The (Extremely) Picky Eaters Clinic: A Pilot Trial of a Seven-Session Group Behavioral Intervention for Parents of Children With Avoidant/Restrictive Food Intake Disorder. Issue 3 (August 2019)

• Record Type: Journal Article
• Authors: Dahlsgaard, Katherine K.; Bodie, Jessica
• Is Part Of: Cognitive and behavioral practice. Volume 26:Issue 3(2019)
• Page Start: 492
• Page End: 505
• Publication Date: 2019-08
• Subjects: picky eating -- ARFID -- children -- behavioral treatment -- group treatment; Behavior therapy -- Periodicals; Cognitive therapy -- Periodicals; Behavior Therapy -- Periodicals; Cognitive Therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.cbpra.2018.11.001
• Languages: English
• ISSNs: 1077-7229

Abstract

Abstract: Excessive and impairing picky eating is a common problem among children for which there is little published research on efficacious psychosocial treatment. Extant research largely concerns single-case studies, or small samples of very young children, who are typically treated in hospital settings. This paper reports on outcomes of 21 children (ages 4–11) described by their parents as extremely picky eaters who met criteria for avoidant/restrictive food intake disorder not associated with a developmental disorder, other eating disorder, or other eating-related anxiety disorder (e.g., specific phobia of vomiting or choking). Seven cohorts of two to four families each took part in a seven-session manualized parent-only group treatment in an outpatient setting. This group treatment focused on training parents to serve as effective coaches for daily in-home exposures to nonpreferred foods, as well as in components of parent management training to reduce problematic mealtime behaviors. Parents completed standardized feeding measures to assess picky eating and associated problem mealtime behaviors at pretreatment, posttreatment, and at 3-month follow-up, as well as a satisfaction measure at posttreatment. Results showed excellent feasibility and adherence by parents and high parent satisfaction with treatment. Paired t tests to measure within-group change showed significant pre–post treatment reductions in picky eating scales with moderate to large effect sizes. Gains were maintained at 3-month follow-up. Findings indicate that a relatively brief group treatment that focuses specifically on training parents to facilitate and carry out food exposures and contingency management procedures in their homes is associated with reductions in functionally impairing picky eating and related negative mealtime behaviors in elementary school-age children. Highlights: Functionally impairing picky eating is a relatively common problem among children. Parents of picky eaters took part in a brief course of group behavioral therapy (BT). Focus of BT was training parents as effective food exposure coaches. Children showed reductions in picky eating and associated negative mealtime behaviors. Parents' satisfaction indicates that group-based, parent-only BT is feasible.