Prevention and management of obesity in children with autism spectrum disorder
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BACKGROUND: Children with autism spectrum disorder (ASD) are at high-risk for being obese. Little is known about how pediatricians address weight management in children with ASD. OBJECTIVE: To examine the attitudes, self-efficacy, practices and barriers to obesity management in children with ASD among pediatricians. METHOD: We conducted an anonymous survey of a random sample of 1500 pediatricians using the American Medical Association Masterfile. We used Likert-scale items to examine attitudes, self-efficacy, practices and barriers to obesity management in ASD. The survey included a fictional clinical vignette of a clinic visit for an obese child. Participants were randomized to a vignette with a child with ASD or a child without ASD. We compared responses by survey vignette type using chi-square tests and used logistic regression to examine the association between self-efficacy and counseling frequency. RESULTS: 327 respondents completed the survey (24% response rate). Respondents were mostly female (65%) and worked in private practice (61%). Although 62% of respondents agreed pediatricians should be the main providers to manage obesity in children with ASD, few reported receiving adequate training to do so. Pediatricians were more likely to refer to specialists for a child with ASD compared to a child without ASD. Higher self-efficacy was associated with increased counseling frequency (aOR: 2.58 [1.57, 4.24]). Top reported barriers were lack of caregiver concern and lack of physician time. CONCLUSION: Pediatricians report obesity in children with ASD as challenging to manage. Training programs may result in increased counseling frequency around obesity for children with ASD.