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Exploration of Treatment Response in Parent Training for Children with Autism Spectrum Disorder and Moderate Food Selectivity

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Abstract

Managing Eating Aversions and Limited Variety (MEAL) Plan is a structured parent-mediated intervention for children with autism spectrum disorder and moderate food selectivity. Our previously reported group-based clinical trial revealed a positive treatment response rate of 47.3%. Although encouraging, this response rate raises questions about factors that may affect treatment outcomes. Here, we examine the impact of child and parent characteristics and feeding behaviors on treatment response. Higher maternal education and higher child communication abilities at baseline were associated with positive treatment response. Improvement in sitting at the table and reductions in disruptive mealtime behavior promoted treatment success. Results also suggest that individually delivered MEAL Plan may offer more flexibility than group-based intervention for some parents.

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References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association.

    Book  Google Scholar 

  • Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., & Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. JAMA, 313, 1524–1533.

    Article  Google Scholar 

  • Cosbey, J., & Muldoon, D. (2017). EAT-UP™ Family-centered feeding intervention to promote food acceptance and decrease challenging behaviors: A single-case experimental design replicated across three families of children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47, 564–578.

    Article  Google Scholar 

  • DeMand, A., Johnson, C., & Foldes, E. (2015). Psychometric Properties of the Brief Autism Mealtime Behaviors Inventory. Journal of Autism and Developmental Disorders, 45(9), 2667–2673.

    Article  Google Scholar 

  • Elliott, C. D. (2012). Chapter 13: The Differential Ability Scales—Second Edition. In D. P. Flanagan & P. L. Harrison (Eds.), Contemporary Intellectual Assessment: Theories, tests, and issues (3rd ed., pp. 336–356). Guilford Press.

    Google Scholar 

  • Goday, P. S., Huh, S. Y., Silverman, A., Lukens, C. T., Dodrill, P., Cohen, S., & Phalen, J. A. (2019). Pediatric feeding disorder consensus definition and conceptual framework. Journal of Pediatric Gastroenterology and Nutrition, 68(1), 124–129. https://doi.org/10.1097/mpg.0000000000002188

    Article  Google Scholar 

  • Guy, W. (1976). Clinical global impressions. In M. D. Rockville (Ed.), Guy W(eds) ECDEU Assessment Manual for Psychopharmacology, Revised DHEW Pub. (ADM) (pp. 218–222). National Institute of Mental Health.

    Google Scholar 

  • Johnson, C. R., Brown, K., Hyman, S. L., Brooks, M., Aponte, C., Levato, L., & Smith, T. (2019). Parent training for feeding problems in children with autism spectrum disorder: Initial randomized trial. Journal of Pediatric Psychology, 44(2), 164–175.

    Article  Google Scholar 

  • Johnson, C. R., Foldes, E., DeMand, A., & Brooks, M. (2015). Behavioral parent training to address feeding problems in children with autism spectrum disorder: A pilot trial. Journal of Developmental Physical Disabilities, 27, 591–607.

    Article  Google Scholar 

  • Kaat, A. J., Lecavalier, L., & Aman, M. G. (2014). Validity of the aberrant behavior checklist in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 1103–1116.

    Article  Google Scholar 

  • Kovacic, K., Rein, L. E., Szabo, A., Kommareddy, S., Bhagavaula, P., & Goday, P. S. (2021). Pediatric feeding disorder: A nationwide prevalence study. Journal of Pediatrics, 228(3), 126–131.

    Article  Google Scholar 

  • Laud, R.B., Girolami, P. A., Boscoe, J. H., & Gulotta, C. S. (2009). Treatment outcomes for severe feeding problems in children with autism spectrum disorder. Behavior Modification, 33(5), 520–536. https://doi.org/10.1177/0145445509346729

    Article  Google Scholar 

  • Ledford, J. R. & Gast, D. L. (2006). Feeding problems in children with autism spectrum disorders: A review. Focus on Autism and Other Developmental Disabilities. https://doi.org/10.1177/10883576060210030401

    Article  Google Scholar 

  • Levy, S., Giarelli, E., Lee, L., Schieve, L., Kirby, R., Cunnif, C., & Rice, C. (2010). Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations in the United States. Journal of Developmental & Behavioral Pediatrics, 31(4), 267–275. https://doi.org/10.1097/DBP.0b013e3181d5d03b

    Article  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule—generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  Google Scholar 

  • Lukens, C. T., & Linscheid, T. R. (2008). Development and validation of an inventory to assess mealtime behavior problems in children with autism. Journal of Autism and Developmental Disorders, 38, 342–352.

    Article  Google Scholar 

  • Mullen, E. M. (1995). Mullen Scales of Early Learning. American Guidance Services Inc.

    Google Scholar 

  • Peterson, K. M., Piazza, C. C., Ibanez, V. F., & Fisher, W. W. (2019). Randomized controlled trial of an applied behavior analytic intervention for food selectivity in children with autism spectrum disorder. Journal of Applied Behavior Analysis, 52, 895–917. https://doi.org/10.1002/jaba.650

    Article  Google Scholar 

  • Postorino, V., Gillespie, S., Lecavalier, L., Smith, T., Johnson, C., Swiezy, N., Aman, M. G., McDougle, C. J., Bearss, K., Andridge, R. R., Vitiello, B., & Scahill, L. (2019). Clinical correlates of parenting stress in children with Autism Spectrum Disorder and serious behavioral problems. Journal of Child and Family Studies, 2, 2069–2077.

    Article  Google Scholar 

  • Roid, G. (2003). Stanford-Binet Intelligence Scales (5th ed.). Western Psychological Services.

    Google Scholar 

  • Rosen, R. E., Mazefsky, C. A., Vasa, R. A., & Lerner, M. D. (2018). Co-occurring psychiatric conditions in autism spectrum disorder. International Review of Psychiatry, 30(1), 40–61. https://doi.org/10.1080/09540261.2018.1450229

    Article  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). The Social Communication Questionnaire: Manual. Western Psychological Services.

    Google Scholar 

  • Scahill, L., Bearss, K., Lecavalier, L., Smith, T., Swiezy, N., Aman, M. G., & Levato, L. (2016). Effect of parent training on adaptive behavior in children with autism spectrum disorder and disruptive behavior: Results of a randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 602–609.

    Article  Google Scholar 

  • Sharp, W. G., Berry, R. C., McCracken, C., Nuhu, N. N., Marvel, E., Saulnier, C. A., Klin, A., Jones, W., & Jaquess, D. L. (2013a). Feeding problems and nutrient intake in children with autism spectrum disorders: A meta-analysis and comprehensive review of the literature. Journal of Autism and Developmental Disorders, 43(9), 2159–2173.

    Article  Google Scholar 

  • Sharp, W. G., Burrell, T. L., & Jaquess, D. L. (2013b). The Autism MEAL Plan: A parent-training curriculum to manage eating aversions and low intake among children with autism. Autism, 18, 712–722.

    Article  Google Scholar 

  • Sharp, W. G., Burrell, T. L., Berry, R. C., Stubbs, K. H., McCracken, C. E., Gillespie, S. E., & Scahill, L. (2019). The autism managing eating aversions and limited variety plan vs parent education: A randomized clinical trial. The Journal of Pediatrics, 211, 185–192.

    Article  Google Scholar 

  • Sharp, W.G., Jaquess, D.L., Morton, J.F., & Miles, A.G. (2011). A retrospective chart review of dietary diversity and feeding behavior of children with autism spectrum disorder before and after admission to a day-treatment program. Focus on Autism and Other Developmental Disabilities. https://doi.org/10.1177/1088357609349245

    Article  Google Scholar 

  • Sharp, W. G., Volkert, V. M., Scahill, L., McCracken, C. E., & Barbara, M. M. (2017). A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: How standard is the standard of care? Journal of Pediatrics, 181, 116–124.

    Article  Google Scholar 

  • Sheridan, E., Gillespie, S., Johnson, C. R., Lecavalier, L., Smith, T., Swiezy, N., Turner, K., Pritchett, J., Mruzek, D. W., Evans, A. N., Bearss, K., & Scahill, L. (2021). Using parent target problem narratives to evaluate outcomes in children with Autism Spectrum Disorder. Research on Child and Adolescent Psychopathology. https://doi.org/10.1007/s10802-021-00843-8

    Article  Google Scholar 

  • Sparrow, S. S., Ciccetti, D. V., & Balla, D. A. (2005). Vineland II: Vineland Adaptive Behavior Scales, Second Edition: Survey Forms Manual. American Guidance Services Inc.

    Google Scholar 

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Authors and Affiliations

  1. Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, 30322, USA

    T. Lindsey Burrell, Lawrence Scahill, Nadratu Nuhu, Scott Gillespie & William Sharp

  2. Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA

    T. Lindsey Burrell, Lawrence Scahill, Nadratu Nuhu & William Sharp

  3. Children’s Healthcare of Atlanta, Atlanta, GA, USA

    T. Lindsey Burrell, Nadratu Nuhu & William Sharp

Authors
  1. T. Lindsey Burrell
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  2. Lawrence Scahill
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  3. Nadratu Nuhu
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  4. Scott Gillespie
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  5. William Sharp
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Contributions

TLB carried out the project, developed research questions and hypotheses, interpreted results and was the primary manuscript author. LS provided project guidance and mentorship of TLB and assisted in interpretation of results and manuscript writing. NN assisted in developing research questions and hypotheses, data collection and analysis, and manuscript writing. SG assisted in project development, data analysis, interpretation of results, and manuscript writing. WS was the principal investigator on the project, provided project guidance, interpretation of results, and manuscript writing.

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Correspondence to T. Lindsey Burrell.

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Burrell, T.L., Scahill, L., Nuhu, N. et al. Exploration of Treatment Response in Parent Training for Children with Autism Spectrum Disorder and Moderate Food Selectivity. J Autism Dev Disord 53, 229–235 (2023). https://doi.org/10.1007/s10803-021-05406-w

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  • DOI: https://doi.org/10.1007/s10803-021-05406-w

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