Realist evaluation of a transdisciplinary mealtime management service for autistic children.

Chan et al. (2023) asked 19 parents and 17 team members about a joint feeding clinic. The team mixed BCBAs, OTs, SLPs, dietitians, and doctors. They used hour-long interviews to learn why the service felt helpful or not.

Kids were autistic, with severe food refusal. The study did not count bites or weight. It only looked at what people said worked.

Three themes came up again and again. First, parents liked that every child got a unique plan. Second, the team spoke with one voice instead of giving separate reports. Third, staff spent time up front to shape what parents expected.

When these three pieces were in place, families said the clinic was "life-changing." When any piece was missing, they called the service "confusing" or "a waste of time."

Kemmerer et al. (2023) scoured the caregiver-training papers and found most studies skip early expectation talks. Ting’s team shows exactly how to fill that gap: hold a pre-meeting, list goals, and agree on timelines.

LaFrance et al. (2019) warned that BCBAs, SLPs, and OTs often clash over turf. Ting’s data say turf battles disappear when the team writes one shared plan before the first session.

Iadarola et al. (2015) heard urban school staff blame "tension among groups" for poor ASD services. Ting gives the fix: merge roles, co-write goals, and speak to parents with one message.

If you run or join a feeding team, copy the three-step bundle. Schedule a 30-minute caregiver hump-day huddle. Draft one goal sheet together. End the meeting by asking parents, "What do you expect in six weeks?" Record their answer and revisit it every visit. This tiny routine may prevent dropouts and boost parent buy-in without extra billable hours.