Abstract
Evidence-based weight-loss treatments for children with autism spectrum disorder (ASD) are lacking. Therefore, a parent-based weight-loss treatment for children with ASD (PBT-ASD) was developed. A pilot study was conducted to test the initial efficacy, feasibility, and acceptability of this intervention. Parents of 20 children with ASD and overweight/obesity (mean age = 9.90 (SD = 2.31) years; 90% male; 40% Hispanic) participated in a 16-session PBT-ASD. The PBT-ASD program was found to be feasible and acceptable. Both children and parents lost weight from pre- to post-treatment (p’s < .05). Parent-reported child physical activity and vegetable consumption increased at post-treatment (p’s < .05). This pilot study provides a proof-of-concept for PBT-ASD. Randomized controlled trials with larger samples and follow-up are needed.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., … Dowling, N. F. (2018). Prevalence of autism spectrum disorder among children aged 8 years: Autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1.
Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., et al. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. Journal of Pediatrics, 157(2), 259–264. https://doi.org/10.1016/j.jpeds.2010.02.013.
Barnhill, K., Gutierrez, A., Ghossainy, M., Marediya, Z., Marti, C. N., & Hewitson, L. (2017). Growth status of children with autism spectrum disorder: A case–control study. Journal of Human Nutrition & Dietetics, 30(1), 59–65. https://doi.org/10.1111/jhn.12396.
Block, G., Hartman, A. M., Dresser, C. M., Carroll, M. D., Gannon, J., & Gardner, L. (1986). A data-based approach to diet questionnaire design and testing. American Journal of Epidemiology, 124(3), 453–469. https://doi.org/10.1093/oxfordjournals.aje.a114416.
Bochukova, E. G., Huang, N., Keogh, J., Henning, E., Purmann, C., Blaszczyk, K., … Farooqi, I. S. (2010). Large, rare chromosomal deletions associated with severe early-onset obesity. Nature, 463(7281), 666–670. https://doi.org/10.1038/nature08689.
Boutelle, K. N., Braden, A., Douglas, J. M., Rhee, K. E., Strong, D., Rock, C. L., … Crow, S. (2015). Design of the FRESH study: A randomized controlled trial of a parent-only and parent-child family-based treatment for childhood obesity. Contemporary Clinical Trials, 45, 364–370. https://doi.org/10.1016/j.cct.2015.09.007.
Boutelle, K. N., Cafri, G., & Crow, S. J. (2011). Parent-only treatment for childhood obesity: A randomized controlled trial. Obesity, 19(3), 574–580. https://doi.org/10.1038/oby.2010.238.
Boutelle, K. N., Rhee, K. E., Liang, J., Braden, A., Douglas, J., Strong, D., … Crow, S. J. (2017). Effect of attendance of the child on body weight, energy intake, and physical activity in childhood obesity treatment: A randomized clinical trial. JAMA Pediatrics, 171(7), 622–628. https://doi.org/10.1001/jamapediatrics.2017.0651.
Casagrande, K., & Ingersoll, B. (2017). Parent-mediated interventions for social communication in young children with ASD. In J. Leaf (Ed.), Handbook of social skills and autism spectrum disorder: Assessment, curricula, and interventions. New York, NY: Springer.
Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238. https://doi.org/10.1016/j.jada.2009.10.032.Food.
Curtin, C., Bandini, L. G., Perrin, E. C., Tybor, D. J., & Must, A. (2005). Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: A chart review. BMC Pediatrics. https://doi.org/10.1186/1471-2431-5-48.
Epstein, L. H., Paluch, R. A., Roemmich, J. N., & Beecher, M. D. (2007). Family-based obesity treatment, then and now: Twenty-five years of pediatric obesity treatment. Health Psychology, 26(4), 381–391. https://doi.org/10.1037/0278-6133.26.4.381.
Evans, E. W., Must, A., Anderson, S. E., Curtin, C., Scampini, R., Maslin, M., et al. (2012). Dietary patterns and body mass index in children with autism and typically developing children. Research in Autism Spectrum Disorders, 6(1), 399–405. https://doi.org/10.1016/j.rasd.2011.06.014.
Friedemann, C., Heneghan, C., Mahtani, K., Thompson, M., Perera, R., & Ward, A. M. (2012). Cardiovascular disease risk in healthy children and its association with body mass index: Systematic review and meta-analysis. BMJ. https://doi.org/10.1136/bmj.e4759.
Golan, M., & Crow, S. (2004). Parents are key players in the prevention and treatment of weight-related problems. Nutrition Reviews. https://doi.org/10.1301/nr.2004.jan.39?50.
Goran, M. I., Ball, G. D. C., & Cruz, M. L. (2003). Cardiovascular endocrinology 2: Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/jc.2002-021442.
Griffiths, L. J., Parsons, T. J., & Hill, A. J. (2010). Self-esteem and quality of life in obese children and adolescents: A systematic review. International Journal of Pediatric Obesity, 1, 4. https://doi.org/10.3109/17477160903473697.
Hannon, T. S. (2005). Childhood obesity and type 2 diabetes mellitus. Pediatrics, 116(2), 473–480. https://doi.org/10.1542/peds.2004-2536.
IBM Corp. (2017). IBM SPSS statistics for Macintosh, version 25.0. Armonk, NY: IBM Corp.
Ingersoll, B., & Wainer, A. (2013). Initial efficacy of project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43(12), 2943–2952. https://doi.org/10.1007/s10803-013-1840-9.
Koegel, R. L., Schreibman, L., Britten, K. R., Burke, J. C., & Neill, R. E. (1982). A comparison of parent training to direct child treatment. In A. L. Koegel, R. L. Rincover, & A. Egel (Eds.), Educating and understanding autistic children (pp. 260–279). San Diego, CA: College Hill Press.
Kuczmarski, R. R. J., Ogden, C. L. C., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., … Johnson, C. L. (2002). 2000 CDC Growth Charts for the United States: Methods and development. Vital and Health Statistics. Series 11, Data from the National Health Survey.
Liang, J., Matheson, B. E., Kaye, W. H., & Boutelle, K. N. (2014). Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents. International Journal of Obesity, 38(4), 494–506. https://doi.org/10.1038/ijo.2013.142.
Lovaas, O. I., Koegel, R., Simmons, J. Q., & Long, J. S. (1973). Some generalization and follow-up measures on autistic children in behavior therapy1. Journal of Applied Behavior Analysis, 6(1), 1310815. https://doi.org/10.1901/jaba.1973.6-131.
MacDonald, M., Esposito, P., & Ulrich, D. (2011). The physical activity patterns of children with autism. BMC Research Notes. https://doi.org/10.1186/1756-0500-4-422.
Matheson, B. E., & Douglas, J. M. (2017). Overweight and obesity in children with autism spectrum disorder (ASD): A critical review investigating the etiology, development, and maintenance of this relationship. Review Journal of Autism and Developmental Disorders, 4(2), 142–156. https://doi.org/10.1007/s40489-017-0103-7.
Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(8), 1757–1767. https://doi.org/10.1007/s10803-011-1413-8.
Obrusnikova, I., & Cavalier, A. R. (2011). Perceived barriers and facilitators of participation in after-school physical activity by children with autism spectrum disorders. Journal of Developmental and Physical Disabilities, 23(3), 195–211. https://doi.org/10.1007/s10882-010-9215-z.
Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(4), 512–520. https://doi.org/10.1007/s10803-011-1218-9.
Schreck, K. A., Williams, K., & Smith, A. F. (2004). A comparison of eating behaviors between children with and without autism. Journal of Autism and Developmental Disorders, 34(4), 433–438. https://doi.org/10.1023/B:JADD.0000037419.78531.86.
Sharma, J. R., Arieff, Z., & Sagar, S. (2012). Autism and obesity: Prevalence, molecular basis and potential therapies. Autism Insights. https://doi.org/10.4137/AUI.S9138.
Shinawi, M., Sahoo, T., Maranda, B., Skinner, S. A., Skinner, C., Chinault, C., … Beaudet, A. L. (2011). 11p14.1 microdeletions associated with ADHD, autism, developmental delay, and obesity. American Journal of Medical Genetics, Part A, 155(6), 1272–1280. https://doi.org/10.1002/ajmg.a.33878.
Telama, R., Viikari, J., Valikmaki, I., Siren-Tiusanen, H., Åkerblom, H. K., Uhari, M., … Suoninen, P. (1985). Atherosclerosis precursors in Finnish children and adolescents. X. Leisure‐time physical activity. Acta Pædiatrica, 74, 169–180. https://doi.org/10.1111/j.1651-2227.1985.tb10092.x.
Trasande, L., & Chatterjee, S. (2009). The impact of obesity on health service utilization and costs in childhood. Obesity, 17(9), 1749–1754. https://doi.org/10.1038/oby.2009.67.
Tsiros, M. D., Olds, T., Buckley, J. D., Grimshaw, P., Brennan, L., Walkley, J., … Coates, A. M. (2009). Health-related quality of life in obese children and adolescents. International Journal of Obesity. https://doi.org/10.1038/ijo.2009.42.
Walters, R. G., Jacquemont, S., Valsesia, A., De Smith, A. J., Martinet, D., Andersson, J., … Beckmann, J. S. (2010). A new highly penetrant form of obesity due to deletions on chromosome 16p11.2. Nature, 463(7281), 671–675. https://doi.org/10.1038/nature08727.
Zimmer, M. H., Hart, L. C., Manning-Courtney, P., Murray, D. S., Bing, N. M., & Summer, S. (2012). Food variety as a predictor of nutritional status among children with autism. Journal of Autism and Developmental Disorders, 42(4), 549–556. https://doi.org/10.1007/s10803-011-1268-z.
Acknowledgments
The authors are grateful to the Healthy Weight Research Network for Children with Autism Spectrum Disorder and Developmental Disabilities for providing the funding for this pilot study (HRSA UA3 MC25735). Amy Drahota, Ph.D., also received funding from the National Institutes of Mental Health (K01 MH093477). The authors would like to thank the families that participated in the TEAM UP study as well as the dedicated staff at the Center for Healthy Eating and Activity Research. Initial findings regarding treatment development and preliminary results from this study were presented at the Obesity Society Annual Scientific Meeting and the Association for Behavioral and Cognitive Therapies Convention in 2015.
Funding
The study was funded by Healthy Weight Research Network for Children with Autism Spectrum Disorder and Developmental Disabilities (HRSA UA3 MC25735); National Institutes of Mental Health (K01 MH093477; PI: Drahota)
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All authors contributed to the design of the study and jointly developed the treatment. BM was responsible for data collection and analyses. All authors contributed to the interpretation of findings, participated in the preparation and writing of the manuscript, and have approved the final version.
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Matheson, B.E., Drahota, A. & Boutelle, K.N. A Pilot Study Investigating the Feasibility and Acceptability of a Parent-Only Behavioral Weight-Loss Treatment for Children with Autism Spectrum Disorder. J Autism Dev Disord 49, 4488–4497 (2019). https://doi.org/10.1007/s10803-019-04178-8
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DOI: https://doi.org/10.1007/s10803-019-04178-8