Early psychological intervention model based on sensory integration and parental empowerment for dietary abnormalities in children with autism

Table 1 Comparison of baseline data between the two groups, mean ± SD/n (%)

	Intervention group (n = 72)	Control group (n = 70)	χ2/t	P value
Gender (male/female)	48/24	46/24	0.014	0.905
Age (years)	4.25 ± 1.08	4.32 ± 1.15	0.374	0.709
Course of the disease (months)	18.62 ± 5.37	19.15 ± 5.62	0.575	0.566
Severity of autism			0.119	0.942
Mild	28 (38.89)	26 (37.14)
Moderate	36 (50.00)	35 (50.00)
Severe	8 (11.11)	9 (12.86)
Abnormal types of eating behavior
Food refusal	42 (58.33)	40 (57.14)	0.021	0.886
Selective eating	51 (70.83)	49 (70.00)	0.012	0.913
Bradyphagia	38 (52.78)	36 (51.43)	0.026	0.872
Emotional eating	32 (44.44)	30 (42.86)	0.036	0.849
Educational level of parents			0.019	0.990
Junior high school and below	18 (25.00)	17 (24.29)
Senior high school/secondary specialized school	27 (37.50)	26 (37.14)
College degree or above	27 (37.50)	27 (38.57)

Table 2 Comparison of dietary behavior scores of the two groups of children before and after intervention, mean ± SD

Dimensionality	Group	T0	T1	T2	F among groups/P value	F time/P value	F interactive/P value
Food refusal	Intervention group (n = 72)	3.25 ± 0.48	2.01 ± 0.36	1.82 ± 0.35	137.642/< 0.001	378.910/< 0.001	130.359/< 0.001
	Control group (n = 70)	3.28 ± 0.46	2.89 ± 0.41	2.95 ± 0.42
Emotional eating	Intervention group (n = 72)	3.18 ± 0.45	1.92 ± 0.34	1.76 ± 0.32	153.272/< 0.001	452.895/< 0.001	182.498/< 0.001
	Control group (n = 70)	3.21 ± 0.43	2.85 ± 0.39	2.88 ± 0.40
Bradyphagia	Intervention group (n = 72)	3.22 ± 0.47	2.05 ± 0.37	1.85 ± 0.36	131.763/< 0.001	353.137/< 0.001	139.331/< 0.001
	Control group (n = 70)	3.25 ± 0.45	2.92 ± 0.42	2.91 ± 0.43
Selective eating	Intervention group (n = 72)	3.15 ± 0.44	1.89 ± 0.33	1.79 ± 0.33	156.814/< 0.001	526.763/< 0.001	152.472/< 0.001
	Control group (n = 70)	3.18 ± 0.42	2.82 ± 0.38	2.85 ± 0.41
CEBQ Total Score	Intervention group (n = 72)	68.52 ± 7.35	45.12 ± 6.28	41.25 ± 5.96	144.685/< 0.001	575.820/< 0.001	108.889/< 0.001
	Control group (n = 70)	68.87 ± 7.28	58.96 ± 6.73	59.23 ± 6.81

CEBQ: Children’s Eating Behavior Scale.

Table 3 Comparison of core symptom scores of autism spectrum disorder in the two groups of children before and after intervention, mean ± SD

Dimensionality	Group	T0	T1	T2	F among groups/P value	F time/P value	F interactive/P value
ABC Total Score	Intervention group (n = 72)	50.36 ± 8.74	29.58 ± 5.44	25.49 ± 4.76	82.977/< 0.001	396.255/< 0.001	127.132/< 0.001
	Control group (n = 70)	50.57 ± 8.91	42.30 ± 6.85	42.71 ± 6.98
CDI Total Score	Intervention group (n = 72)	20.11 ± 3.65	9.97 ± 2.00	7.87 ± 1.67	170.825/< 0.001	624.828/< 0.001	158.186/< 0.001
	Control group (n = 70)	20.23 ± 3.71	16.19 ± 2.80	16.36 ± 2.86

ABC: Autism Behavior Scale; CDI: Child Anxiety and Depression Scale.

Table 4 Comparison of sensory integration function scores of the two groups of children before and after intervention, mean ± SD

Group	T0	T1	T2	F among groups/P value	F time/P value	F interactive/P value
Intervention group (n = 72)	65.32 ± 8.16	92.65 ± 10.23	98.42 ± 11.35	122.684/< 0.001	438.517/< 0.001	96.273/< 0.001
Control group (n = 70)	65.18 ± 8.21	75.36 ± 9.42	76.15 ± 9.58

Table 5 Comparison of care ability scores of parents in the two groups before and after intervention, mean ± SD

Dimensionality	Group	T0	T1	T2	F among groups/P value	F time/P value	F interactive/P value
Care knowledge	Intervention group (n = 72)	12.35 ± 2.14	21.68 ± 3.25	23.52 ± 3.46	155.005/< 0.001	274.393/< 0.001	128.397/< 0.001
	Control group (n = 70)	12.40 ± 2.18	15.36 ± 2.62	15.48 ± 2.67
Care skills	Intervention group (n = 72)	13.12 ± 2.26	22.53 ± 3.38	24.61 ± 3.59	155.391/< 0.001	233.605/< 0.001	211.956/< 0.001
	Control group (n = 70)	13.18 ± 2.30	16.25 ± 2.75	16.39 ± 2.80
Psychological adjustment	Intervention group (n = 72)	12.86 ± 2.21	21.95 ± 3.31	23.86 ± 3.52	165.859/< 0.001	231.409/< 0.001	219.775/< 0.001
	Control group (n = 70)	12.91 ± 2.25	15.82 ± 2.69	15.95 ± 2.73
Social support	Intervention group (n = 72)	11.95 ± 2.08	20.36 ± 3.12	22.15 ± 3.34	108.572/< 0.001	246.829/< 0.001	108.394/< 0.001
	Control group (n = 70)	12.00 ± 2.12	14.93 ± 2.56	15.06 ± 2.60
PCCS Total Score	Intervention group (n = 72)	50.28 ± 8.69	86.52 ± 13.06	94.14 ± 13.91	128.910/< 0.001	239.601/< 0.001	174.553/< 0.001
	Control group (n = 70)	50.49 ± 8.85	62.36 ± 10.62	62.88 ± 10.70

PCCS: Parental Care Ability Scale.

Table 6 Comparison of dietary and nutritional status between the two groups of children, n (%)

Indicator	Intervention group (n = 72)	Control group (n = 70)	χ2 value	P value
Nutrition intake attainment rate	65 (90.28)	42 (60.00)	17.519	< 0.001
Dietary regularity rate	63 (87.50)	39 (55.71)	17.722	< 0.001
Autonomous eating ability	61 (84.72)	36 (51.43)	18.174	< 0.001

Table 7 Comparison of intervention-related indicators between the two groups, n (%)

	Complete adherence	Partial adherence	Nonadherence	Overall adherence rate	Markedly effective	Effective	Ineffective	Overall effective rate	Recurrence rate
Intervention group (n = 72)	56 (77.78)	14 (19.44)	2 (2.78)	70 (97.22)	38 (52.78)	29 (40.28)	5 (6.94)	67 (93.04)	3 (4.17)
Control group (n = 70)	32 (45.71)	25 (35.71)	13 (18.57)	57 (81.43)	15 (21.43)	32 (45.71)	23 (32.86)	47 (67.14)	18 (25.71)
χ2				9.371				15.055	13.077
P value				0.002				< 0.001	< 0.001

Table 8 Analysis of mediating effects

Effect pathway	Effect size	Bootstrap SE	95%CI	Proportion of effect (%)
Total effect	17.624	1.229	15.213-20.036	100.00
Direct effect	5.983	1.101	3.824-8.141	33.94
Total indirect effects	11.641	1.394	9.038-14.505	66.06
Group → ΔPCCS → ΔCEBQ	4.280	0.846	2.711-6.084	24.29
Group → ΔSITS → ΔCEBQ	2.978	0.751	1.624-4.619	16.90
Group → ΔPCCS → ΔSITS → ΔCEBQ	4.383	0.813	2.965-6.102	24.87

CEBQ: Children’s Eating Behavior Scale; PCCS: Parental Care Ability Scale; SITS: Sensory Integration Development Scale; CI: Confidence interval.