Project LEaH: Learning to Eat at Home

Study Overview
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Brief Summary
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The investigators are trying to determine if delivery a feeding intervention program using videoconferencing technology is feasible.

Detailed Description
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The investigators hope to recruit 10 participants who have a diagnosis of autism spectrum disorder and food selectivity. A Multidisciplinary feeding assessment will be conducted and factors which contribute to the participant's feeding challenges will be identified. Treatment goals will be identified using the Canadian Occupational Performance Measure (COPM). Intervention geared to address the goals identified by parents will be delivered by the clinician(s) via videoconferencing. Participants will participate in up to 12 weekly 1hr visits over the study period.

Official Title
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Delivering Specialty Care Access Through Use of an Innovative Telehealth-home Based Intervention Feeding Program (Telefeeding) to Address Food Selectivity in Autism Spectrum Disorder

Conditions
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Autism Spectrum Disorder, Feeding Behavior

Intervention / Treatment
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* Behavioral: Parent coaching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 2-5 years of age Diagnosed with Autism Spectrum Disorder History of mild to moderate food selectivity Access to internet service Access to a Windows based laptop with a web camera One Parent is available to participate in a 1 hour intervention program within the home environment once per week over a 12 week period. English speaking participants Parent consents to use of Ontario Telemedicine Network (OTN) technology within in the home. Parent is able to use a laptop Access to a telephone in order to trouble shoot problems that may arise in setting up OTN technology. Exclusion Criteria: Age: > 6 year of age (rationale being most children will be enrolled in school during the week thus not available for intervention services). History of severe food selectivity No access to internet service and/or laptop History of dysphagia or other swallowing difficulties Oro-motor abnormalities such as cleft lip and palate, macroglossia Presently has a G-tube insitu Participants on medications that may significantly alter appetite such as stimulants and antipsychotic medications. Currently enrolled in a feeding intervention program.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Participants will be recruited to participate in a multidisciplinary feeding assessment, after which an intervention plan will be developed to address the participants feeding challenges.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Feeding Challenges<br>Parents will be coached to implement strategies to address factors contributing to feeding challenges based on a multidisciplinary assessment using the medico-oral-behaviour-sensory-environment (MOBSE) approach. | Behavioral: Parent coaching<br>* Parents will be coached to implement behavioural strategies to address factors which are contributing to difficult mealtime behaviours and feeding challenges.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Parent Treatment Adherence Scale | Parent Treatment Adherence scale will be used to rate parent engagement and understanding of in session materials. The scale will be completed by the therapists at the end of each intervention session to rate parent engagement and understanding of instructions and assignment on a three point likert scale. | 12 weeks | 
| Parent Satisfaction Scale | A questionnaire was developed for the study to obtain parent feedback at week 12 on the quality of the block of intervention. Questions rated the length of the sessions, number of sessions, the usefulness of teaching tools (for e.g. homework), and participants confidence in handling future feeding challenges. Scores range from 0(strongly disagree) to 4 (strongly agree). | 12 weeks | 
| Treatment Fidelity Scale | A treatment fidelity checklist was developed for this study. Treatment fidelity will be measured using a questionnaire to rate if the intervention session goals were met during the session. This will be done using a 3 point likert scale. After completion of each session the therapists will rate themselves as: 0= Goal was not achieved; 1- Goal was partially achieved; 2= Goal was fully achieved for each treatment goal for that session. | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in number of foods eaten from baseline to week 12 (or end of intervention whichever comes first) | Number of foods eaten will be captured by a 1 day food diary at baseline and week 12 | 12 weeks | 
| Change from baseline in performance scores on the COPM scale at 12 weeks | Change in participants performance on a single tasks from baseline to 12 weeks (or end of intervention whichever comes first) | 12 weeks |