Effectiveness of the Schmetterling-NBI Program in Reducing Selective Eating and Improving Autonomic Regulation in Children with Autism Spectrum Disorder: A Randomized Controlled Trial

This randomized controlled trial evaluated the effectiveness of the Schmetterling-NBI Program™ in reducing selective eating behaviors, improving autism-related symptoms, and enhancing autonomic nervous system (ANS) regulation in children diagnosed with Autism Spectrum Disorder (ASD). A total of 24 children with ASD and selective eating were randomly assigned to an experimental group (n = 12) receiving the Schmetterling-NBI Program™ or a control group (n = 12) receiving standard care. Outcomes were assessed using the Child Eating Behavior Questionnaire (CEBQ), the Childhood Autism Rating Scale, Second Edition (CARS-2), and heart rate variability (HRV) parameters, including standard deviation of normal-to-normal intervals (SDNN) and stress index. Children in the experimental group demonstrated significant reductions in selective eating behaviors (CEBQ: Z = 16.39, p < 0.001), as well as improvements in autism symptom severity (CARS-2: F = 23.26, p < 0.001), compared to the control group. HRV analyses revealed marked physiological improvements, with increased SDNN (Z = -74.07, p < 0.001) and reduced stress index (Z = 23.54, p < 0.001), indicating enhanced autonomic regulation. These findings suggest that the Schmetterling-NBI Program™ is an effective multidisciplinary intervention for improving selective eating behaviors, reducing autism-related symptoms, and promoting physiological well-being in children with ASD.