Prevention and Management of Obesity in Children with Autism Spectrum Disorder Among Primary Care Pediatricians.
Morgan Walls, Sarabeth Broder-Fingert, Emily Feinberg and 2 others
PMID 29450838WHAT IT FOUND
Pediatricians ranked screen time lower for an obese child with autism and referred more often to dietitian or developmental-behavioral care.
Self-reported confidence, not ASD caseload, was linked to counseling frequency.
Key findings
01When the vignette child had autism, pediatricians were less likely to rank screen time as a first or second priority (4.4% versus 13.1%, p=0.006) and more likely to prioritize sleep (67.9% versus 52.7%, p=0.005).
02Pediatricians were more likely to refer the child with autism to a dietitian (odds ratio 1.79, CI 1.14 to 2.79) and to a developmental-behavioral pediatrician (odds ratio 3.85, CI 2.32 to 6.38).
03After adjustment for vignette type, age, sex, and years since pediatric training, higher self-efficacy was associated with more frequent reported weight-related counseling at well-visits for children with autism (odds ratio 2.58, 95% CI 1.57 to 4.24).
STILL TO COME
How it was doneWhat they found
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The response rate was 24%, lower than the 53% mean response rate cited for health professional surveys, so non-response bias is possible. The findings are self-reported and may not match actual practice; pediatricians may overstate confidence or counseling frequency. The study used fictional cases, not real patients or chart review, so it cannot show what care children actually received. The survey was cross-sectional, so it cannot show that higher confidence caused more counseling; it measured both at the same time. It surveyed only primary care pediatricians, so it does not describe care outside the medical home or what therapists, dietitians, or other specialists did.
Declared interests
The paper states that the institutional review board approved the study. No funding or conflict of interest declaration is provided in the supplied text.
The easy way to misread this
Do not read this as evidence that referring children with autism to a dietitian or developmental-behavioral pediatrician improves weight. The study measured pediatricians' reported choices in fictional cases, not patient outcomes.