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B.
Time frame: Immediately after reading feeding case study, within approximately 5 minutes
Population: Participant responses to Case A and Case B were analyzed separately.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| With Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case A-Yes response | 27 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case B-Yes response | 27 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case A-No response | 1 Participants |
| With Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case B-No response | 1 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case B-No response | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case A-Yes response | 25 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case A-No response | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Referral to Other Providers | Case B-Yes response | 25 Participants |
Secondary
Decision Support Tool Acceptability Score
The Acceptability of Intervention Measure (AIM) will be used to measure acceptability of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) meets my approval; (Intervention) is appealing to me; I like (Intervention) and I welcome (Intervention).
Time frame: Immediately after using tool, within approximately 5 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| With Decision Support Tool | Decision Support Tool Acceptability Score | 3.40 score on a scale | Standard Deviation 0.52 |
Secondary
Decision Support Tool Appropriateness Score.
The Intervention Appropriateness Measure (IAM) will be used to measure appropriateness of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) seems fitting; (Intervention) seems suitable; (Intervention) seems applicable; (Intervention) seems like a good match.
Time frame: Immediately after using tool, within approximately 5 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| With Decision Support Tool | Decision Support Tool Appropriateness Score. | 3.37 score on a scale | Standard Deviation 0.54 |
Secondary
Decision Support Tool Feasibility Score.
The Feasibility of Intervention Measure (FIM) will be used to measure feasibility of use of the decision support tool. This tool includes four items, rated on a five-point Likert scale from completely disagree to completely agree, and will be quantified with a score of 0 for completely disagree, 1 for disagree, 2 for neither agree nor disagree, 3 for agree, and 4 for completely agree. The average score across the four items will be calculated, with higher scores indicating higher acceptability of the decision making tool. The minimum score is 0 and the maximum score is 4. Items on this measure include: (Intervention) seems implementable; (Intervention) seems possible; (Intervention) seems doable; (Intervention) seems easy to use.
Time frame: Immediately after using tool, within approximately 5 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| With Decision Support Tool | Decision Support Tool Feasibility Score. | 3.50 score on a scale | Standard Deviation 0.57 |
Secondary
Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week
After reading the feeding case study, early intervention professionals who recommended feeding therapy will answer the question With what frequency would you recommend therapy? with three choices: 2 times per week or more, 1 time per week, less than one time per week. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B.
Time frame: Immediately after reading feeding case study, within approximately 5 minutes
Population: The question was only answered by those participants who recommended feeding therapy. Participant responses to Case A and Case B were analyzed separately.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-2 times per week or more | 8 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-1 time per week | 19 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-less than one time per week | 0 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-2 times per week or more | 12 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-1 time per week | 14 Participants |
| With Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-less than one time per week | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-1 time per week | 12 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-2 times per week or more | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-2 times per week or more | 13 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-1 time per week | 24 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case B-less than one time per week | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Feeding Therapy Categorized by Number of Times Per Week | Case A-less than one time per week | 0 Participants |
Secondary
Number of Participants That Recommend Intervention Target Choices
After reading the feeding case study, early intervention professionals who recommended feeding therapy will answer the question What therapy targets might you include for this child? and may check all that apply from the following choices: oral motor skills, sensory, behavioral, medication, modification of food/liquid, modification of equipment (seating, utensils, etc.), modification of environment (location, distractions, routine, etc.), parent coaching, or other. Difference in agreement between early intervention professionals using the decision support tool and those not will be calculated and compared for cases A and B.
Time frame: Immediately after reading feeding case study, within approximately 5 minutes
Population: The question was only answered by those participants who recommended feeding therapy. Participant responses to Case A and Case B were analyzed separately.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of Environment | 16 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Other | 2 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Oral Motor Skills | 26 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Sensory | 22 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Sensory | 11 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Parent Coaching | 27 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Behavioral | 6 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Behavioral | 22 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Medication | 2 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of food/liquid | 22 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Other | 3 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of Equipment | 26 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Medication | 4 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of Environment | 24 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Oral Motor Skills | 26 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Parent Coaching | 26 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of food/liquid | 15 Participants |
| With Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of Equipment | 12 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Other | 4 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of Equipment | 8 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of Environment | 14 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Parent Coaching | 27 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Medication | 0 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Oral Motor Skills | 25 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Sensory | 19 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Behavioral | 11 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Medication | 5 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Other | 3 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Oral Motor Skills | 23 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Sensory | 9 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Behavioral | 1 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of food/liquid | 24 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of Equipment | 24 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Modification of Environment | 21 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case B-Parent Coaching | 25 Participants |
| Without Decision Support Tool | Number of Participants That Recommend Intervention Target Choices | Case A-Modification of food/liquid | 16 Participants |