Measuring the impact of feeding covariates on health-related quality of life in children with autism spectrum disorder

Meral, Bekir Fatih; Fidan, Ahmet

doi:10.1016/j.rasd.2014.11.009

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…The most commonly reported were the Pediatric Quality of Life Inventory™ (PedsQL™) measure, used in 15 studies; 170,174,175,179,180,182,185,187,[189][190][191][192][193][194][195]200,201 the Health Utilities Index measure, used in seven studies; 120,127,177,178,188,196,197 and the KIDSCREEN measure, used in four studies. 172,176,186,195 A detailed description of participants and results of the included studies are presented in Table 50.…”

Section: Fundingmentioning

confidence: 99%

Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis

Rodgers

Marshall

Simmonds

et al. 2020

Health Technol Assess

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Background Early intensive applied behaviour analysis-based interventions are intensive interventions for autistic children that are often delivered on a one-to-one basis for 20–50 hours per week. Objectives To evaluate the clinical effectiveness and cost-effectiveness of early intensive applied behaviour analysis-based interventions for autistic children, based on current evidence. Methods A systematic review and individual participant data meta-analysis were conducted to evaluate the clinical effectiveness of an early intensive applied behaviour analysis-based intervention for autistic children. An economic analysis included a review of existing analyses and the development of a new model. Results Twenty studies were included in the clinical review. Individual participant data were retrieved from 15 of these studies. Results favoured the interventions when assessing adaptive behaviour after 2 years compared with treatment as usual/eclectic interventions (mean difference 7.00, 95% confidence interval 1.95 to 12.06). In analyses of cognitive ability (intelligence quotient), results favoured the interventions by approximately 10 points after 1 year (mean difference 9.16, 95% confidence interval 4.38 to 13.93) and 2 years (mean difference 14.13, 95% confidence interval 9.16 to 19.10). Evidence for other outcomes was limited and meta-analyses were generally inconclusive. There was no evidence that the effect of the interventions varied with characteristics of the children, but data were limited. Adopting a £30,000 per quality-adjusted life-year threshold, the results of the cost-effectiveness analysis indicate that early intensive applied behaviour analysis-based interventions would need to generate larger benefits or cost savings to be cost-effective. Adopting a public sector perspective and making pessimistic assumptions about long-term effects, the incremental cost-effectiveness ratio for early intensive applied behaviour analysis-based therapy compared with treatment as usual is £189,122 per quality-adjusted life-year. When optimistic assumptions are made, the incremental cost-effectiveness ratio is £46,768 per quality-adjusted life-year. Scenario analyses indicated that these interventions can potentially be cost-effective if long-term improvements persist into adulthood, or if they have significant impact on educational placement. Care should be taken when interpreting these scenarios owing to the limited data. Limitations All included studies were at risk of bias, there was substantial heterogeneity and effects varied considerably across studies. The effect of intervention on autism symptom severity, language development and school placement remains uncertain because of the limited data. The long-term effects are unclear owing to a lack of follow-up data. Conclusions This review found limited evidence that early intensive applied behaviour analysis-based interventions may improve cognitive ability and adaptive behaviour, but the long-term impact of the interventions remains unknown. The economic analysis is constrained by the limited effectiveness evidence, but suggests that these interventions are unlikely to be cost-effective unless clear long-term benefits, or a substantial change in which schools children attend, can be identified. Future work Further studies into the effectiveness of early intensive applied behaviour analysis-based interventions may be warranted if they include well-defined, alternative interventions as comparators and collect relevant outcomes. Consideration should be given to future studies that not only address whether or not early intensive applied behaviour analysis-based interventions are clinically effective, but also aim to identify which components of early intensive applied behaviour analysis-based interventions might drive effectiveness. Study registration This study is registered as PROSPERO CRD42017068303. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 35. See the NIHR Journals Library website for further project information.

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Section: Fundingmentioning

confidence: 99%

Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis

Rodgers

Marshall

Simmonds

et al. 2020

Health Technol Assess

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“…17,22 The presence of feeding problems can increase risks for other more serious conditions and feeding problems have both short-and long-term implications for health. 23 Short-term consequences can result in weight loss, dehydration, choking, asphyxiation, failure to thrive and malnutrition. 24,25,26 Long-term implications of feeding problems include gastrointestinal discomfort, 27 and iron deficiency anemia.…”

Section: Autism Spectrum Disorder and Feeding Problemsmentioning

confidence: 99%

“…29,35,36 Feeding problems have been found to be a predictive of decreased overall Health-related Quality of Life (HRQoL). 23 While highly relevant as an outcome of treatment and intervention, HRQoL has been explored considerably less often than other outcome measures. 55,56 Consistent with adaptive behavior, the available research indicated HRQoL scores of children and adults with ASD were substantially lower than their same-aged peers.…”

Section: Feeding Problems and Health-related Quality Of Lifementioning

confidence: 99%

Comorbid Feeding and Gastrointestinal Symptoms, Challenging Behavior, Sensory Issues, Adaptive Functioning and Quality of Life in Children and Adolescents with Autism Spectrum Disorder

Leader

O'Reilly

Gilroy

et al. 2020

Developmental Neurorehabilitation

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Aim: Children and adolescents diagnosed with an autism spectrum disorder (ASD) often demonstrate difficulties with feeding. The goal of the current study was to investigate co-occurring issues that often accompany feeding problems in 120 children and adolescents with ASD.Method: This study investigated the relationship between feeding problems and gastrointestinal symptoms, challenging behavior and sensory issues, quality of life, adaptive functioning and use of complementary and alternative medicine (CAM). Results: High rates of feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues were endorsed by caregivers. Considerable differences were observed in the levels of gastrointestinal symptoms, challenging behavior, sensory issues, quality of life and CAM practices. Conclusion:The results of this study extend the present literature by highlighting comorbid conditions related to feeding problems and how feeding problems impact quality of life and adaptive behavior.

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“…Davy et al (2022) highlighted the impact on caregivers' quality of life, which influenced their own social participation levels for leisure, community access and employment. Yet caregiver wellbeing is often overlooked in the context of an autistic child's feeding difficulties despite the known impacts that feeding difficulties can have on family dynamics (Marshall et al, 2014; Meral & Fidan, 2015; Zhu & Dalby‐Payne, 2019) and parental stress (McStay et al, 2014). Further understanding of autistic children's feeding and relationship to the caregiver impact of these feeding difficulties and resulting well‐being is required.…”

Section: Introductionmentioning

confidence: 99%

Investigating the impact of autistic children's feeding difficulties on caregivers

Gent,

Marshall,

Weir

et al. 2024

Child

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AimThe aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver‐reported impact at mealtimes.BackgroundCaregivers of children (5–12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2–short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver‐reported impact of feeding difficulties (Feeding‐Swallowing Impact Survey, FS‐IS).ResultsSeventy‐eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver‐reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS‐IS; U = 257.000, z = −4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS‐IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver‐reported impact with a moderate effect size (r = 0.49).ConclusionAutistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families.

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Measuring the impact of feeding covariates on health-related quality of life in children with autism spectrum disorder

Cited by 10 publications

References 38 publications

Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis

Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis

Comorbid Feeding and Gastrointestinal Symptoms, Challenging Behavior, Sensory Issues, Adaptive Functioning and Quality of Life in Children and Adolescents with Autism Spectrum Disorder

Investigating the impact of autistic children's feeding difficulties on caregivers

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