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A Pilot Study Investigating the Feasibility and Acceptability of a Parent-Only Behavioral Weight-Loss Treatment for Children with Autism Spectrum Disorder

  • Brittany E. MathesonEmail author
  • Amy Drahota
  • Kerri N. Boutelle
Article

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.

Keywords

Autism spectrum disorder Obesity Weight-loss Parent training 

Notes

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.

Author Contributions

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.

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)

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.CrossRefGoogle Scholar
  2. 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.
  3. 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.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. 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.CrossRefGoogle Scholar
  6. 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.
  7. 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.
  8. 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.CrossRefGoogle Scholar
  9. 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.
  10. 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.Google Scholar
  11. 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.CrossRefGoogle Scholar
  12. 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.Google Scholar
  13. 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.CrossRefGoogle Scholar
  14. 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.CrossRefGoogle Scholar
  15. 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.Google Scholar
  16. 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.Google Scholar
  17. 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.Google Scholar
  18. 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.Google Scholar
  19. Hannon, T. S. (2005). Childhood obesity and type 2 diabetes mellitus. Pediatrics, 116(2), 473–480.  https://doi.org/10.1542/peds.2004-2536.CrossRefGoogle Scholar
  20. IBM Corp. (2017). IBM SPSS statistics for Macintosh, version 25.0. Armonk, NY: IBM Corp.Google Scholar
  21. 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.CrossRefGoogle Scholar
  22. 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.Google Scholar
  23. 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.Google Scholar
  24. 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.CrossRefGoogle Scholar
  25. 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.CrossRefGoogle Scholar
  26. 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.Google Scholar
  27. 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.CrossRefGoogle Scholar
  28. 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.CrossRefGoogle Scholar
  29. 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.CrossRefGoogle Scholar
  30. 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.CrossRefGoogle Scholar
  31. 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.CrossRefGoogle Scholar
  32. 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.Google Scholar
  33. 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.
  34. 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.
  35. 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.CrossRefGoogle Scholar
  36. 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.
  37. 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.
  38. 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.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordUSA
  2. 2.Department of PsychologyMichigan State UniversityEast LansingUSA
  3. 3.Child & Adolescent Services Research CenterSan DiegoUSA
  4. 4.Department of PediatricsUniversity of California, San DiegoLa JollaUSA
  5. 5.Department of PsychiatryUniversity of California, San DiegoLa JollaUSA

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