Autistic children have higher rates of overweight and obesity (OW/OB) compared to nonautistic children. Family-based behavioral treatment (FBT) is the standard of care for children with obesity and is delivered to both the parent and the child. Common autism characteristics, such as sensory sensitivities, social communication challenges, and behavioral rigidity, can limit the feasibility of providing FBT to both parent and child. Our team developed a parent-based treatment (PBT) model that is delivered only to the parent of an autistic child with OW/OB. Our published pilot data established the initial feasibility, acceptability and initial weight-loss efficacy of this program. This paper presents a protocol for an ongoing two-arm randomized controlled trial comparing the effect of a telehealth PBT program tailored for families with an autistic child (PBT-A) with a health education (HE) comparator on the child's weight over 18 months. We aim to recruit 150 families with an autistic child with OW/OB and randomize them to either six-months of telehealth PBT-A or HE treatment delivered to the parent only. The primary outcome is change in child body size, assessed by BMIz and percent of the 95th percentile, over the 18 months of the study. Secondary outcomes include parent BMI, dietary intake for both parent and child, child mealtime behavior, physical activity levels, parenting style, and parental self-efficacy. This ongoing study may provide a scalable, cost-effective intervention for families with an autistic child with OW/OB. Clinical trials # NCT05741840.
Boutelle et al. (Tue,) studied this question.