Children with autism spectrum disorder are at increased risk for obesity compared to typically developing children. Many obesity intervention programs exclude children with autism spectrum disorder. There is little research on developmentally inclusive approaches to pediatric weight management. We examined the outcomes of children and families with autism spectrum disorder in an inclusive, comprehensive behavioral family-based lifestyle intervention. A secondary analysis of a randomized controlled trial on families enrolled in a comprehensive behavioral family-based lifestyle intervention was conducted. Analyses included chi-square or Fisher’s exact tests to examine family and child differences in program completion rates and multivariate regression analysis using generalized estimating equation to further examine differences in weight outcomes between children with autism spectrum disorder versus no autism spectrum disorder accounting for other covariates. There were 158 families; 15 families had children with autism spectrum disorder. There were no significant differences in demographics, program completion, or weight outcomes between the two groups. Children who completed the intervention had a significant decrease in body mass index Z-scores, but no change in their percentage of the 95th percentiles. Families of children with autism spectrum disorder participated in a comprehensive behavioral family-based lifestyle intervention alongside children without autism spectrum disorder with similar outcomes. Comprehensive behavioral family-based lifestyle intervention can meet the weight management needs of children with autism spectrum disorder using an inclusive approach, expanding access to needed obesity interventions.

Lay abstract

Children diagnosed with autism are likely to be more overweight than children who do not have autism. There are many group programs that help children to be more physically active and improve their eating habits to achieve healthy weight, but most of these programs do not allow children with autism to participate. We studied a program that was specially adapted so children with autism could participate together with peers who do not have autism. The program lasted 8 weeks and was offered in the evening at a large healthcare center in a big city. The children participated with a parent or another adult who takes care of them. We analyzed data that were part of a previous project where we studied how physical activity trackers called Fitbit help overweight children to change their eating and exercise habits so they can achieve healthier weight. Out of 158 families in the study, 15 families had a child or children with autism. We measured changes in the weight of children with and without autism and compared how many of the children completed the program. Children who had autism had similar results in achieving healthy weight and finishing the program compared to their peers without autism. Our study found that when a group weight management program is slightly changed to meet the needs of children with autism, they can successfully participate and benefit similarly to their peers who do not have autism.

Registration

This trial was registered with ClinicalTrials.gov (NCT03215641).

中文翻译：

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不只是在学校：在社区儿科环境中将患有自闭症谱系障碍的儿童纳入体重管理计划

与正常发育的儿童相比，患有自闭症谱系障碍的儿童患肥胖症的风险更高。许多肥胖干预计划将自闭症谱系障碍儿童排除在外。关于儿科体重管理的发展包容性方法的研究很少。我们在一项包容、全面的基于行为家庭的生活方式干预中检查了患有自闭症谱系障碍的儿童和家庭的结果。对参加综合行为家庭生活方式干预的家庭进行的随机对照试验进行了二次分析。分析包括卡方或费舍尔精确检验，以检查家庭和儿童在计划完成率方面的差异，以及使用广义估计方程的多变量回归分析，以进一步检查患有自闭症谱系障碍的儿童与没有自闭症谱系障碍的儿童之间的体重结果差异（考虑其他协变量）。有158个家庭；15个家庭有自闭症谱系障碍儿童。两组之间的人口统计、计划完成或体重结果没有显着差异。完成干预的儿童体重指数显着下降 两组之间的人口统计、计划完成或体重结果没有显着差异。完成干预的儿童体重指数显着下降 两组之间的人口统计、计划完成或体重结果没有显着差异。完成干预的儿童体重指数显着下降Z -scores，但它们在第 95 个百分位数中的百分比没有变化。自闭症谱系障碍儿童的家庭与没有自闭症谱系障碍的儿童一起参与了一项基于行为家庭的综合生活方式干预，结果相似。基于行为家庭的综合生活方式干预可以使用包容性方法满足自闭症谱系障碍儿童的体重管理需求，从而扩大获得所需肥胖干预的机会。

抽象

被诊断患有自闭症的儿童可能比没有患有自闭症的儿童更重。有许多团体计划可以帮助儿童更加积极地锻炼身体并改善他们的饮食习惯以达到健康的体重，但这些计划中的大多数都不允许自闭症儿童参与。我们研究了一个特别改编的项目，这样自闭症儿童可以与没有自闭症的同龄人一起参与。该计划持续了 8 周，晚上在大城市的一家大型医疗保健中心提供。孩子们与父母或其他照顾他们的成年人一起参加。我们分析了之前项目的一部分数据，在该项目中，我们研究了名为 Fitbit 的身体活动追踪器如何帮助超重儿童改变他们的饮食和锻炼习惯，从而实现更健康的体重。在研究的 158 个家庭中，有 15 个家庭有一个或多个患有自闭症的孩子。我们测量了患有和不患有自闭症的儿童体重的变化，并比较了有多少儿童完成了该计划。与没有自闭症的同龄人相比，患有自闭症的儿童在达到健康体重和完成计划方面的结果相似。我们的研究发现，当团体体重管理计划稍微改变以满足自闭症儿童的需求时，他们可以成功地参与并获得与没有自闭症的同龄人相似的益处。与没有自闭症的同龄人相比，患有自闭症的儿童在达到健康体重和完成计划方面的结果相似。我们的研究发现，当团体体重管理计划稍微改变以满足自闭症儿童的需求时，他们可以成功地参与并获得与没有自闭症的同龄人相似的益处。与没有自闭症的同龄人相比，患有自闭症的儿童在达到健康体重和完成计划方面的结果相似。我们的研究发现，当团体体重管理计划稍微改变以满足自闭症儿童的需求时，他们可以成功地参与并获得与没有自闭症的同龄人相似的益处。

登记

该试验已在 ClinicalTrials.gov (NCT03215641) 注册。