Feeding Disorder Clinical Trial
Official title:
The Impact of Desensitization as a Modality to Reduce Oral Hypersensitivity and Improve Intake in Children With Pediatric Feeding Disorders
Verified date | December 2019 |
Source | University of Michigan |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Many children with feeding disorders frequently gag, vomit, spit out their food, and/or hold food in their cheeks. These behaviors make it difficult for children to eat enough food to grow. The purpose of this study is to evaluate if a specific behavioral feeding intervention called desensitization is an effective intervention to improve oral intake in children with feeding disorders by decreasing gagging, vomiting, spitting, and holding food in the cheeks. The study will enroll eligible children (6) and their caretakers (6) in the study and they will receive behavioral feeding treatment. All treatment sessions will be videotaped and the study will last a maximum 8 weeks after the first treatment visit, or until treatment goals have been met.
Status | Completed |
Enrollment | 7 |
Est. completion date | May 31, 2019 |
Est. primary completion date | May 31, 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 10 Months to 10 Years |
Eligibility |
Inclusion Criteria: - Behavior problems (i.e., spitting, crying, head turning, gagging, physical aggression) are interfering with feeding - Medical causes of feeding disorder have been treated or are well-controlled without resolution of the feeding problem - Normal feeding milestones have not been met or regression has occurred - Enteral feeding dependence as defined by the participant relying on Nasal Gastric or gastrostomy-tube feedings in order to receive appropriate nutrition and gain weight - Accepts a limited number of foods and limited volume of foods by mouth (i.e., not enough variety or volume to maintain growth and/or good nutritional status) Exclusion Criteria: - Children who had anatomical/active medical problems that prohibit safe oral intake will be excluded |
Country | Name | City | State |
---|---|---|---|
United States | University of Michigan | Ann Arbor | Michigan |
Lead Sponsor | Collaborator |
---|---|
University of Michigan |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change from baseline frequency of gags at 8 weeks, or when treatment goals are met | Participants will be observed for gags to evaluate the effectiveness of Desensitization | Baseline, up to eight weeks after first treatment visit | |
Primary | Change from baseline latency to clean mouth at 8 weeks, or when treatment goals are met | Participants will be observed for latency to clean mouth to evaluate the effectiveness of Desensitization | Baseline, up to eight weeks after first treatment visit | |
Primary | Change from baseline frequency of packs at 8 weeks,or when treatment goals are met | Participants will be observed for number of packs to evaluate the effectiveness of Desensitization | Baseline, up to eight weeks after first treatment visit | |
Primary | Change from baseline frequency of emesis at 8 weeks, or when treatment goals are met | Participants will be observed for emesis to evaluate the effectiveness of Desensitization | Baseline, up to eight weeks after first treatment visit | |
Primary | Change from baseline frequency of combined inappropriate behaviors (CI's) at 8 weeks, or when treatment goals are met | Participants will be observed for CI's to evaluate the effectiveness of Desensitization | Baseline, up to eight weeks after first treatment visit | |
Secondary | Pediatric Eating Assessment Tool (PediEAT) | This is a parent-report instrument that is comprised of 78 questions that assess feeding difficulties across 4 subscales including: physiologic symptoms, problematic mealtime behaviors, selective/restrictive eating, and oral processing. Caregivers are asked to "think about what is typical for your child at this time" and to select from a scale of 6 response options including (0) Never, (1) Almost Never, (2) Sometimes, (3) Often, (4) Almost Always, and (5) Always. Higher scores indicate more symptoms of problematic feeding. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Family Management Measure of Feeding Questionnaire (FaMM Feed) | This is a 49 question survey that the parent/caregiver completes to evaluate mealtime feeding behaviors. Responses include: strongly disagree, disagree, neutral, agree, and strongly agree with each response score given is from 1-5 (1 = strongly disagree to strongly agree = 5). Lower scores indicating lower family management, or less feelings of being able to manage in the context of daily family life. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Parenting Stress Index-Short Form, 4th Edition (PSI4-SF) | This is a 36-item self-report questionnaire that assesses the level of stress in a parent-child relationship for parents of children 0-12 years of age. Each item is rated on a five-point Likert scale (1 = Strongly Agree, 2 = Agree, 3 = Not Sure, 4 = Disagree, and 5 = Strongly Disagree). It yields three subscales: Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI), and Difficult Child (DC). Items are scored and added together to establish a total score as well as three subscale scores. The PSI-SF produces subscale raw scores ranging from 12 to 60 and an overall Parenting Stress (PSI-PS) total score that ranges from 36 to 180. Higher scores are indicative of a greater level of stress. A PSI-SF score above 85 indicates clinically significant parenting stress. The PSI-SF also includes a Defensive Responding (DR) scale to identify parents who might be attempting to minimize or deny problems. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Child Oral and Motor Proficiency Scale (ChOMPS) | This is a parent-report assessment of eating and drinking in children 6 months to 7 years. Consisting of 63-items, caregivers are asked to indicate the child's ability to perform a skill by choosing 'yes' (established skill; score = 2), 'sometimes' (emerging skill; score = 1), and 'not yet' (not yet emerging skill; score = 0). Total scores range from 0-126 with higher scores indicating greater skills. This measure yields 4 subscales including: basic movement patterns, fundamental oral-motor skills, oral-motor coordination, and complex movement patterns. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Child Behavior Checklist (CBCL) for ages 1 1/2 to 5 years old | The Checklist is a parent measure of emotional, behavioral and social problems in children ages 1.5-5 years. This 100-item measure yields broad-band scores of Internalizing Behavior Problems, Externalizing Behavior Problems, and Total Behavior Problems. It also yields eight additional problem scales: Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. Caregivers rate each behavior or symptom on a three-point scale: not true (0), somewhat or sometimes true (1), or very true or often true (2). A computer program will be used to calculate the T-scores for each scale. Raw scores are converted to gender and age standardized scores (T-scores having a mean of 50 and SD of 10). Internal consistency Chronbach's alphas for each subscale are moderately high, ranging from .63 to .79. Alphas range from .78 to .97 for broad-band problem scales. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Child Behavior Checklist (CBCL) for ages 6-10 years old | The Checklist is a parent measure of emotional, behavioral and social problems in children ages 6-18 years. This 113-item measure yields broad-band scores of Internalizing Behavior Problems, Externalizing Behavior Problems, and Total Behavior Problems. It also yields eight additional problem scales: Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. Caregivers rate each behavior or symptom on a three-point scale: not true (0), somewhat or sometimes true (1), or very true or often true (2). A computer program will be used to calculate the T-scores for each scale. Raw scores are converted to gender and age standardized scores (T-scores having a mean of 50 and SD of 10). Internal consistency Chronbach's alphas for each subscale are moderately high, ranging from .63 to .79. Alphas range from .78 to .97 for broad-band problem scales. | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Change in Body Weight | Weight change from baseline | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Change in Height | Height change from baseline | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Change in Mid-upper arm circumference | Mid-upper arm circumference change from baseline | Baseline (pre-treatment), up to eight weeks (post-treatment) | |
Secondary | Change in Hand Grip Strength | Change in Hand Grip Strength from baseline will be measured using a JAMAR hydraulic hand dynamometer. | Baseline (pre-treatment), up to eight weeks (post-treatment) |
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