A YouTube Curriculum for Children With Autism and Obesity

Parents as primary caregivers play an important role in shaping children's mealtime and eating behaviors; and in preventing weight gain. Conventionally, in-person, parent-implemented treatments have worked well for children with autism, however, post-COVID-19 pandemic there is a need for virtual, evidence-based training for parents to improve nutrition in children with autism and weight issues. This study aims to: a) increase self-efficacy among parents of children with autism and overweight or obesity to feed their children a healthy diet, b) improve parental nutrition knowledge and skills on how to feed their child with autism and overweight or obesity a healthier diet, c) improve their child's mealtime behaviors, and d) increase the child's dietary variety.

This study sought to recruit 24 parents of children with Autism Spectrum Disorder (ASD), and overweight or obesity via emails, digital flyers, and handouts on social media (Facebook), in the USA. This randomized, controlled trial behavioral intervention was conducted from September 2023 to February 2024 and included a YouTube-delivered, 8-week, virtual, nutrition education intervention for the parents.

Participants were randomly allotted to either the intervention or control group by using the randomization (RAND) function on Microsoft Excel. Participants in the intervention group received access to the 16 YouTube videos, educational handbook, recipe modeling, and other training, while participants in the control group only got access to the questionnaires/surveys.

All 8 video modules focused on increasing parental nutrition knowledge, skills, and perceived confidence in making food and nutrition-related decisions to feed their child and address mealtime problems, which aligns with Bandura's Social Cognitive Theory constructs of self-efficacy and behavioral capabilities.

Participants were asked to complete validated questionnaires at baseline, mid-point, and end: parental self-efficacy; the Nutrition knowledge survey; Brief Autism Mealtime Behavior Inventory (BAMBI), followed by a small qualitative open-ended questionnaire for parental feedback on the overall acceptability and satisfaction of the intervention at the end of 8-weeks. All participants were asked to use the ASA-24 (National Cancer Institute) to complete a 24-hour food recall for their child with autism at baseline and end-point.

Demographic data was collected at baseline for all participants. Participants were selected if a) they were 18 years or older; b)had a child with autism between the ages 6 and 11 years c) child's Body Mass Index was \> 85th percentile; d) child accepted at least 20 foods e) child did not take any medicines that affect appetite and weight.

Eligibility Criteria:
Inclusion Criteria:

1. Participants have a child between the ages of 6 to 11 years with a diagnosis of autism
2. have a child with autism with a Body Mass Index (BMI) equal to or greater than the 85 percentile
3. they can read and understand English
4. they can access the internet and participate in online research
5. their child with autism accepts at least 20 foods
6. their child with autism is not on a special restricted diet
7. their child with autism does not consume any medications affecting eating.
8. they are 18 years of age or older

Exclusion Criteria:

1. if the child is on medication such as antidepressants, antipsychotics, or SSRIs
2. if the child has high food selectivity (eats less than 20 foods).
3. if the child has a healthy body weight.